18F-Flortaucipir (AV1451) imaging identifies grey matter atrophy in retired athletes

J Neurol. 2024 Sep;271(9):6068-6079. doi: 10.1007/s00415-024-12573-0. Epub 2024 Jul 22.

Abstract

Background: The long-term consequences of concussions may include pathological neurodegeneration as seen in Alzheimer's disease (AD) and chronic traumatic encephalopathy (CTE). Tau-PET showed promise as a method to detect tau pathology of CTE, but more studies are needed OBJECTIVE: This study aimed (1) to assess the association of imaging evidence of tau pathology with brain volumes in retired athletes and (2) to examine the relationship between tau-PET and neuropsychological functioning.

Methods: Former contact sport athletes were recruited through the Canadian Football League Alumni Association or the Canadian Concussion Centre clinic. Athletes completed MRI, [18F]flortaucipir tau-PET, and a neuropsychological battery. Memory composite was created by averaging the Rey Auditory Verbal Learning Test and Rey Visual Design Learning Test z-scores. Grey matter (GM) volumes were age/intracranial volume corrected using normal control MRIs. Tau-PET % positivity in GM was calculated as the number of positive voxels (≥ 1.3 standardized uptake value ratio (SUVR)/total voxels).

Results: 47 retired contact sport athletes negative for AD (age:51 ± 14; concussions/athlete:15 ± 2) and 54 normal controls (age:50 ± 13) were included. Tau-PET positive voxels had significantly lower GM volumes, compared to tau-PET negative voxels (- 0.37 ± 0.41 vs. - 0.31 ± 0.37, paired p = .006). There was a significant relationship between GM tau-PET % positivity and memory composite score (r = - .366, p = .02), controlled for age, PET scanner, and PET scan duration. There was no relationship between tau-PET measures and concussion number, or years of sport played.

Conclusion: A higher tau-PET signal was associated with reduced GM volumes and lower memory scores. Tau-PET may be useful for identifying those at risk for neurodegeneration.

Keywords: Athletes; Chronic traumatic encephalopathy; Concussion; Neurodegeneration; Pet; Tau.

MeSH terms

  • Adult
  • Aged
  • Athletes*
  • Athletic Injuries / complications
  • Athletic Injuries / diagnostic imaging
  • Athletic Injuries / pathology
  • Atrophy* / pathology
  • Brain Concussion / diagnostic imaging
  • Brain Concussion / pathology
  • Carbolines*
  • Female
  • Gray Matter* / diagnostic imaging
  • Gray Matter* / pathology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Positron-Emission Tomography*
  • Retirement
  • tau Proteins* / metabolism

Substances

  • Carbolines
  • tau Proteins
  • 7-(6-fluoropyridin-3-yl)-5H-pyrido(4,3-b)indole