MRI findings could hint at early development of CTE
New imaging data offer clues that could help predict the development of chronic traumatic encephalopathy (CTE), potentially leading to in vivo treatment options.
Currently, CTE can only be diagnosed post-mortem via brain tissue assessment during an autopsy. This makes understanding how the neurodegenerative condition manifests in living individuals difficult, which hinders medical experts' ability to develop treatment strategies.
However, new data published in Brain Communications suggest certain in vivo MRI findings in individuals who have participated in contact or collision sports could be indicative of early onset CTE.
“Chronic traumatic encephalopathy is defined by the abnormal accumulation of phosphorylated tau protein, particularly at the depths of the superior frontal sulci, suggesting that sulcal morphology may serve as a relevant structural biomarker,” explained study senior investigator Hector Arciniega, PhD, an assistant professor in the Department of Rehabilitation Medicine at the New York University (NYU) Grossman School of Medicine. “Contact sport athletes, such as former football players, are at elevated risk due to their prolonged exposure to repetitive head impacts. Cortical atrophy linked to underlying tau accumulation may result in shallower and wider sulci, potentially making sulcal morphology an imaging marker for identifying individuals at risk for this disease.”
The study compared the brain MRIs of 169 former college and professional football players to those of 54 carefully matched males with no history of playing contact sports or being a member of the military. Researchers focused on sulcal morphological differences between the two groups, which were compared alongside a myriad of other factors, including age, length of exposure to contact sports, diagnoses related to encephalopathy, neuropsychological performance and PET imaging using flortaucipir.
The football players’ imaging showed consistently shallower left superior frontal sulci compared to the control group. These are located in the main groove that runs along the top, front and left side of the brain and have been implicated in CTE in prior research. What’s more, individuals who had lengthier histories of playing football showed greater widening of the left occipitotemporal sulcus. Other measures, such as the PET data and neuropsychological assessments, did not correlate with the MRI findings.
“Our study shows what we believe can be the first structural differences that tell apart brains more at risk of developing chronic traumatic encephalopathy from the brains of people who are less at risk,” Arciniega noted. “The work also proves that we can apply what we know about the physical changes observed postmortem in the brains of those with confirmed chronic traumatic encephalopathy to brain scans of living people at increased risk for it.”
Though the findings are a positive step toward understanding CTE, the authors acknowledge their results also prompt more questions. They were unable to determine why just one side of the brain appears to be affected by contact sports, nor could they explain why the psychological and memory assessments did not align with anatomical findings. The group plans to continue their study and intends to expand their work to other parts of the brain.
Read more about the findings here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.