TY  - JOUR
PY  - 2018//
TI  - Dementia after moderate-severe traumatic brain injury: coexistence of multiple proteinopathies
JO  - Journal of neuropathology and experimental neurology
A1  - Kenney, Kimbra
A1  - Iacono, Diego
A1  - Edlow, Brian L.
A1  - Katz, Douglas I.
A1  - Diaz-Arrastia, Ramon
A1  - Dams-O'connor, Kristen
A1  - Daneshvar, Daniel H.
A1  - Stevens, Allison
A1  - Moreau, Allison L.
A1  - Tirrell, Lee S.
A1  - Varjabedian, Ani
A1  - Yendiki, Anastasia
A1  - van der Kouwe, Andre
A1  - Mareyam, Azma
A1  - McNab, Jennifer A.
A1  - Gordon, Wayne A.
A1  - Fischl, Bruce
A1  - McKee, Ann C.
A1  - Perl, Daniel P.
SP  - 50
EP  - 63
VL  - 77
IS  - 1
N2  - We report the clinical, neuroimaging, and neuropathologic characteristics of 2 patients who developed early onset dementia after a moderate-severe traumatic brain injury (TBI). Neuropathological evaluation revealed abundant β-amyloid neuritic and cored plaques, diffuse β-amyloid plaques, and frequent hyperphosphorylated-tau neurofibrillary tangles (NFT) involving much of the cortex, including insula and mammillary bodies in both cases. Case 1 additionally showed NFTs in both the superficial and deep cortical layers, occasional perivascular and depth-of-sulci NFTs, and parietal white matter rarefaction, which corresponded with decreased parietal fiber tracts observed on ex vivo MRI. Case 2 additionally showed NFT predominance in the superficial layers of the cortex, hypothalamus and brainstem, diffuse Lewy bodies in the cortex, amygdala and brainstem, and intraneuronal TDP-43 inclusions. The neuropathologic diagnoses were atypical Alzheimer disease (AD) with features of chronic traumatic encephalopathy and white matter loss (Case 1), and atypical AD, dementia with Lewy bodies and coexistent TDP-43 pathology (Case 2). These findings support an epidemiological association between TBI and dementia and further characterize the variety of misfolded proteins that may accumulate after TBI. Analyses with comprehensive clinical, imaging, genetic, and neuropathological data are required to characterize the full clinicopathological spectrum associated with dementias occurring after moderate-severe TBI.<br><br>2017 American Association of Neuropathologists, Inc. This work is written by US Government employees and is in the public domain in the US.<p />  <p>Language: en</p>
LA  - en
SN  - 0022-3069
UR  - http://dx.doi.org/10.1093/jnen/nlx101
ID  - ref1
ER  -