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Chronic traumatic encephalopathy-neuropathologic change in a routine neuropathology service: 7-year follow-up

To follow our 2016 study of chronic traumatic encephalopathy neuropathologic change (CTE-NC) in our forensic autopsy service, we prospectively screened all cases with clinical histories of multiple concussions, persistent post-head injury symptoms, or ≥3 hospital investigations for head injuries fro...

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Autores principales: Del Bigio, Marc R, Krawitz, Sherry, Sinha, Namita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588000/
https://www.ncbi.nlm.nih.gov/pubmed/37846159
http://dx.doi.org/10.1093/jnen/nlad079
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author Del Bigio, Marc R
Krawitz, Sherry
Sinha, Namita
author_facet Del Bigio, Marc R
Krawitz, Sherry
Sinha, Namita
author_sort Del Bigio, Marc R
collection PubMed
description To follow our 2016 study of chronic traumatic encephalopathy neuropathologic change (CTE-NC) in our forensic autopsy service, we prospectively screened all cases with clinical histories of multiple concussions, persistent post-head injury symptoms, or ≥3 hospital investigations for head injuries from 2016 to 2022 inclusive using hyperphosphorylated tau (p-tau) immunostaining. The cases had routine brain sampling plus 4-6 additional lateral hemisphere samples. When “pathognomonic” CTE-NC lesions were identified, additional p-tau immunostaining was done for CTE-NC staging. Of ∼1100 adult brains aged 18–65 years examined, 85 were screened, and 16 were positive for CTE-NC (2 women, 14 men, ages 35–61 years, median 47 years). Alcohol abuse was documented in 14 of 16 (8 in combination with other substances); 5 had developmental brain anomalies (2 presumed genetic, 3 from acquired perinatal insults). Widespread p-tau deposits (high CTE-NC) were found in 7 of 16. Old brain contusions were present in 9 of 16, but CTE-NC did not colocalize. Of particular interest were (1) a man with FGFR3 mutation/hypochondroplasia and life-long head banging, (2) a woman with cerebral palsy and life-long head banging, and (3) a man with bilateral peri-Sylvian polymicrogyria, alcohol abuse, and multiple head injuries. Thus, CTE-NC occurs in association with repeated head trauma outside contact sports. Substance abuse is a common determinant of risk behavior. The utility of diagnosing mild-/low-stage CTE-NC in this population remains to be determined.
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spelling pubmed-105880002023-10-21 Chronic traumatic encephalopathy-neuropathologic change in a routine neuropathology service: 7-year follow-up Del Bigio, Marc R Krawitz, Sherry Sinha, Namita J Neuropathol Exp Neurol Original Article To follow our 2016 study of chronic traumatic encephalopathy neuropathologic change (CTE-NC) in our forensic autopsy service, we prospectively screened all cases with clinical histories of multiple concussions, persistent post-head injury symptoms, or ≥3 hospital investigations for head injuries from 2016 to 2022 inclusive using hyperphosphorylated tau (p-tau) immunostaining. The cases had routine brain sampling plus 4-6 additional lateral hemisphere samples. When “pathognomonic” CTE-NC lesions were identified, additional p-tau immunostaining was done for CTE-NC staging. Of ∼1100 adult brains aged 18–65 years examined, 85 were screened, and 16 were positive for CTE-NC (2 women, 14 men, ages 35–61 years, median 47 years). Alcohol abuse was documented in 14 of 16 (8 in combination with other substances); 5 had developmental brain anomalies (2 presumed genetic, 3 from acquired perinatal insults). Widespread p-tau deposits (high CTE-NC) were found in 7 of 16. Old brain contusions were present in 9 of 16, but CTE-NC did not colocalize. Of particular interest were (1) a man with FGFR3 mutation/hypochondroplasia and life-long head banging, (2) a woman with cerebral palsy and life-long head banging, and (3) a man with bilateral peri-Sylvian polymicrogyria, alcohol abuse, and multiple head injuries. Thus, CTE-NC occurs in association with repeated head trauma outside contact sports. Substance abuse is a common determinant of risk behavior. The utility of diagnosing mild-/low-stage CTE-NC in this population remains to be determined. Oxford University Press 2023-10-16 /pmc/articles/PMC10588000/ /pubmed/37846159 http://dx.doi.org/10.1093/jnen/nlad079 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of American Association of Neuropathologists, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Article
Del Bigio, Marc R
Krawitz, Sherry
Sinha, Namita
Chronic traumatic encephalopathy-neuropathologic change in a routine neuropathology service: 7-year follow-up
title Chronic traumatic encephalopathy-neuropathologic change in a routine neuropathology service: 7-year follow-up
title_full Chronic traumatic encephalopathy-neuropathologic change in a routine neuropathology service: 7-year follow-up
title_fullStr Chronic traumatic encephalopathy-neuropathologic change in a routine neuropathology service: 7-year follow-up
title_full_unstemmed Chronic traumatic encephalopathy-neuropathologic change in a routine neuropathology service: 7-year follow-up
title_short Chronic traumatic encephalopathy-neuropathologic change in a routine neuropathology service: 7-year follow-up
title_sort chronic traumatic encephalopathy-neuropathologic change in a routine neuropathology service: 7-year follow-up
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588000/
https://www.ncbi.nlm.nih.gov/pubmed/37846159
http://dx.doi.org/10.1093/jnen/nlad079
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