English 3307
Tom Akbari
Unit 1 Final Draft
May 13, 2017
perspectives and future directions, outlines the current [as of 2011] information and knowledge
that the medical field has regarding chronic traumatic encephalopathy (CTE). This article has
several authors from various institutions, all of whom have a Ph.D. or M.D.: Brandon E. Gavett,
Robert C. Cantu, Martha Shenton, Alexander P. Lin, Christopher J. Nowinski, Ann C. McKee
and Robert A. Stern. It was published in Current Opinion in Neurology in 2011 with the purpose
of providing an overview of existing and upcoming methods for diagnosing CTE. CTE is a
disease characterized by degeneration of neuronal tissue in the patients brain and it is commonly
thought that multiple concussive or subconcussive injuries can lead to the development of the
disease. CTE cannot be confirmed in a living person as there is not an established set of clinical
criteria that allow it to be diagnosed or treated. Based on this notion, I feel that this article is
significant because doctors or researchers who deal with neurodegenerative diseases, traumatic
brain injuries, or CTE specifically can learn about new techniques in their field which may allow
Although researchers and other people may read this review, doctors in particular would
benefit from the information; it is imperative that doctors know the most recent diagnostic tools
available to them so that they can alter, if necessary, how they assess a patient. Doctors, as the
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only ones qualified to examine patients, can use the proposed clinical tests and look for the
symptoms discussed throughout the article. For instance, whole brain atrophy has been
of these features may be detected with MRI1(p.527). Since these neuropathological phenomena
are often seen in the post-mortem examination of confirmed CTE patients, the authors are
suggesting that doctors utilize MRI as a tool to check for these changes within the brains of
living people. The language and terms used within the quoted sentence show, again, that doctors
are meant to read and glean information from this review. Through the use of specific
neuroanatomical terms the authors were able to narrow down the group of people who would be
able to effectively understand and use the information that they present; this lends itself to the
concept of a discourse community as described by Swales. Had this review been intended for
coaches of football players, the authors would not have used such technical language such as
cavum septum pellucidum; but rather everyday language, prevention tips, and signs of a
concussion would have been discussed. Instead, the authors discuss specific pathologies of the
brain and how these can be detected by tools accessible to physicians in order to potentially
There are various means by which diseases and disorders can be diagnosed; the review is
organized into sections based on different detectable effects that CTE is thought to have on a
patients body. The four headings (Neurologic effects, Neuropsychological and neuropsychiatric
effects, Radiologic effects, and Blood and cerebrospinal fluid biomarkers)1(p.526, 527, 529) function
to outline which category a potential diagnostic criterion falls into. The Neurologic effects and
Blood cerebrospinal fluid biomarkers sections are substantially shorter than the other two and
also lack subheadings. Despite having less information, these sections were not omitted because
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the aforementioned areas exude potential in the future of CTE diagnosis as evidenced by this
quote: Blood and CSF biomarkers have yielded promising results for the detection of
CTE share some neuropathological changes which is why the authors chose to mention that
biomarkers may be a diagnostic tool for CTE in the future. The inclusion of these sections
implies that doctors and researchers should expect more upcoming findings about biomarkers
death [16]. Poor insight, judgment, and disinhibition have been reported very commonly in
individuals with CTE,1(p.527). The cognitive deficits described in this quote fall under the
neuropsychatric effects. Organization of this sort allows the reader to more easily see which of
these CTE pathologies present in a manner that can be tested for and subsequently confirmed.
The quote states specifically how executive function is thought to be impeded in cases of CTE;
the neuropsychological tests that a doctor should administer to patients are not detailed in this
unnecessary in this case because, as the authors assume, a doctor should already know how
he/she can test for deficits in executive function. This lends itself to a point made earlier: the
review is meant to be read by doctors or researchers with prior knowledge in the field. By only
including which cognitive deficits to test for and how they are related to CTE, the authors made
the paper more focused on the goal of summarizing new and future information for the readers.
A known expectation of every physician is that he/she does not stop learning about
conditions that they encounter and treat after medical school or residency. In this sense, reviews
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similar to this one are what I would expect to encounter in the field of medicine. Particularly
when dealing with a disease such as CTE that is gaining attention from the media, athletes, and
the research community, I would want to ensure that I am administering the proper
neuropsychological tests, neuroimaging tests, and (hopefully in the near future) blood tests to
patients. In order to be able to write a medical document such as this review, one must have
extensively studied patients or cases of the specific disease. This necessitates either going
educational path should prepare me to become a member of this specific discourse community;
during medical school it is vital that one learns the medical lexicon used in hospitals and other
clinical settings. I have shadowed a neurologist and can attest to the fact that there are acronyms,
abbreviations, and terms specific not only to medicine, but to the narrower field of neurology.
At this point in my education, I feel that I can read and potentially write a review on the research
with the neural mechanisms discussed in a review such as this one; however I think that if I
needed to write a more medicine-oriented review I would need to learn much more about and
have administered medical evaluations and treatment for the disease as opposed to just
Reference
1. Gavett BE, Cantu RC, Shenton M, Lin AP, Nowinski CJ, McKee AC, Stern RA. 2011.