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Beta-amyloid deposition in chronic traumatic encephalopathy.

ABSTRACT: Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease associated with repetitive mild traumatic brain injury. It is defined pathologically by the abnormal accumulation of tau in a unique pattern that is distinct from other tauopathies, including Alzheimer's disease (AD). Although trauma has been suggested to increase amyloid ? peptide (A?) levels, the extent of A? deposition in CTE has not been thoroughly characterized. We studied a heterogeneous cohort of deceased athletes and military veterans with neuropathologically diagnosed CTE (n = 114, mean age at death = 60) to test the hypothesis that A? deposition is altered in CTE and associated with more severe pathology and worse clinical outcomes. We found that A? deposition, either as diffuse or neuritic plaques, was present in 52 % of CTE subjects. Moreover, A? deposition in CTE occurred at an accelerated rate and with altered dynamics in CTE compared to a normal aging population (OR = 3.8, p < 0.001). We also found a clear pathological and clinical dichotomy between those CTE cases with A? plaques and those without. A? deposition was significantly associated with the presence of the APOE ?4 allele (p = 0.035), older age at symptom onset (p < 0.001), and older age at death (p < 0.001). In addition, when controlling for age, neuritic plaques were significantly associated with increased CTE tauopathy stage (? = 2.43, p = 0.018), co-morbid Lewy body disease (OR = 5.01, p = 0.009), and dementia (OR = 4.45, p = 0.012). A subset of subjects met the diagnostic criteria for both CTE and AD, and in these subjects both A? plaques and total levels of A?1-40 were increased at the depths of the cortical sulcus compared to the gyral crests. Overall, these findings suggest that A? deposition is altered and accelerated in a cohort of CTE subjects compared to normal aging and that A? is associated with both pathological and clinical progression of CTE independent of age.

SUBMITTER: Stein TD

PROVIDER: S-EPMC4529056 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature

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Beta-amyloid deposition in chronic traumatic encephalopathy.

Stein Thor D TD Montenigro Philip H PH Alvarez Victor E VE Xia Weiming W Crary John F JF Tripodis Yorghos Y Daneshvar Daniel H DH Mez Jesse J Solomon Todd T Meng Gaoyuan G Kubilus Caroline A CA Cormier Kerry A KA Meng Steven S Babcock Katharine K Kiernan Patrick P Murphy Lauren L Nowinski Christopher J CJ Martin Brett B Dixon Diane D Stern Robert A RA Cantu Robert C RC Kowall Neil W NW McKee Ann C AC

Acta neuropathologica 20150506 1

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease associated with repetitive mild traumatic brain injury. It is defined pathologically by the abnormal accumulation of tau in a unique pattern that is distinct from other tauopathies, including Alzheimer's disease (AD). Although trauma has been suggested to increase amyloid β peptide (Aβ) levels, the extent of Aβ deposition in CTE has not been thoroughly characterized. We studied a heterogeneous cohort of deceased athletes and m ...[more]

PMID: 25943889

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Project description:Chronic traumatic encephalopathy (CTE) is a tauopathy associated with repetitive head impacts (RHI) that has been neuropathologically diagnosed in American football players and other contact sport athletes. In 2013, McKee and colleagues proposed a staging scheme for characterizing the severity of the hyperphosphorylated tau (p-tau) pathology, the McKee CTE staging scheme. The staging scheme defined four pathological stages of CTE, stages I(mild)-IV(severe), based on the density and regional deposition of p-tau. The objective of this study was to test the utility of the McKee CTE staging scheme, and provide a detailed examination of the regional distribution of p-tau in CTE. We examined the relationship between the McKee CTE staging scheme and semi-quantitative and quantitative assessments of regional p-tau pathology, age at death, dementia, and years of American football play among 366 male brain donors neuropathologically diagnosed with CTE (mean age 61.86, SD 18.90). Spearman's rho correlations showed that higher CTE stage was associated with higher scores on all semi-quantitative and quantitative assessments of p-tau severity and density (p's < 0.001). The severity and distribution of CTE p-tau followed an age-dependent progression: older age was associated with increased odds for having a higher CTE stage (p < 0.001). CTE stage was independently associated with increased odds for dementia (p < 0.001). K-medoids cluster analysis of the semi-quantitative scales of p-tau across 14 regions identified 5 clusters of p-tau that conformed to increasing CTE stage (stage IV had 2 slightly different clusters), age at death, dementia, and years of American football play. There was a predilection for p-tau pathology in five regions: dorsolateral frontal cortex (DLF), superior temporal cortex, entorhinal cortex, amygdala, and locus coeruleus (LC), with CTE in the youngest brain donors and lowest CTE stage restricted to DLF and LC. These findings support the usefulness of the McKee CTE staging scheme and demonstrate the regional distribution of p-tau in CTE.

Dataset Information

Beta-amyloid deposition in chronic traumatic encephalopathy.

Publications

Beta-amyloid deposition in chronic traumatic encephalopathy.

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