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Alzheimer-s Research and Therapy

, 7:62

First Online: 12 October 2015Received: 03 July 2015Accepted: 15 September 2015

Abstract

IntroductionChronic traumatic encephalopathy CTE is a progressive neurodegeneration associated with repetitive head impacts. Understanding Neurologic Injury and Traumatic Encephalopathy UNITE is a U01 project recently funded by the National Institute of Neurological Disorders and Stroke and the National Institute of Biomedical Imaging and Bioengineering. The goal of the UNITE project is to examine the neuropathology and clinical presentation of brain donors designated as -at risk- for the development of CTE based on prior athletic or military exposure. Here, we present the rationale and methodology for UNITE.

MethodsOver the course of 4 years, we will analyze the brains and spinal cords of 300 deceased subjects who had a history of repetitive head impacts sustained during participation in contact sports at the professional or collegiate level or during military service. Clinical data are collected through medical record review and retrospective structured and unstructured family interviews conducted by a behavioral neurologist or neuropsychologist. Blinded to the clinical data, a neuropathologist conducts a comprehensive assessment for neurodegenerative disease, including CTE, using published criteria. At a clinicopathological conference, a panel of physicians and neuropsychologists, blinded to the neuropathological data, reaches a clinical consensus diagnosis using published criteria, including proposed clinical research criteria for CTE.

ResultsWe will investigate the validity of these clinical criteria and sources of error by using recently validated neuropathological criteria as a gold standard for CTE diagnosis. We also will use statistical modeling to identify diagnostic features that best predict CTE pathology.

ConclusionsThe UNITE study is a novel and methodologically rigorous means of assessing clinicopathological correlation in CTE. Our findings will be critical for developing future iterations of CTE clinical diagnostic criteria.

AbbreviationsADAlzheimer’s disease

ADCAlzheimer’s Disease Center

AESApathy Evaluation Scale

ALSAmyotrophic lateral sclerosis

BABrodmann area

BIS-11Barratt Impulsivity Scale version 11

BUBoston University

CDSCognitive Difficulties Scale

CLFConcussion Legacy Foundation

CPCClinicopathological consensus conference

CSFCerebrospinal fluid

CTEChronic traumatic encephalopathy

FTLDFrontotemporal lobar degeneration

LARLegally authorized representative

NFLNational Football League

NIHNational Institutes of Health

NINDSNational Institute of Neurological Disorders and Stroke

PETPositron emission tomography

p-tauHyperphosphorylated tau

pTDP-43Phosphorylated transactive response DNA binding protein 43 kDa

RHIRepetitive head impacts

TBITraumatic brain injury

TESTraumatic encephalopathy syndrome

UNITEUnderstanding Neurologic Injury and Traumatic Encephalopathy

VAU.S. Department of Veterans Affairs

Jesse Mez, Todd M. Solomon and Daniel H. Daneshvar contributed equally to this work.

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Autor: Jesse Mez - Todd M. Solomon - Daniel H. Daneshvar - Lauren Murphy - Patrick T. Kiernan - Philip H. Montenigro - Joshua 

Fuente: https://link.springer.com/



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