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Tau aggregation and increased neuroinflammation in athletes after sports-related concussions and in traumatic brain injury patients-a PET/MR study
Department of Neuroscience, Neurosurgery, Uppsala, Uppsala University, Sweden. Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Neurosurgery, Lund, Sweden.
Department of Neuroscience, Neurosurgery, Uppsala, Uppsala University, Sweden.
Medical Physics, Uppsala University Hospital, Uppsala, Sweden. Department of Surgical sciences, Nuclear medicine and PET, Uppsala University, Sweden.
Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.ORCID iD: 0000-0003-3628-0705
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2021 (English)In: NeuroImage: Clinical, E-ISSN 2213-1582, Vol. 30, article id 102665Article in journal (Refereed) Published
Abstract [en]

Traumatic brain injury (TBI) and repeated sports-related concussions (rSRCs) are associated with an increased risk for neurodegeneration. Autopsy findings of selected cohorts of long-term TBI survivors and rSRC athletes reveal increased tau aggregation and a persistent neuroinflammation. To assess in vivo tau aggregation and neuroinflammation in young adult TBI and rSRC cohorts, we evaluated 9 healthy controls (mean age 26 ± 5 years; 4 males, 5 females), 12 symptomatic athletes (26 ± 7 years; 6 males, 6 females) attaining ≥ 3 previous SRCs, and 6 moderate-to severe TBI patients (27 ± 7 years; 4 males, 2 females) in a combined positron emission tomography (PET)/ magnetic resonance (MR) scanner ≥6 months post-injury. Dual PET tracers, [18F]THK5317 for tau aggregation and [11C]PK11195 for neuroinflammation/microglial activation, were investigated on the same day. The Repeated Battery Assessment of Neurological Status (RBANS) scores, used for cognitive evaluation, were lower in both the rSRC and TBI groups (p<0.05). Neurofilament-light (NF-L) levels were increased in plasma and cerebrospinal fluid (CSF; p<0.05), and serum tau levels lower, in TBI although not in rSRC. In rSRC athletes, PET imaging showed increased neuroinflammation in the hippocampus and tau aggregation in the corpus callosum. In TBI patients, tau aggregation was observed in thalami, temporal white matter and midbrain; widespread neuroinflammation was found e.g. in temporal white matter, hippocampus and corpus callosum. In mixed-sex cohorts of young adult athletes with persistent post-concussion symptoms and in TBI patients, increased tau aggregation and neuroinflammation are observed at ≥ 6 months post-injury using PET. Studies with extended clinical follow-up, biomarker examinations and renewed PET imaging are needed to evaluate whether these findings progress to a neurodegenerative disorder or if spontaneous resolution is possible.

Place, publisher, year, edition, pages
Elsevier, 2021. Vol. 30, article id 102665
Keywords [en]
Traumatic brain injury, Sports-related concussion, Inflammation, Tau, Positron emission tomography (PET)
National Category
Neurology
Research subject
Medical Science
Identifiers
URN: urn:nbn:se:ltu:diva-83701DOI: 10.1016/j.nicl.2021.102665ISI: 000670324000007PubMedID: 33894460Scopus ID: 2-s2.0-85104484593OAI: oai:DiVA.org:ltu-83701DiVA, id: diva2:1544587
Funder
The Swedish Brain FoundationSwedish Research CouncilSwedish National Centre for Research in SportsEU, European Research CouncilAlzheimerfonden
Note

Validerad;2021;Nivå 2;2021-05-03 (alebob);

Finansiär: Bissen Brain Walk; Selander Foundation; Swedish State Support for Clinical Research; ALF-agreement

Available from: 2021-04-15 Created: 2021-04-15 Last updated: 2024-01-17Bibliographically approved

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Tegner, Yelverton

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