TY  - JOUR
PY  - 2019//
TI  - Early-onset dementia in war veterans: brain polypathology and clinicopathologic complexity
JO  - Journal of neuropathology and experimental neurology
A1  - Iacono, Diego
A1  - Lee, Patricia
A1  - Edlow, Brian L.
A1  - Gray, Nichelle
A1  - Fischl, Bruce
A1  - Kenney, Kimbra
A1  - Lew, Henry L.
A1  - Lozanoff, Scott
A1  - Liacouras, Peter
A1  - Lichtenberger, John
A1  - Dams-O'connor, Kristen
A1  - Cifu, David
A1  - Hinds, Sidney R.
A1  - Perl, Daniel P.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - The neuropathology associated with cognitive decline in military personnel exposed to traumatic brain injury (TBI) and chronic stress is incompletely understood. Few studies have examined clinicopathologic correlations between phosphorylated-tau neurofibrillary tangles, β-amyloid neuritic plaques, neuroinflammation, or white matter (WM) lesions, and neuropsychiatric disorders in veterans. We describe clinicopathologic findings in 4 military veterans with early-onset dementia (EOD) who had varying histories of blunt- and blast-TBI, cognitive decline, behavioral abnormalities, post-traumatic stress disorder, suicidal ideation, and suicide. We found that pathologic lesions in these military-EOD cases could not be categorized as classic Alzheimer's disease (AD), chronic traumatic encephalopathy, traumatic axonal injury, or other well-characterized clinicopathologic entities. Rather, we observed a mixture of polypathology with unusual patterns compared with pathologies found in AD or other dementias. Also, ultrahigh resolution ex vivo MRI in 2 of these 4 brains revealed unusual patterns of periventricular WM injury. These findings suggest that military-EOD cases are associated with atypical combinations of brain lesions and distribution rarely seen in nonmilitary populations. Future prospective studies that acquire neuropsychiatric data before and after deployments, as well as genetic and environmental exposure data, are needed to further elucidate clinicopathologic correlations in military-EOD.<br><br>© 2019 American Association of Neuropathologists, Inc.<p />  <p>Language: en</p>
LA  - en
SN  - 0022-3069
UR  - http://dx.doi.org/10.1093/jnen/nlz122
ID  - ref1
ER  -