CHRONIC POST-TRAUMATIC ENCEPHALOPATHY. A LOOK AT THE PROBLEM
DOI:
https://doi.org/10.11603/bmbr.2706-6290.2020.3.11528Keywords:
chronic traumatic encephalopathy, tauopathy, diagnostic criteriaAbstract
Summary. Chronic traumatic encephalopathy (CTE) is a unique neurodegenerative tauopathy first described in boxers but more recently described in a variety of contact sport athletes, military veterans, and civilians exposed to repetitive mild traumatic brain injury.
The aim of the study – to analyze the world experience of the last decade in the study of prevalence, risk factors, pathogenesis and diagnosis of chronic traumatic encephalopathy.
Materials and Methods. Available resources in the Internet, foreign professional publications, MEDLINE/PubMed medical databases of the last ten years were analyzed. The method of information search and analytical-comparative method were applied.
Results. Experimental and clinical works of the last decade were aimed at solving numerous problems such as defining the prevalence of СTE, risk factors, basic pathogenetic mechanisms, improving morphological and clinical criteria, attempts to classify СTE, search for biomarkers and specific neurovisual criteria. Clinically, there are characteristic progressive deficits in cognition (memory, executive dysfunction), behavior (explosivity, aggression), mood (depression, suicidality), and motor function (dysarthria, dysgraphia, bradykinesia, tremor, rigidity, gait disturbance, falls, and/or other features of parkinsonism).
The search for consensus on the clinical classification of СTE continues. Morphologically, СTE is characterized by a focal perivascular deposits of p-tau in the neocortex, microgliosis and astrocytosis, which leads to progressive neurodegeneration. The frontal, temporal and parietal lobes are often affected. The role of contact sports, the age the first traumatic brain injury was received (critically 9–12 years), the duration of a sports career has been determined.
Conclusions. Despite the almost century-long history of studying СTE the number of issues to be addressed is growing. It is promising to search for diagnostic criteria that will not only confirm the diagnosis of CTE in life, but also to determine markers (neuronal, axonal and astroglial trauma) that will predict the risk of neurodegenerative pathology after traumatic brain injury.
References
Raquel C Gardner, Kristine Yaffe. Epidemiology of mild traumatic brain injury and neurodegenerative disease. Molecular and Cellular Neuroscience. 2015;66(B): 75-80. DOI: https://doi.org/10.1016/j.mcn.2015.03.001
Daniel H Daneshvar, Lee E Goldstein, Patrick T Kiernan, Thor D Stein, Ann C McKee, Post-traumatic neurodegeneration and chronic traumatic encephalopathy. Molecular and Cellular Neuroscience. 2015;66(B): 81-90, DOI: https://doi.org/10.1016/j.mcn.2015.03.007
Martland H. Dementia pugilistica. JAMA. 1928;91: 364-65.
Jordan BD. The clinical spectrum of sport-related traumatic brain injury. Nat Rev Neurol. 2013;9: 222-30.
Victoroff J. Traumatic encephalopathy: review and provisional research diagnostic criteria. NeuroRehabilitation. 2013;32: 211-24. DOI: https://doi.org/10.3233/NRE-130839
Montenigro PH, Baugh CM, Daneshvar DH, Mez J, Budson AE, Au R, еt al. Clinical subtypes of chronic traumatic encephalopathy: literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome. Alzheimers Res. Ther. 2014;6: 68.
Reams N, Eckner JT, Almeida AA, Aagesen AL, Giordani B, Paulson H, et al. A clinical approach to the diagnosis of traumatic encephalopathy syndrome: a review. JAMA Neurol.2016;73: 743-9. DOI: https://doi.org/10.1001/jamaneurol.2015.5015
Laffey M, Darby AJ, Cline MG, Teng E, Mendez MF. The utility of clinical criteria in patients with chronic traumatic encephalopathy. NeuroRehabilitation. 2018;43: 431-41. DOI: https://doi.org/10.3233/NRE-182452
Weir DR, Jackson J. National Football League Player Care Foundation: Study of Retired NFL Players. Institute for Social Research;. 2009;56
Bieniek KF, Ross OA, Cormier KA, Walton RL, Soto-Ortolaza A, Johnston AE, et al. Chronic traumatic encephalopathy pathology in a neurodegenerative disorders brain bank. Acta neuropathol. 2015;130: 877-89. DOI: https://doi.org/10.1007/s00401-015-1502-4
Tagge CA, Fisher AM, Minaeva OV, Gaudreau-Balderrama A, Moncaster JA, Zhang XL, et al. Concussion, microvascular injury, and early tauopathy in young athletes after impact head injury and an impact concussion mouse model. Brain. 2018;141: 422-58. DOI: https://doi.org/10.1093/brain/awx350
Blaylock RL, Maroon MJ. Chapter 3. Immunoexcitotoxicity as a central mechanism of chronic traumatic encephalopathy – a unifying hypothesis. Biomark Traum Brain Injury RSC Drug Discov. 2011;2: 45-65.
Shand LK, Cowlishaw S, Brooker JE, Burney S & Ricciardelli LA. Correlates of post-traumatic stress symptoms and growth in cancer patients: a systematic review and meta-analysis. Psycho-oncology. 2015;24(6): 624-34. DOI: https://doi.org/10.1002/pon.3719
Hawkins BE, Krishnamurthy S, Castillo-Carranza DL, Sengupta U, Prough DS, Jackson GR et al. Rapid accumulation of endogenous tau oligomers in a rat model of traumatic brain injury. J Biol. Chem. 2013;288: 17042-50.
Bachstetter AD, Morganti JM, Bodnar CN, Webster SJ, Higgins EK, Roberts KN et al. The effects of mild closed head injuries on tauopathy and cognitive deficits in rodents: Primary results in wild type and rTg4510 mice, and a systematic review. Experimental neurology. 2020;326: 113180. DOI: https://doi.org/10.1016/j.expneurol.2020.113180
Omalu BI. Chronic traumatic encephalopathy. Prog Neurol Surg. 2014;28: 38-49. DOI: https://doi.org/10.1159/000358761
McKee AC, Stein TD, Kiernan PT, Alvarez VE. The neuropathology of chronic traumatic encephalopathy. Brain Pathol. 2015;25: 350-64. DOI: https://doi.org/10.1111/bpa.12248
McKee AC, Cairns NJ, Dickson DW, Folkerth RD, Keene CD, Litvan I, et al. The first NINDS/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy. Acta Neuropathol. 2016;131: 75-86. DOI: https://doi.org/10.1007/s00401-015-1515-z
Multani N, Goswami R, Khodadadi M, Ebraheem A, Davis KD, Tator CH, et al. Erratum to: the association between white-matter tract abnormalities, and neuropsychiatric and cognitive symptoms in retired professional football players with multiple concussions. J Neurol. 2016;263: 1342. DOI: https://doi.org/10.1007/s00415-016-8172-6
Alosco ML, Koerte IK, Tripodis Y, Mariani M, Chua AS, Jarnagin J, et al. White matter signal abnormalities in former National Football League players. Alzheimer Dement. 2018;10: 56-65. DOI: https://doi.org/10.1016/j.dadm.2017.10.003
Lebel C, Walker L, Leemans A, Phillips L, Beaulieu C. Microstructural maturation of the human brain from childhood to adulthood. NeuroImage. 2008;40: 1044-55. DOI: https://doi.org/10.1016/j.neuroimage.2007.12.053
Uematsu A, Matsui M, Tanaka C, Takahashi T, Noguchi K, Suzuki M, et al. Developmental trajectories of amygdala and hippocampus from infancy to early adulthood in healthy individuals. PLoS ONE. 2012;7: e46970. DOI: https://doi.org/10.1371/journal.pone.0046970
Stamm JM, Koerte IK, Muehlmann M, Pasternak O, Bourlas AP, Baugh CM, et al. Age at first exposure to football is associated with altered corpus callosum white matter microstructure in former professional football players. J Neurotrauma. 2015;32: 1768-76. DOI: https://doi.org/10.1089/neu.2014.3822
Schultz V, Stern RA, Tripodis Y, Stamm J, Wrobel P, Lepage C, et al. Age at first exposure to repetitive head impacts is associated with smaller thalamic volumes in former professional American Football Players. J Neurotrauma. 2018;35: 278-85. DOI: https://doi.org/10.1089/neu.2017.5145
Ward A, Crean S, Mercaldi CJ, Collins JM, Boyd D, Cook MN, et al. Prevalence of apolipoprotein E4 genotype and homozygotes (APOE e4/4) among patients diagnosed with Alzheimer's disease: a systematic review and meta-analysis. Neuroepidemiology. 2012;38: 1-17. DOI: https://doi.org/10.1159/000334607
Stern Y. Cognitive reserve in ageing and Alzheimer's disease. Lancet Neurol. 2012;11: 1006-12. DOI: https://doi.org/10.1016/S1474-4422(12)70191-6
Stern RA, Daneshvar DH, Baugh CM, Seichepine DR, Montenigro PH, RileyDO, et al. Clinical presentation of chronic traumatic encephalopathy. Neurology. 2013;81: 1122-9. DOI: https://doi.org/10.1212/WNL.0b013e3182a55f7f
Jordan BD. The clinical spectrum of sport-related traumatic brain injury. Nat Rev Neurol. 2013;9: 222-30. DOI: https://doi.org/10.1038/nrneurol.2013.33
Mez J, Stern RA, McKee AC. Chronic traumatic encephalopathy: where are we and where are we going? Curr Neurol Neurosci Rep. 2013;13(12): 407. DOI: https://doi.org/10.1007/s11910-013-0407-7
Montenigro PH, Baugh CM, Daneshvar DH, Mez J, Budson AE, Rhoda A, et al. Clinical subtypes of chronic traumatic encephalopathy: literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome. Alzheimer's Research and Therapy. 2014;6: 68-85. DOI: https://doi.org/10.1186/s13195-014-0068-z
Gardner A, Iverson GL, McCrory P. Chronic traumatic encephalopathy in sport: a systematic review. Br J Sports Med. 2014;48: 84-90. DOI: https://doi.org/10.1136/bjsports-2013-092646
Henrik Zetterberg, Kaj Blennow. Fluid markers of traumatic brain injury. Molecular and Cellular Neuroscience. 2015;66(B): 99-102. DOI: https://doi.org/10.1016/j.mcn.2015.02.003
Lee BG, Leavitt MJ, Bernick CB, Leger GC, Rabinovici G Banks SJ. A Systematic Review of Positron Emission Tomography of Tau, Amyloid Beta, and Neuroinflammation in Chronic Traumatic Encephalopathy: The Evidence To Date. Journal of Neurotrauma. 2018;35(17): 2015-24. DOI: https://doi.org/10.1089/neu.2017.5558
Stern RA, Adler CH, Chen K, Navitsky M, Luo J, Dodick DW, et al. Tau positron-emission tomography in former National Football League players. The New England journal of medicine. 2019;380(18): 1716-25. DOI: https://doi.org/10.1056/NEJMoa1900757
Mantyh WG, Spina S, Lee A, Iaccarino L, Soleimani-Meigooni D, Tsoy E et al. Tau positron emission tomographic findings in a former US football player with pathologically confirmed chronic traumatic encephalopathy. JAMA neurology. 2020;77(4): 517-21. DOI: https://doi.org/10.1001/jamaneurol.2019.4509
Alosco M, Jarnagin J, Rowland B, Liao H, Stern R, Lin A. Magnetic resonance spectroscopy as a biomarker for chronic traumatic encephalopathy. Semin Neurol. 2017;37: 503-9. DOI: https://doi.org/10.1055/s-0037-1608764
Ruprecht R, Scheurer E, Lenz C. Systematic review on the characterization of chronic traumatic encephalopathy by MRI and MRS. J Magn Reson Imaging. 2019;49: 212-28. DOI: https://doi.org/10.1002/jmri.26162
Iverson GL, Gardner AJ, McCrory P, Zafonte R, Castellani RJ. A critical review of chronic traumatic encephalopathy. Neurosci Biobehav Rev. 2015;56: 276-93. DOI: https://doi.org/10.1016/j.neubiorev.2015.05.008
Randolph C. Chronic traumatic encephalopathy is not a real disease. Arch Clin Neuropsychol. 2018;3: 644-8. DOI: https://doi.org/10.1093/arclin/acy063
Falcon B, Zivanov J, Zhang W, Murzin AG, Garringer HJ, Vidal R, et al. Novel tau filament fold in chronic traumatic encephalopathy encloses hydrophobic molecules. Nature. 2019;568: 420-3. DOI: https://doi.org/10.1038/s41586-019-1026-5
Guedes VA, Devoto C, Leete J, Sass D, Acott JD, Mithani S et al. Extracellular vesicle proteins and microRNAs as biomarkers for traumatic brain injury. Front Neurol. 2020;11: 663. DOI: https://doi.org/10.3389/fneur.2020.00663
Lucke-Wold B, Seidel K, Udo R, Omalu B, Ornstein M, Nolan R, et al. Role of tau acetylation in Alzheimer's disease and chronic traumatic encephalopathy: the way forward for successful treatment. J Neurol Neurosurg. 2017;4: 140.
Lagraoui M, Sukumar G, Latoche JR, Maynard SK, Dalgard CL, Schaefer BC. Salsalate treatment following traumatic brain injury reduces inflammation and promotes a neuroprotective and neurogenic transcriptional response with concomitant functional recovery. Brain Behav Immun. 2017;61: 96-109. DOI: https://doi.org/10.1016/j.bbi.2016.12.005
Trzeciakiewicz H, Tseng JH, Wander CM, Madden V, Tripathy A, Yuan CX, et al. A dual pathogenic mechanism links tau acetylation to sporadic tauopathy. Sci Rep. 2017;7: 44102. DOI: https://doi.org/10.1038/srep44102
Drummond E, Goni F, Liu S, Prelli F, Scholtzova H, Wisniewski T. Potential novel approaches to understand the pathogenesis and treat Alzheimer’s disease. J Alzheimer’s Dis JAD. 2018;64(1): 299-312. DOI: https://doi.org/10.3233/JAD-179909
