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Butler T, Chiang GC, Niogi SN, Wang XH, Skudin C, Tanzi E, Wickramasuriya N, Spiegel J, Maloney T, Pahlajani S, Zhou L, Morim S, Rusinek H, Normandin M, Dyke JP, Fung EK, Li Y, Glodzik L, Razlighi QR, Shah SA, de Leon M. Tau PET following acute TBI: Off-target binding to blood products, tauopathy, or both? Front Neuroimaging 2022; 1:958558. [PMID: 36876118 PMCID: PMC9979975 DOI: 10.3389/fnimg.2022.958558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Repeated mild Traumatic Brain Injury (TBI) is a risk factor for Chronic Traumatic Encephalopathy (CTE), characterized pathologically by neurofibrillary tau deposition in the depths of brain sulci and surrounding blood vessels. The mechanism by which TBI leads to CTE remains unknown but has been posited to relate to axonal shear injury leading to release and possibly deposition of tau at the time of injury. As part of an IRB-approved study designed to learn how processes occurring acutely after TBI may predict later proteinopathy and neurodegeneration, we performed tau PET using 18F-MK6240 and MRI within 14 days of complicated mild TBI in three subjects. PET radiotracer accumulation was apparent in regions of traumatic hemorrhage in all subjects, with prominent intraparenchymal PET signal in one young subject with a history of repeated sports-related concussions. These results are consistent with off-target tracer binding to blood products as well as possible on-target binding to chronically and/or acutely-deposited neurofibrillary tau. Both explanations are highly relevant to applying tau PET to understanding TBI and CTE. Additional study is needed to assess the potential utility of tau PET in understanding how processes occurring acutely after TBI, such as release and deposition of tau and blood from damaged axons and blood vessels, may relate to development CTE years later.
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Affiliation(s)
- Tracy Butler
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Gloria C Chiang
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Sumit Narayan Niogi
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Xiuyuan Hugh Wang
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Carly Skudin
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Emily Tanzi
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | | | - Jonathan Spiegel
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Thomas Maloney
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Silky Pahlajani
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Liangdong Zhou
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Simon Morim
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Henry Rusinek
- New York University Grossman School of Medicine, New York, NY, United States
| | - Marc Normandin
- Department of Radiology Harvard Medical School, Boston, MA, United States
| | - Jonathan P Dyke
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Edward K Fung
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Yi Li
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Lidia Glodzik
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | | | - Sudhin A Shah
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Mony de Leon
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
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Li KR, Avecillas-Chasin J, Nguyen TD, Gillen KM, Dimov A, Chang E, Skudin C, Kopell BH, Wang Y, Shtilbans A. Quantitative evaluation of brain iron accumulation in different stages of Parkinson's disease. J Neuroimaging 2021; 32:363-371. [PMID: 34904328 DOI: 10.1111/jon.12957] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND AND PURPOSE Excessive brain iron deposition is involved in Parkinson's disease (PD) pathogenesis. However, the correlation of iron accumulation in various brain nuclei is not well-established in different stages of the disease. This cross-sectional study aims to evaluate quantitative susceptibility mapping (QSM) as an imaging technique to measure brain iron accumulation in PD patients in different stages compared to healthy controls. METHODS Ninety-six PD patients grouped by their Hoehn and Yahr (H&Y) stages and 31 healthy controls were included in this analysis. The magnetic susceptibility values of the substantia nigra (SN), red nucleus (RN), caudate, putamen, and globus pallidus were obtained and compared. RESULTS Iron level was increased in the SN of PD patients in all stages versus controls (p < .001), with no significant difference within stages. Iron in the RN was significantly increased in stage II versus controls (p = .013) and combined stages III and IV versus controls (p < .001). The iron levels in caudate, putamen, and globus pallidus were not different between any groups. CONCLUSIONS Our data suggest iron accumulation occurs early in the disease course and only in the SN and RN of these patients. This is a large cross-sectional study of brain iron deposition in PD patients according to H&Y staging. Prospective studies are warranted to further validate QSM as a method to follow brain iron, which could serve as a disease biomarker and a therapeutic target.
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Affiliation(s)
- Kailyn R Li
- Department of Radiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York, USA.,MD Program, Weill Cornell Medicine, New York, New York, USA
| | | | - Thanh D Nguyen
- Department of Radiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Kelly M Gillen
- Department of Radiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Alexey Dimov
- Department of Radiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Eileen Chang
- Department of Radiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Carly Skudin
- Department of Radiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Brian H Kopell
- Department of Neurosurgery, Mount Sinai Hospital, New York, New York, USA
| | - Yi Wang
- Department of Radiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Alexander Shtilbans
- Department of Neurology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York, USA.,Department of Neurology, Hospital for Special Surgery, New York, New York, USA
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