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Head Trauma and Amyloid Deposition

Summary and Comment |
January 21, 2014

Head Trauma and Amyloid Deposition

  1. Brandy R. Matthews, MD

History of head trauma is associated with markers of Alzheimer disease in elders with mild cognitive impairment but not in those with normal cognition.

  1. Brandy R. Matthews, MD

Studies associating a history of head trauma with increased risk and earlier age of onset for Alzheimer disease (AD) have yielded contradictory results. Now, researchers have conducted a population-based study of 448 cognitively normal (CN) elders (aged 70 and older) and 141 elders with mild cognitive impairment (MCI) who underwent neuroimaging measures of structure (brain magnetic resonance imaging of hippocampal volumes), function (brain fluorodeoxyglucose positron emission tomography [FDG-PET]), and neuropathology (amyloid-PET).

In the CN group, 17% self-reported head trauma associated with loss of consciousness or memory impairment; 18% of the MCI group self-reported such head trauma. In the CN group, none of the neuroimaging measures differed significantly between those with and without head trauma. In the MCI group, amyloid-PET scans revealed greater amyloid deposition in those with than in those without histories of head trauma, but the other imaging measures did not differ significantly within the MCI group.

Comment

Although these results seem contradictory, they highlight the complex and, likely, multifactorial genetic and environmental interactions that contribute to the development of MCI and AD. Of note, this study avoids the selection bias common to many recently published studies on this topic by involving a population-based approach with a large sample size. The three imaging biomarkers used are known to be associated with the progression of AD pathology, serve as a surrogate for autopsy data, and provide important in vivo insight. Given these data, head trauma may not be causally related to AD pathology, but future studies examining the severity and frequency of head trauma in a similar population may be more informative.

  • Disclosures for Brandy R. Matthews, MD at time of publication Grant / research support National Institute on Aging

Citation(s):

Reader Comments (1)

Michel Calache, M.D Physician, Psychiatry

This is an important in vivo study looking at the amyloid deposits after Head Trauma in MCI patients in comparison to controls. Though Head Trauma has been mostly assoicated with AD, it has also been linked though to a lesser extent to FTLD and ALS as well as to Chronic Traumatic Encephalopathy. There is a neuropathologic overlap among these neurodegernative disorders. The distribution and extent of amyloid deposits is known to be different between among these disorders e.g. CTE and AD. The specificity of progression of MCI into developing AD to the exclusion of CTE or other cognitive problems is not well established yet. Follow up studies using amyloid-PET scans in patients with a history of head trauma who have amyloid deposits based on extent and distribution might provide further information about the correlation between Head Trauma and the potential significance of amyloid deposits in MCI patients adn their possible progression to one vs another neurocognitive disorder

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