Tau PET and multimodal brain imaging in patients at risk for chronic traumatic encephalopathy

Journal Article · Thu Oct 17 00:00:00 EDT 2019 · NeuroImage: Clinical

DOI:https://doi.org/10.1016/j.nicl.2019.102025· OSTI ID:1599790

Lesman-Segev, Orit H. ^[1]; La Joie, Renaud ^[1]; Stephens, Melanie L. ^[1]; Sonni, Ida ^[2]; Tsai, Richard ^[1]; Bourakova, Viktoriya ^[1]; Visani, Adrienne V. ^[1]; Edwards, Lauren ^[1]; O'Neil, James P. ^[2]; Baker, Suzanne L ^[2]; Gardner, Raquel C. ^[3]; Janabi, Mustafa ^[2]; Chaudhary, Kiran ^[1]; Perry, David C. ^[1]; Kramer, Joel H. ^[1]; Miller, Bruce L. ^[1]; Jagust, William J. ^[4]; Rabinovici, Gil D. ^[5]

---

1. Univ. of California, San Francisco, CA (United States)
2. Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)
3. Univ. of California, San Francisco, CA (United States); San Francisco Veterans Affair Medical Center, CA (United States)
4. Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Univ. of California, Berkeley, CA (United States)
5. Univ. of California, San Francisco, CA (United States); Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Univ. of California, Berkeley, CA (United States)

OBJECTIVE: To characterize individual and group-level neuroimaging findings in patients at risk for Chronic Traumatic Encephalopathy (CTE). METHODS: Eleven male patients meeting criteria for Traumatic Encephalopathy Syndrome (TES, median age: 64) underwent neurologic evaluation, 3-Tesla MRI, and PET with [¹⁸F]-Flortaucipir (FTP, tau-PET) and [¹¹C]-Pittsburgh compound B (PIB, amyloid-PET). Six patients underwent [¹⁸F]-Fluorodeoxyglucose-PET (FDG, glucose metabolism). We assessed imaging findings at the individual patient level, and in group-level comparisons with modality-specific groups of cognitively normal older adults (CN). Tau-PET findings in patients with TES were also compared to a matched group of patients with mild cognitive impairment or dementia due to Alzheimer's disease (AD). RESULTS: All patients with TES sustained repetitive head injury participating in impact sports, ten in American football. Three patients met criteria for dementia and eight had mild cognitive impairment. Two patients were amyloid-PET positive and harbored the most severe MRI atrophy, FDG hypometabolism, and FTP-tau PET binding. Among the nine amyloid-negative patients, tau-PET showed either mildly elevated frontotemporal binding, a "dot-like" pattern, or no elevated binding. Medial temporal FTP was mildly elevated in a subset of amyloid-negative patients, but values were considerably lower than in AD. Voxelwise analyses revealed a convergence of imaging abnormalities (higher FTP binding, lower FDG, lower gray matter volumes) in frontotemporal areas in TES compared to controls. CONCLUSIONS: Mildly elevated tau-PET binding was observed in a subset of amyloid-negative patients at risk for CTE, in a distribution consistent with CTE pathology stages III-IV. FTP-PET may be useful as a biomarker of tau pathology in CTE but is unlikely to be sensitive to early disease stages.

• Research Organization: Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States)
• Sponsoring Organization: Alzheimer's Association; National Institute on Aging; USDOE Office of Science (SC)
• Grant/Contract Number: AC02-05CH11231
• OSTI ID: 1599790
• Journal Information: NeuroImage: Clinical, Journal Name: NeuroImage: Clinical Journal Issue: C Vol. 24; ISSN 2213-1582
• Publisher: Elsevier
• Country of Publication: United States
• Language: English

Related Subjects

60 APPLIED LIFE SCIENCES
amyloid
chronic traumatic encephalopathy (CTE)
imaging
magnetic resonance imaging (MRI)
positron emission tomography (PET)
tau