McKee CTE staging scheme accurate in diagnosing severity, location of disease



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Since 2008, researchers at Boston University School of Medicine (BUSM) and VA Boston Healthcare System have studied Chronic Traumatic Encephalopathy (CTE), a progressive mind disease related to repetitive head impacts that has been identified after dying in the brains of American soccer gamers and different contact sport athletes in addition to members of the armed companies.

In 2013, these similar researchers proposed standards for the pathological prognosis of CTE and a technique for grading the severity of the disease referred to as the McKee CTE staging scheme. The McKee staging scheme outlined 4 pathological levels of CTE, levels I (gentle) to IV (extreme), based mostly on the density and regional deposition of hyperphosphorylated tau (p-tau) pathology. The standards for pathological prognosis of CTE have been adopted and refined by the National Institute of Neurological Disorders and Stroke/National Institute of Biomedical Imaging and Bioengineering consensus panel of skilled neuropathologists in 2015. Since then, though the staging scheme has been used broadly to characterize the severity of pathology in a whole bunch of CTE topics, its effectiveness and accuracy has not been formally examined.

Now a brand new research for the primary time proves that the McKee staging scheme for CTE precisely represents the development of tau pathology in CTE and correlates with medical dementia. It additionally confirms that it correlates with age at dying and years of American soccer play.

To take a look at its effectiveness and accuracy and supply an in depth examination of the regional distribution of p-tau in CTE, researchers from Boston University examined the connection between the McKee staging scheme and p-tau pathology in areas all through the mind, age at dying, dementia and years of American soccer play amongst 366 male mind donors neuropathologically identified with CTE. They discovered having the next CTE stage was related to larger scores on all assessments of p-tau severity and density and in the end extra clinically superior CTE. Severity and distribution of p-tau in CTE adopted an age-dependent development, that means older age was related to elevated odds for having the next CTE stage and CTE stage was independently related to elevated odds for dementia.

In addition, the researchers recognized 5 areas in the mind the place there have been clusters of growing p-tau pathology that conformed to CTE stage, age at dying, dementia and years of American soccer play. Tau pathology was constantly most extreme in 5 mind areas: dorsolateral frontal cortex, superior temporal cortex, entorhinal cortex, amygdala and locus coeruleus. In the youngest mind donors with the least superior CTE stage, tau pathology was most extreme in dorsolateral frontal cortex and locus coeruleus.

“These findings further advance our understanding of CTE and lay the groundwork for diagnosis during life using imaging techniques that can identify the specific tau of CTE in the brains of living people. This work will also help focus the development of therapies aimed at arresting tau progression,” defined corresponding writer Ann McKee, MD, chief of neuropathology at VA Boston Healthcare System and director of the BU CTE Center.

While additional research is required to make clear the medical correlates of CTE throughout the completely different levels of disease and establish repetitive head impacts (RHI) and non-RHI associated danger elements that improve susceptibility and course development, these findings help the usefulness of the McKee CTE staging scheme in assessing CTE pathological severity and help their continued use in the research of CTE.

“This study addresses a key knowledge gap in the field by confirming the usefulness of the McKee CTE staging scheme and directly linking the tau from CTE with age, years of American football play and dementia. The findings will play an important role in guiding both clinical and basic science research on CTE,” mentioned lead writer Michael Alosco, Ph.D., affiliate professor of neurology at BUSM and co-director of the BU Alzheimer’s Disease Center Clinical Core.

These findings seem on-line in the journal Acta Neuropathologica.

CTE risk, severity increases with years playing American football

McKee CTE staging scheme accurate in diagnosing severity, location of disease (2020, August 10)
retrieved 10 August 2020

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