Bobak Abdolmohammadi (United States of America)
Boston University School of Medicine NeurologyAuthor Of 1 Presentation
NEUROPATHOLOGICAL FEATURES OF YOUNG INDIVIDUALS EXPOSED TO REPETITIVE HEAD IMPACTS
Abstract
Aims
Chronic traumatic encephalopathy (CTE) is a tauopathy associated with exposure to repetitive head impacts (RHI). CTE has been reported in individuals as young as 17, yet there have been no large-scale neuropathological studies of young individuals exposed to RHI.
Methods
We characterized the neuropathological findings found in 143 brain donors in the UNITE brain bank who were exposed to RHI and were 29 years and younger at the time of death.
Results
CTE was diagnosed in 60 contact sport athletes (42%); nearly all had mild CTE (stages I and II, 96.7%). Age at death of donors with CTE (mean 25 years) was significantly older than those without CTE (21 years) (p<.001). Most played football as their primary sport (59%) and mean years of football, 11.2 years, was significantly longer in those with CTE. 71% of athletes with CTE were amateurs and included American football, ice hockey, soccer and rugby players, and wrestlers. Donors with CTE had significantly more ventricular dilatation (p<.05) and cavum septum pellucidum (p<.001) than those without CTE. Perivascular pigment-laden macrophages in the subcortical white matter were frequent with and without CTE but were significantly increased in the frontal (p<.001) and temporal lobe (p< .05) in those with CTE.White matter rarefaction was found in 45% of the total sample. Multiplex immunofluorescent labelling of the pathognomonic CTE lesions indicated that the p-tau immunoreactive cells were neuronal and contained exclusively 4R tau. No p-tau astrocytes were found.
Conclusions
In a brain bank sample of 143 young brain donors exposed to RHI, 42% were diagnosd with CTE. CTE was associated with ventricular dilation, cavum septum pellucidum and perivascular pigment-laden macrophages in the white matter. Most were amateur contact sport athletes, and most were football players.