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diagnosis of chronic traumatic encephalopathy

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https://www.readbyqxmd.com/read/28888534/psychiatric-phenotypes-in-chronic-traumatic-encephalopathy
#1
REVIEW
Ian Mahar, Michael L Alosco, Ann C McKee
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disorder involving cognitive, motor, and psychiatrically-relevant symptoms resulting from repetitive head impacts. Psychiatric phenotypes of CTE, including depression and suicidality, present particular challenges for CTE research, given that the diagnosis requires postmortem neuropathological examination. The pathognomonic lesion of CTE is the perivascular accumulation of hyperphosphorylated tau (ptau) protein at the depths of cortical sulci. These lesions are found in the earliest disease stages, and with advancing pathological severity, ptau deposition occurs in widespread brain regions in a four-stage scheme of severity...
September 6, 2017: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/28841573/pediatric-providers-attitudes-and-practices-regarding-concussion-diagnosis-and-management
#2
Khalida Itriyeva, Ronald Feinstein, Linda Carmine
Background Concussions, a form of mild traumatic brain injury, are a current "hot topic" in sports and medicine, with current research focusing on diagnosis, treatment, and the long-term effects of repeated concussions on development of chronic traumatic encephalopathy. Concussions represent 8.9% of all high school athletic injuries, and pediatricians see many of these patients in their practices, however evolving guidelines and recommendations have resulted in varying practices among providers. Objective To assess how local pediatricians in New York Chapter 2 of the American Academy of Pediatrics (AAP) diagnose and treat concussion patients, and to evaluate the need for continuing education in this area...
August 25, 2017: International Journal of Adolescent Medicine and Health
https://www.readbyqxmd.com/read/28805003/protein-astrogliopathies-in-human-neurodegenerative-diseases-and-aging
#3
Gabor G Kovacs, Virginia M Lee, John Q Trojanowski
Neurodegenerative diseases are characterized by progressive dysfunction and loss of neurons associated with depositions of pathologically altered proteins showing hierarchical involvement of brain regions. The role of astrocytes in the pathogenesis of neurodegenerative diseases is explored as contributors to neuronal degeneration or neuroprotection pathways, and also as potential mediators of the transcellular spreading of disease-associated proteins. Protein astrogliopathy (PAG), including deposition of amyloid-β, prion protein, tau, α-synuclein, and very rarely transactive response DNA-binding protein 43 (TDP-43) is not unprecedented or unusual in neurodegenerative diseases...
September 2017: Brain Pathology
https://www.readbyqxmd.com/read/28674990/traumatic-brain-injury-as-a-trigger-of-neurodegeneration
#4
Victoria E Johnson, William Stewart, John D Arena, Douglas H Smith
Although millions of individuals suffer a traumatic brain injury (TBI) worldwide each year, it is only recently that TBI has been recognized as a major public health problem. Beyond the acute clinical manifestations, there is growing recognition that a single severe TBI (sTBI) or repeated mild TBIs (rTBI) can also induce insidious neurodegenerative processes, which may be associated with early dementia, in particular chronic traumatic encephalopathy (CTE). Identified at autopsy examination in individuals with histories of exposure to sTBI or rTBI, CTE is recognized as a complex pathology featuring both macroscopic and microscopic abnormalities...
2017: Advances in Neurobiology
https://www.readbyqxmd.com/read/28664614/evolving-concepts-of-chronic-traumatic-encephalopathy-as-a-neuropathological-entity
#5
Helen Ling, James W Neal, Tamas Revesz
Chronic traumatic encephalopathy (CTE) is a long-term neurodegenerative consequence of repetitive head impacts which can only be definitively diagnosed in post-mortem. Recently, the consensus neuropathological criteria for the diagnosis of CTE was published requiring the presence of the accumulation of abnormal tau in neurons and astroglia distributed around small blood vessels at the depths of cortical sulci in an irregular pattern as the mandatory features. The clinical diagnosis and antemortem prediction of CTE pathology remain challenging if not impossible due to the common co-existing underlying neurodegenerative pathologies and the lack of specific clinical pointers and reliable biomarkers...
June 30, 2017: Neuropathology and Applied Neurobiology
https://www.readbyqxmd.com/read/28653647/advances-in-progressive-supranuclear-palsy-new-diagnostic-criteria-biomarkers-and-therapeutic-approaches
#6
REVIEW
Adam L Boxer, Jin-Tai Yu, Lawrence I Golbe, Irene Litvan, Anthony E Lang, Günter U Höglinger
Progressive supranuclear palsy (PSP), previously believed to be a common cause of atypical parkinsonism, is now recognised as a range of motor and behavioural syndromes that are associated with a characteristic 4-repeat tau neuropathology. New research criteria that recognise early presentations of PSP and operationalise diagnosis of the full spectrum of clinical phenotypes have been reported. The Movement Disorders Society PSP diagnostic criteria include syndromes with few or mild symptoms that are suggestive of underlying PSP pathology and could provide an opportunity for earlier therapeutic interventions in the future...
July 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28615399/concussion-diagnosis-and-management-knowledge-and-attitudes-of-family-medicine-residents
#7
Aneetinder Mann, Charles H Tator, James D Carson
OBJECTIVE: To assess the knowledge of, attitudes toward, and learning needs for concussion diagnosis and management among family medicine residents. DESIGN: E-mail survey. SETTING: University of Toronto in Ontario. PARTICIPANTS: Family medicine residents (N = 348). MAIN OUTCOME MEASURES: To describe relationships between awareness of concussion management and lifestyle, education background, and residency placement, t tests and (2) tests were used as appropriate...
June 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28520686/clinical-correlates-to-assist-with-chronic-traumatic-encephalopathy-diagnosis-insights-from-a-novel-rodent-repeat-concussion-model
#8
Gretchen M Thomsen, Ara Ko, Megan Y Harada, Annie Ma, Livia Wyss, Patricia Haro, Jean-Philippe Vit, Pablo Avalos, Navpreet K Dhillon, Noell Cho, Oksana Shelest, Eric J Ley
INTRODUCTION: Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease linked to repetitive head injuries. Chronic traumatic encephalopathy symptoms include changes in mood, behavior, cognition, and motor function; however, CTE is currently diagnosed only postmortem. Using a rat model of recurrent traumatic brain injury (TBI), we demonstrate rodent deficits that predict the severity of CTE-like brain pathology. METHODS: Bilateral, closed-skull, mild TBI was administered once per week to 35 wild-type rats; eight rats received two injuries (2×TBI), 27 rats received five injuries (5×TBI), and 13 rats were sham controls...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28390515/chronic-traumatic-encephalopathy-known-causes-unknown-effects
#9
REVIEW
Diego Iacono, Sharon B Shively, Brian L Edlow, Daniel P Perl
Chronic traumatic encephalopathy (CTE) is a neuropathologic diagnosis typically made in human brains with a history of repetitive traumatic brain injury (rTBI). It remains unknown whether CTE occurs exclusively after rTBI, or whether a single TBI (sTBI) can cause CTE. Similarly, it is unclear whether impact (eg, motor vehicle accidents) and non-impact (eg, blasts) types of energy transfer trigger divergent or common pathologies. While it is established that a history of rTBI increases the risk of multiple neurodegenerative diseases (eg, dementia, parkinsonism, and CTE), the possible pathophysiologic and molecular mechanisms underlying these risks have yet to be elucidated...
May 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28338593/clinical-correlates-to-assist-with-cte-diagnosis-insights-from-a-novel-rodent-repeat-concussion-model
#10
Gretchen M Thomsen, Ara Ko, Megan Y Harada, Annie Ma, Livia Wyss, Patricia Haro, Jean-Philippe Vit, Pablo Avalos, Navpreet Dhillon, Noell Cho, Oksana Shelest, Eric J Ley
INTRODUCTION: Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease linked to repetitive head injuries. CTE symptoms include changes in mood, behavior, cognition and motor function, however CTE is only currently diagnosed post-mortem. Using a rat model of recurrent traumatic brain injury (TBI) we demonstrate rodent deficits that predict the severity of CTE-like brain pathology. METHODS: Bilateral, closed skull, mild TBI was administered once per week to 35 WT rats, 8 rats received 2 injuries ('2xTBI'), 27 rats received 5 injuries ('5xTBI') and 13 rats were sham controls...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28214960/axonal-disruption-in-white-matter-underlying-cortical-sulcus-tau-pathology-in-chronic-traumatic-encephalopathy
#11
Laurena Holleran, Joong Hee Kim, Mihika Gangolli, Thor Stein, Victor Alvarez, Ann McKee, David L Brody
Chronic traumatic encephalopathy (CTE) is a progressive degenerative disorder associated with repetitive traumatic brain injury. One of the primary defining neuropathological lesions in CTE, based on the first consensus conference, is the accumulation of hyperphosphorylated tau in gray matter sulcal depths. Post-mortem CTE studies have also reported myelin loss, axonal injury and white matter degeneration. Currently, the diagnosis of CTE is restricted to post-mortem neuropathological analysis. We hypothesized that high spatial resolution advanced diffusion MRI might be useful for detecting white matter microstructural changes directly adjacent to gray matter tau pathology...
March 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28205009/mixed-pathologies-including-chronic-traumatic-encephalopathy-account-for-dementia-in-retired-association-football-soccer-players
#12
Helen Ling, Huw R Morris, James W Neal, Andrew J Lees, John Hardy, Janice L Holton, Tamas Revesz, David D R Williams
In retired professional association football (soccer) players with a past history of repetitive head impacts, chronic traumatic encephalopathy (CTE) is a potential neurodegenerative cause of dementia and motor impairments. From 1980 to 2010, 14 retired footballers with dementia were followed up regularly until death. Their clinical data, playing career, and concussion history were prospectively collected. Next-of-kin provided consent for six to have post-mortem brain examination. Of the 14 male participants, 13 were professional and 1 was a committed amateur...
March 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28070125/antemortem-biomarker-support-for-a-diagnosis-of-clinically-probable-chronic-traumatic-encephalopathy
#13
M Y Pullman, D L Dickstein, S T DeKosky, S Gandy
No abstract text is available yet for this article.
May 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/27829969/chronic-traumatic-encephalopathy-in-athletes-involved-with-high-impact-sports
#14
Cyrus Safinia, Eric M Bershad, H Brent Clark, Karen SantaCruz, Naila Alakbarova, Jose I Suarez, Afshin A Divani
BACKGROUND AND PURPOSE: Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease occurring most commonly in athletes and is caused by repeated concussive or subconcussive blows to the head. The main purpose of this review is to evaluate the published literature on chronic traumatic encephalopathy (CTE) in athletes participating in high-impact sports. In particular, we highlight the significance of concussive and subconcussive impacts in multiple sports, elucidate the differences between clinical/pathological features of CTE and related neurodegenerative diseases, and provide an explanation for the variation in clinical presentation between athletes of different sports...
October 2016: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/27793189/microglial-neuroinflammation-contributes-to-tau-accumulation-in-chronic-traumatic-encephalopathy
#15
Jonathan D Cherry, Yorghos Tripodis, Victor E Alvarez, Bertrand Huber, Patrick T Kiernan, Daniel H Daneshvar, Jesse Mez, Philip H Montenigro, Todd M Solomon, Michael L Alosco, Robert A Stern, Ann C McKee, Thor D Stein
The chronic effects of repetitive head impacts (RHI) on the development of neuroinflammation and its relationship to chronic traumatic encephalopathy (CTE) are unknown. Here we set out to determine the relationship between RHI exposure, neuroinflammation, and the development of hyperphosphorylated tau (ptau) pathology and dementia risk in CTE. We studied a cohort of 66 deceased American football athletes from the Boston University-Veteran's Affairs-Concussion Legacy Foundation Brain Bank as well as 16 non-athlete controls...
October 28, 2016: Acta Neuropathologica Communications
https://www.readbyqxmd.com/read/27765734/current-public-knowledge-pertaining-to-traumatic-brain-injury-influence-of-demographic-factors-social-trends-and-sport-concussion-experience-on-the-understanding-of-traumatic-brain-injury-sequelae
#16
Zachary C Merz, Ryan Van Patten, John Lace
Objective: The current study aimed to assess current broad traumatic brain injury (TBI)-related knowledge in the general public, as well as understanding regarding specific TBI-related conditions including post-concussive syndrome (PCS) and chronic traumatic encephalopathy (CTE). Methods: Data were collected from 307 domestic and 73 international individuals via online researcher-developed survey instrumentation utilizing the Amazon Mechanical Turk marketplace, a recently developed website that allows for a streamlined process of survey-based participant recruitment and data collection...
March 1, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/27676441/cerebral-18-%C3%A2-f-t807-av1451-retention-pattern-in-clinically-probable-cte-resembles-pathognomonic-distribution-of-cte-tauopathy
#17
D L Dickstein, M Y Pullman, C Fernandez, J A Short, L Kostakoglu, K Knesaurek, L Soleimani, B D Jordan, W A Gordon, K Dams-O'Connor, B N Delman, E Wong, C Y Tang, S T DeKosky, J R Stone, R C Cantu, M Sano, P R Hof, S Gandy
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disorder most commonly associated with repetitive traumatic brain injury (TBI) and characterized by the presence of neurofibrillary tangles of tau protein, known as a tauopathy. Currently, the diagnosis of CTE can only be definitively established postmortem. However, a new positron emission tomography (PET) ligand, [(18)F]T807/AV1451, may provide the antemortem detection of tau aggregates, and thus various tauopathies, including CTE. Our goal was to examine [(18)F]T807/AV1451 retention in athletes with neuropsychiatric symptoms associated with a history of multiple concussions...
September 27, 2016: Translational Psychiatry
https://www.readbyqxmd.com/read/27632903/fluid-biomarkers-for-mild-traumatic-brain-injury-and-related-conditions
#18
REVIEW
Henrik Zetterberg, Kaj Blennow
Diagnostic and prognostic biomarkers for mild traumatic brain injury (TBI), also known as concussion, remain a major unmet clinical need. Moderate to severe TBI can be diagnosed definitively by clinical assessment and standard neuroimaging techniques that detect the gross damage to the brain parenchyma. Diagnostic tools for mild TBI are lacking and, currently, the diagnosis has to be made on clinical grounds alone, because most patients show no gross pathological changes on CT. Most patients with mild TBI recover quickly, but about 15% develop an ill-defined condition called postconcussive syndrome (PCS)...
October 2016: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/27543120/chronic-traumatic-encephalopathy-pathology-in-multiple-system-atrophy
#19
Shunsuke Koga, Dennis W Dickson, Kevin F Bieniek
Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disorder associated with repetitive traumatic brain injury. Multiple system atrophy (MSA) is a Parkinsonian disorder that can result in repetitive falls with associated head trauma. We hypothesized that patients with neurodegenerative disorders like MSA could develop CTE pathology. Therefore, we assessed CTE pathology in 139 MSA cases in our brain bank. Sections from convexity cerebral cortices were screened by immunohistochemistry with anti-phospho-tau antibody...
October 2016: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/27445251/sports-neurology-in-clinical-practice-case-studies
#20
REVIEW
Tad Seifert
With regard to persistent posttraumatic headache, there is legitimate concern that duration of symptoms may have an impact on the efficacy of future treatment attempts. Without neuropathologic confirmation, a clinical diagnosis of chronic traumatic encephalopathy cannot be made with a high degree of confidence. Sport-related headaches are challenging in a return-to-play context, because it is often unclear whether an athlete has an exacerbation of a primary headache disorder, has new-onset headache unrelated to trauma, or is in the recovery phase after concussion...
August 2016: Neurologic Clinics
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