Tauopathy in veterans with long-term posttraumatic stress disorder and traumatic brain injury.

Content Provider	Europe PMC
Author	Mohamed, Abdalla Z. Cumming, Paul Götz, Jürgen Nasrallah, Fatima
Abstract	PurposeTraumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) have emerged as independent risk factors for an earlier onset of Alzheimer’s disease (AD), although the pathophysiology underlying this risk is unclear. Postmortem studies have revealed extensive cerebral accumulation of tau following multiple and single TBI incidents. We hypothesized that a history of TBI and/or PTSD may induce an AD-like pattern of tau accumulation in the brain of nondemented war veterans.MethodsVietnam War veterans (mean age 71.4 years) with a history of war-related TBI and/or PTSD underwent [18F]AV145 PET as part of the US Department of Defense Alzheimer’s Disease Neuroimaging Initiative. Subjects were classified into the following four groups: healthy controls (n = 21), TBI (n = 10), PTSD (n = 32), and TBI+PTSD (n = 17). [18F]AV1451 reference tissue-normalized standardized uptake value (SUVr) maps, scaled to the cerebellar grey matter, were tested for differences in tau accumulation between groups using voxel-wise and region of interest approaches, and the SUVr results were correlated with neuropsychological test scores.ResultsCompared to healthy controls, all groups showed widespread tau accumulation in neocortical regions overlapping with typical and atypical patterns of AD-like tau distribution. The TBI group showed higher tau accumulation than the other clinical groups. The extent of tauopathy was positively correlated with the neuropsychological deficit scores in the TBI+PTSD and PTSD groups.ConclusionA history of TBI and/or PTSD may manifest in neurocognitive deficits in association with increased tau deposition in the brain of nondemented war veterans decades after their trauma. Further investigation is required to establish the burden of increased risk of dementia imparted by earlier TBI and/or PTSD.Electronic supplementary materialThe online version of this article (10.1007/s00259-018-4241-7) contains supplementary material, which is available to authorized users.
ISSN	16197070
Journal	European Journal of Nuclear Medicine and Molecular Imaging
Volume Number	46
PubMed Central reference number	PMC6451714
Issue Number	5
PubMed reference number	30617964
e-ISSN	16197089
DOI	10.1007/s00259-018-4241-7
Language	English
Publisher	Springer Berlin Heidelberg
Publisher Date	2019-01-07
Publisher Place	Berlin/Heidelberg
Access Restriction	Open
Rights License	Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. © The Author(s) 2019
Subject Keyword	Traumatic brain injury Posttraumatic stress disorder Alzheimer’s disease Tau Positron emission tomography US Department of Defense Alzheimer’s Disease Neuroimaging Initiative
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging