MRI’s may be initial window into CTE diagnosis in living; approach may shave years off diagnosis

(Boston)—While chronic traumatic encephalopathy (CTE) cannot yet be diagnosed during life, a new study provides the best evidence to date that a commonly used brain imaging technique, magnetic resonance imaging (MRI), may expedite the ability to diagnose CTE with confidence in the living.

Researchers have found that participants diagnosed with CTE post-mortem had shrinkage in regions of the brain associated with CTE, as well as other abnormalities, compared with healthy controls. “Specifically, those with CTE had shrinkage in the frontal and temporal lobes of the brain, the regions most impacted by CTE” explained corresponding author Jesse Mez, MD, MS, director of the Boston University (BU) Alzheimer’s Disease Center Clinical Core and a BU CTE Center Investigator.

CTE is a progressive brain disease associated with repetitive head impacts. It has been diagnosed after death in American football players and other contact sport athletes as well as members of the armed services and victims of physical abuse.

To learn how to diagnose neurodegenerative diseases like Alzheimer’s disease, scientists usually study a population during life and confirm a diagnosis after death, which can take decades. To shorten this timeline, Mez and colleagues worked backwards, reviewing the medical records of deceased brain donors and analyzing MRIs obtained during life an average of four years prior to death.

They compared the MRIs of 55 men diagnosed with CTE to 31 male healthy controls with normal cognition at the time of their scan. “MRI is commonly used to diagnose progressive brain diseases that are similar to CTE such as Alzheimer’s disease. Findings from this study show us what we can expect to see on MRI in CTE. This is very exciting because it brings us that much closer to detecting CTE in living people,” said first author Michael Alosco, PhD, associate professor of neurology at BU School of Medicine, co-director of the BU Alzheimer’s Disease Center Clinical Core, and a lead BU CTE Center investigator.

“While this finding is not yet ready for the clinic, it shows we are making rapid progress, and we encourage patients and families to continue to participate in research so we can find answers even faster,” adds Mez.

Alosco also added, “there is more to do as we still need to understand whether the patterns we saw on MRI are specific to CTE, that is, do they differentiate CTE from Alzheimer’s disease and other causes of dementia.”
 

These findings appear online in the journal Alzheimer's Research & Therapy.

This work was supported by grant funding from: NIA (AG057902, AG06234, RF1AG054156, K23AG046377, AG008122, AG016495, AG033040, AG054156, AG049810, AG062109, P30AG072978), NINDS (U54NS115266, U01NS086659, K23NS102399), National Institute of Aging Boston University AD Center (P30AG13846; supplement 0572063345-5); Department of Veterans Affairs Merit Award (I01-CX001038), the Nick and Lynn Buoniconti Foundation, and BU-CTSI Grant Number 1UL1TR001430.  JC is funded by the Alzheimer’s Association (AARF-17-529888).

Note to editors:

Lee E. Goldstein is a paid consultant to Johnson & Johnson (New Brunswick, NJ) / Janssen Research & Development, LLC (Raritan, NJ) and Rebiscan, Inc. (Cambridge, MA). He has received funding from the WWE and Ivivi Health Sciences. Robert A. Stern is a member of the Mackey-White Committee of the NFL Players Association. He is a paid consultant to Biogen (Cambridge, MA, USA). He receives royalties for published neuropsychological tests from Psychological Assessment Resources, Inc. (Lutz, FL, USA) and is a member of the Board of Directors of King-Devick Technologies (Chicago, IL, USA). Robert C. Cantu is a senior advisor to the NFL Head Neck & Spine Committee, VP of NOCSAE and Chair Scientific Advisory Committee, Co-Founder and  Medical Director of the Concussion Legacy Foundation, receives royalties from Houghton Mifflin Harcourt, receives compensation for legal expert opinion (NCAA, NHL etc.), and is on the medical science committee for the National Collegiate Athletic Association Student-Athlete Concussion Injury Litigation. Ann C. McKee is a member of the Mackey-White Committee of the NFL Players Association. Chris Nowinski is a member of the Mackey-White committee of the NFL Players Association and a shareholder in Oxeia Biopharmaceuticals. Rhoda Au is a scientific advisor to Signant Health and Biogen.