ADDF CTE Imaging Consortium. Chronic traumatic encephalopathy: Diagnosing the repetitively injured brains of athletes and soldiers. Curr Res Concussion. 2015 Dec 31.

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  1. The Mez et al. report is important in pointing toward the possible roles of youth, high school, and collegiate sports in the pathogenesis of CTE.

    Also on CTE, we just reported the first image of T807 retention in a retired NFL player. It shows a subcortical pattern strikingly similar to the pattern of tauopathy that is the signature of CTE as recently reported by the NINDS consensus group (McKee et al., 2016). 

    A detailed case report on this retired NFL player will be presented by Dara Dickstein, Icahn School of Medicine at Mount Sinai, later this month at the Keystone meeting on CTE.

    This patient has clinical CTE but is still highly functional, which makes me optimistic about the prospects of T807 imaging for pre-symptomatic detection. The challenge will be developing protocols for interacting with parents, coaches, school boards, colleges, and professional teams. At a minimum, with screening, we can get an idea of the prevalence of this tauopathy and perhaps begin to define the natural history.

    I am not yet convinced of just how pervasive a problem we are facing. Tauopathy is not always clinically important and there are examples of reversible tauopathy (e.g., during hibernation). Still, I think that these images, when positive, might indicate who is at risk and should at least consider refraining from high-impact sports and careers.

    References:

    McKee AC, Cairns NJ, Dickson DW, Folkerth RD, Keene CD, Litvan I, Perl DP, Stein TD, Vonsattel JP, Stewart W, Tripodis Y, Crary JF, Bieniek KF, Dams-O'Connor K, Alvarez VE, Gordon WA, TBI/CTE group. The first NINDS/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy. Acta Neuropathol. 2016 Jan;131(1):75-86. Epub 2015 Dec 14 PubMed.

    View all comments by Sam Gandy

  2. This report of extensive CTE in a young adult with repeated concussions is a cautionary tale. PET scanning of taupathy probably will not be adopted widely to detect CTE in adolescent athletes. However, diffusion tensor imaging of sports-related concussion has been reported in adolescents with concussion. It should be more readily available in community hospitals, as it has demonstrated structural changes in white matter after sports-related concussion. Then prevention, for example via an NIR helmet, might reduce CTE in adolescents and young adults with concussion.

    References:

    Virji-Babul N, Borich MR, Makan N, Moore T, Frew K, Emery CA, Boyd LA. Diffusion tensor imaging of sports-related concussion in adolescents. Pediatr Neurol. 2013 Jan;48(1):24-9. PubMed.

    Nichols TW. Hyperphosphorylation of Tau Protein in Down’s Dementia and Alzheimer’s Disease: Methylation and Implications in Prevention and Therapy. J Alzheimers Dis Parkinsonism. 2014 Oct 6;(4):159.

    Morries LD, Cassano P, Henderson TA. Treatments for traumatic brain injury with emphasis on transcranial near-infrared laser phototherapy. Neuropsychiatr Dis Treat. 2015;11:2159-75. Epub 2015 Aug 20 PubMed.

    View all comments by Trent Nichols

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  1. Cognitive Decline in Young Football Player Tied to Extensive Brain Damage