Systematic review on the characterization of chronic traumatic encephalopathy by MRI and MRS

Ruprecht, Rahel; Scheurer, Eva; Lenz, Claudia

doi:10.1002/jmri.26162

Cited by 17 publications

(13 citation statements)

References 56 publications

(421 reference statements)

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“…Therefore, future directions to improve radiographic diagnosis of patients with CTE include: validation of diagnostic criteria; adequately controlled imaging studies with increased sample sizes and greater statistical power; inclusion of female study participants; consistent imaging methodologies; consistent use of age-matched control groups; and neuropathological evaluation to directly correlate imaging and pathologic findings. Furthermore, more studies investigating additional, more specific tau ligands like flortaucapir are needed [98]. We look forward to the results of the DIAGNOSE-CTE project, which will perform longitudinal investigations in athletes to validate various diagnostic tests [99].…”

Section: Future Discoveriesmentioning

confidence: 99%

Chronic Traumatic Encephalopathy: Update on Current Clinical Diagnosis and Management

et al. 2021

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Chronic traumatic encephalopathy is a disease afflicting individuals exposed to repetitive neurotrauma. Unfortunately, diagnosis is made by postmortem pathologic analysis, and treatment options are primarily symptomatic. In this clinical update, we review clinical and pathologic diagnostic criteria and recommended symptomatic treatments. We also review animal models and recent discoveries from pre-clinical studies. Furthermore, we highlight the recent advances in diagnosis using diffusor tensor imaging, functional magnetic resonance imaging, positron emission tomography, and the fluid biomarkers t-tau, sTREM2, CCL11, NFL, and GFAP. We also provide an update on emerging pharmaceutical treatments, including immunotherapies and those that target tau acetylation, tau phosphorylation, and inflammation. Lastly, we highlight the current literature gaps and guide future directions to further improve clinical diagnosis and management of patients suffering from this condition.

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Section: Future Discoveriesmentioning

confidence: 99%

Chronic Traumatic Encephalopathy: Update on Current Clinical Diagnosis and Management

et al. 2021

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“…They concluded that ex vivo diffusion MRI is sensitive for the microstructural changes in CTE, but that application in the in vivo setting has yet to be determined [91]. Nevertheless, initial in vivo studies show promising results [92].…”

Section: Tbi and Strokementioning

confidence: 99%

Post-Mortem MRI and Histopathology in Neurologic Disease: A Translational Approach

et al. 2019

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In this review, combined post-mortem brain magnetic resonance imaging (MRI) and histology studies are highlighted, illustrating the relevance of translational approaches to define novel MRI signatures of neuropathological lesions in neuroinflammatory and neurodegenerative disorders. Initial studies combining post-mortem MRI and histology have validated various MRI sequences, assessing their sensitivity and specificity as diagnostic biomarkers in neurologic disease. More recent studies have focused on defining new radiological (bio)markers and implementing them in the clinical (research) setting. By combining neurological and neuroanatomical expertise with radiological development and pathological validation, a cycle emerges that allows for the discovery of novel MRI biomarkers to be implemented in vivo. Examples of this cycle are presented for multiple sclerosis, Alzheimer's disease, Parkinson's disease, and traumatic brain injury. Some applications have been shown to be successful, while others require further validation. In conclusion, there is much to explore with post-mortem MRI and histology studies, which can eventually be of high relevance for clinical practice.

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“…Neurometabolites such as N-acetyl aspartate, choline, and glutamine/glutamate (NAA, Cho and Glx) are shown to have similar changes on MRS imaging to CTE pathological changes, although not specific ( 81 ). More recently, Ruprecht et al ( 82 ) included 25 studies for qualitative synthesis in their systematic review on the characterization of CTE by MRI and MRS, finding that there is only partial comparability amongst published studies given presentation of diffusion MRI, structural MRI, functional MRI, and MRS ( 82 ). These authors found gender bias and inconsistently applied age-matched controls limit direct comparison.…”

Section: Future Directions In Potential In-vivo DImentioning

confidence: 99%

“…In general, current limitations of CTE assessment with MRI are studies with small sample sizes, lack of disease comparison groups, and inability to confirm CTE diagnosis in - vivo , rendering elucidation of a direct relationship between MRS and CTE currently lacking. Further ante- and postmortem research in the use of MRS is acknowledged to be necessary ( 81 , 82 ).…”

Section: Future Directions In Potential In-vivo DImentioning

confidence: 99%

Chronic Traumatic Encephalopathy in Professional American Football Players: Where Are We Now?

et al. 2018

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Repetitive head trauma provides a favorable milieu for the onset of inflammatory and neurodegenerative processes. The result of long-lasting head trauma is chronic traumatic encephalopathy (CTE), a disease process well-recognized in boxers, military personnel, and more recently, in American football players. CTE is a chronic neurodegenerative disease with hallmarks of hyperphosphorylated tau (p-tau) aggregates and intercellular lesions of neurofibrillary tangles. The criteria for CTE diagnosis requires at least 1–2 focal perivascular lesions of p-tau in the cerebral cortex, at the depth of the sulci. These pathognomonic lesions aggregate within neurons and glial cells such as astrocytes, and cell processes within the vicinity of small blood vessels. CTE presents in a distinct topographical distribution pattern compared to other tauopathies such as AD and other age-related astrogliopathies. CTE also has an insidious onset, years after repetitive head trauma. The disease course of CTE is characterized by cognitive dysfunction, behavioral changes, and can progress to altered motor function with parkinsonian-like manifestations in later stages. This short review aims to summarize CTE in professional football, epidemiology, diagnosis based on neuroanatomical abnormalities, cognitive degeneration, and adverse mental health effects, as well as gaps in the literature and future directions in diagnostics, therapeutics, and preventive measures.

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Systematic review on the characterization of chronic traumatic encephalopathy by MRI and MRS

Abstract: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;00:000-000.

Cited by 17 publications

References 56 publications

Chronic Traumatic Encephalopathy: Update on Current Clinical Diagnosis and Management

Chronic Traumatic Encephalopathy: Update on Current Clinical Diagnosis and Management

Post-Mortem MRI and Histopathology in Neurologic Disease: A Translational Approach

Chronic Traumatic Encephalopathy in Professional American Football Players: Where Are We Now?

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