F-18 FDG PET imaging of chronic traumatic brain injury in boxers

Provenzano, Frank A.; Jordan, Barry; Tikofsky, Ronald S.; Saxena, Chitra; Heertum, Ronald L. Van; Ichise, Masanori

doi:10.1097/mnm.0b013e32833e37c4

Cited by 70 publications

(46 citation statements)

References 15 publications

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“…In a series of 19 boxers, 18 F-FDG PET showed hypometabolism in the posterior cingulate cortex, parietooccipital region, frontal lobes (Broca's area) bilaterally, and the cerebellum. 119 These PET studies are significant because for the first time, the pathological component of CTE (tau protein) can be detected premortem. With recent emphasis on early detection of AD, new tau tracers are being developed with enhanced specificity, which will augment their diagnostic ability in the settings of both AD and CTE.…”

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confidence: 99%

Sports-related brain injuries: connecting pathology to diagnosis

Pan¹,

Connolly²,

Dangelmajer³

et al. 2016

FOC

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Neurosurg Focus 40 (4):E14, 2016M any sports-related brain injuries involve mild traumatic brain injuries (mTBIs), which result from physical blows to the head sustained over a period of time. Sports associated with an increased risk of head injury include American football, ice hockey, soccer, rugby, the martial arts, boxing, and bicycling. 21,90 These injuries are often unrecognized, undiagnosed, or underreported, which reflects the fact that this is a growing medical concern, often labeled a "silent epidemic." 8,66 Chronic exposure to mild brain injuries can result in long-term neurological consequences and represents a spectrum of disorders. The most remarkable outcome of mTBI is termed chronic traumatic encephalopathy (CTE), a clinical syndrome that is associated with neurodegeneration and behavioral, cognitive, and/or motor deficits. Although this disease has distinct pathological features, CTE is considered a diagnosis of exclusion because only postmortem biopsies can confirm the diagnosis. Therefore, new diagnostic methods need to be developed to: 1) inform patients of a definitive diagnosis, 2) better understand the epidemiology and risk factors of the disease, and 3) implement intervention programs to prevent any potential long-term complications. This review examines how understanding the pathology and molecular changes associated with repeated head trauma can lead to the discovery of novel imaging techniques and biomarkers. Mild Traumatic Brain Injury and CTEChronic traumatic encephalopathy has evolved from the so-called punch-drunk syndrome, which was used to describe a distinct neuropsychiatric condition that seemed to affect boxers, eventually becoming known as dementia pugilistica during the 1920s and 1930s. Symptoms such ABBrEvIATIoNs AD = Alzheimer's disease; APOE = apolipoprotein E; ASL = arterial spin labeling; BBB = blood-brain barrier; BOLD = blood oxygen level-dependent; CA = cornu ammonis; CTE = chronic traumatic encephalopathy; DTI = diffusion tensor imaging; FA = fractional anisotropy; fMRI = functional MRI; GFAP = glial fibrillary acidic protein; GRE = gradient recall echo; miRNA = microRNA; MRS = MR spectroscopy; mTBI = mild traumatic brain injury; NFL = National Football League; NFT = neurofibrillary tangle; NINDS = National Institute of Neurological Disorders and Stroke; NSE = neuron-specific enolase; p-tau = phosphorylated tau; SWI = susceptibility-weighted imaging; TDP-43 = TAR DNA-binding protein 43;18 F-FDDNP = 2-(1-{6- [(2-[fluorine-18] Brain injuries are becoming increasingly common in athletes and represent an important diagnostic challenge. Early detection and management of brain injuries in sports are of utmost importance in preventing chronic neurological and psychiatric decline. These types of injuries incurred during sports are referred to as mild traumatic brain injuries, which represent a heterogeneous spectrum of disease. The most dramatic manifestation of chronic mild traumatic brain injuries is termed chronic traumatic encephalopathy, which is associated with profo...

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confidence: 99%

Sports-related brain injuries: connecting pathology to diagnosis

Pan¹,

Connolly²,

Dangelmajer³

et al. 2016

FOC

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“…Follow-up CT studies, however, demonstrated structural abnormalities consistent with the early PET findings, supporting the predictive value of 18 F-FDG PET (4). More recently, diffuse cerebral hypometabolism has also been demonstrated in boxers with neurologic and cognitive disabilities as a consequence of chronic TBI and in war veterans with persistent postconcussive symptoms (5,6).…”

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confidence: 99%

Widespread and Prolonged Increase in (R)-¹¹C-PK11195 Binding After Traumatic Brain Injury

et al. 2011

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“…222 In boxers who experienced repeated episodes of head trauma, hypometabolism was found in the frontal lobe, posterior parietal lobe, posterior cingulate gyrus, and cerebellum bilaterally; neuropsychological data were not available. 223 Of particular interest is a recent study of Iraq war veterans with chronic mTBI after repetitive military blast exposure. 224 In this study, decreased CMRglc was observed in the cerebellum, vermis, pons, and medial temporal lobe; the subjects also exhibited behavioral symptoms and impaired information processing.…”

Section: Chronic Tbimentioning

confidence: 99%

A Review of the Effectiveness of Neuroimaging Modalities for the Detection of Traumatic Brain Injury

Amyot

Arciniegas

et al. 2015

Journal of Neurotrauma

174

147

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The incidence of traumatic brain injury (TBI) in the United States was 3.5 million cases in 2009, according to the Centers for Disease Control and Prevention. It is a contributing factor in 30.5% of injury-related deaths among civilians. Additionally, since 2000, more than 260,000 service members were diagnosed with TBI, with the vast majority classified as mild or concussive (76%). The objective assessment of TBI via imaging is a critical research gap, both in the military and civilian communities. In 2011, the Department of Defense (DoD) prepared a congressional report summarizing the effectiveness of seven neuroimaging modalities (computed tomography [CT], magnetic resonance imaging [MRI], transcranial Doppler [TCD], positron emission tomography, single photon emission computed tomography, electrophysiologic techniques [magnetoencephalography and electroencephalography], and functional near-infrared spectroscopy) to assess the spectrum of TBI from concussion to coma. For this report, neuroimaging experts identified the most relevant peer-reviewed publications and assessed the quality of the literature for each of these imaging technique in the clinical and research settings. Although CT, MRI, and TCD were determined to be the most useful modalities in the clinical setting, no single imaging modality proved sufficient for all patients due to the heterogeneity of TBI. All imaging modalities reviewed demonstrated the potential to emerge as part of future clinical care. This paper describes and updates the results of the DoD report and also expands on the use of angiography in patients with TBI.

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F-18 FDG PET imaging of chronic traumatic brain injury in boxers

Abstract: Our results suggest that F-18 FDG PET scans of boxers suspected of chronic traumatic brain injury show unique patterns of hypometabolism, and that these patterns may reflect the mechanisms of repeated traumatic brain injury unique to boxers.

Cited by 70 publications

References 15 publications

Sports-related brain injuries: connecting pathology to diagnosis

Sports-related brain injuries: connecting pathology to diagnosis

Widespread and Prolonged Increase in (R)-¹¹C-PK11195 Binding After Traumatic Brain Injury

A Review of the Effectiveness of Neuroimaging Modalities for the Detection of Traumatic Brain Injury

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F-18 FDG PET imaging of chronic traumatic brain injury in boxers

Abstract: Our results suggest that F-18 FDG PET scans of boxers suspected of chronic traumatic brain injury show unique patterns of hypometabolism, and that these patterns may reflect the mechanisms of repeated traumatic brain injury unique to boxers.

Cited by 70 publications

References 15 publications

Sports-related brain injuries: connecting pathology to diagnosis

Sports-related brain injuries: connecting pathology to diagnosis

Widespread and Prolonged Increase in (R)-11C-PK11195 Binding After Traumatic Brain Injury

A Review of the Effectiveness of Neuroimaging Modalities for the Detection of Traumatic Brain Injury

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Product

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Widespread and Prolonged Increase in (R)-¹¹C-PK11195 Binding After Traumatic Brain Injury