Association between Traumatic Brain Injury and Late Life Neurodegenerative Conditions and Neuropathological Findings

Details

• Alternative Title:
  JAMA Neurol
• Personal Author:
  Crane, Paul K. ; Gibbons, Laura E. ; Dams-O’Connor, Kristen ; Trittschuh, Emily ; Leverenz, James B. ; Keene, C. Dirk ; Sonnen, Joshua ; Montine, Thomas J. ; Bennett, David A. ; Leurgans, Sue ; Schneider, Julie A. ; Larson, Eric B.
• Description:
  IMPORTANCE
  
  There is great interest in the late effects of traumatic brain injury (TBI).
  
  OBJECTIVE
  
  To determine whether TBI with loss of consciousness (LOC) is associated with increased risk for clinical and neuropathological findings of Alzheimer’s disease, Parkinson’s disease, and other dementias. Our primary hypothesis was that TBI with LOC would be associated with increased risk for Alzheimer’s disease and neurofibrillary tangles.
  
  DESIGN
  
  Prospective cohort studies which follow all participants (Religious Orders Study and the Memory and Aging Project, ROS and MAP) or all consenting participants (Adult Changes in Thought, ACT) to autopsy. Studies performed annual (ROS and MAP) or biennial (ACT) cognitive and clinical testing to identify incident cases of dementia and Alzheimer’s disease.
  
  SETTING
  
  Members of a Seattle-area healthcare delivery system (ACT); priests and nuns living in orders across the US (ROS), and Chicago-area adults in retirement communities (MAP).
  
  PARTICIPANTS
  
  7,130 older adults; 1,589 came to autopsy.
  
  EXPOSURE
  
  Self reported TBI reported when free of dementia, categorized as <1 hour vs. > 1 hour of LOC.
  
  MAIN OUTCOMES AND MEASURES
  
  Clinical: incident all-cause dementia, Alzheimer’s disease, and Parkinson’s disease (all studies), and incident mild cognitive impairment and progression of parkinsonian signs (ROS and MAP). Neuropathology: neurofibrillary tangles, neuritic plaques, microinfarcts, cystic infarcts, Lewy bodies, and hippocampal sclerosis (all studies).
  
  RESULTS
  
  865 participants reported a history of TBI with LOC. In >45,000 person-years of follow-up, there were 1,537 incident dementia and 117 incident Parkinson’s disease cases. There was no association between TBI with LOC and incident dementia or Alzheimer’s disease. There were associations between TBI with LOC and incident Parkinson’s disease and progression of parkinsonian signs. There was no association between TBI with LOC and neurofibrillary tangles or neuritic plaques. There was an association between TBI with LOC and Lewy bodies, and with microinfarcts, though numbers of people with these findings were small.
  
  CONCLUSIONS AND RELEVANCE
  
  Pooled clinical and neuropathology data from three prospective cohort studies indicate that TBI with LOC is associated with risk of Lewy body accumulation, progression of parkinsonism, and Parkinson’s disease, but not dementia, Alzheimer’s disease, neuritic plaques, or neurofibrillary tangles.
  
  
• Subjects:
  Aged Aged, 80 And Over Autopsy Brain Injuries, Traumatic Cognition Disorders Consciousness Disorders Disease Progression Female Humans Incidence Longitudinal Studies Male Neurodegenerative Diseases Regression Analysis

  More +
• Source:
  JAMA Neurol. 73(9):1062-1069
• Pubmed ID:
  27400367
• Pubmed Central ID:
  PMC5319642
• Document Type:
  Journal Article
• Funding:
  U01 NS086625/NS/NINDS NIH HHSUnited States/ ; R01 NS078009/NS/NINDS NIH HHSUnited States/ ; R01 AG017917/AG/NIA NIH HHSUnited States/ ; P30 AG010161/AG/NIA NIH HHSUnited States/ ; P50 NS062684/NS/NINDS NIH HHSUnited States/ ; U01 AG006781/AG/NIA NIH HHSUnited States/ ; R01 AG022018/AG/NIA NIH HHSUnited States/ ; R01 AG015819/AG/NIA NIH HHSUnited States/ ; R01 AG042210/AG/NIA NIH HHSUnited States/ ; RF1 AG015819/AG/NIA NIH HHSUnited States/ ; K01 HD074651/HD/NICHD NIH HHSUnited States/ ; R49 CE002092/CE/NCIPC CDC HHSUnited States/ ; P50 AG005136/AG/NIA NIH HHSUnited States/
• Volume:
  73
• Issue:
  9
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:db3cef679752f4e3d47f51a159f7d4af77512b8d8c7da2b00001238b4713a5ff
• Download URL:
  https://stacks.cdc.gov/view/cdc/85841/cdc_85841_DS1.pdf
• File Type:
  [PDF - 354.79 KB ]