Flortaucipir tau PET findings from former professional and college American football players in the DIAGNOSE CTE research project

Yi Su; Hillary Protas; Ji Luo; Kewei Chen; Michael L Alosco; Charles H Adler; Laura J Balcer; Charles Bernick; Rhoda Au; Sarah J Banks; William B Barr; Michael J Coleman; David W Dodick; Douglas I Katz; Kenneth L Marek; Michael D McClean; Ann C McKee; Jesse Mez; Daniel H Daneshvar; Joseph N Palmisano; Elaine R Peskind; Robert W Turner 2nd; Jennifer V Wethe; Gil Rabinovici; Keith Johnson; Yorghos Tripodis; Jeffrey L Cummings; Martha E Shenton; Robert A Stern; Eric M Reiman; DIAGNOSE CTE Research Project Investigators

doi:10.1002/alz.13602

Flortaucipir tau PET findings from former professional and college American football players in the DIAGNOSE CTE research project

Alzheimers Dement. 2024 Mar;20(3):1827-1838. doi: 10.1002/alz.13602. Epub 2023 Dec 22.

Authors

Yi Su¹, Hillary Protas¹, Ji Luo¹, Kewei Chen¹, Michael L Alosco², Charles H Adler³, Laura J Balcer^{4

5}, Charles Bernick^{6

7}, Rhoda Au^{2

8

9}, Sarah J Banks¹⁰, William B Barr⁴, Michael J Coleman¹¹, David W Dodick³, Douglas I Katz^{2

12}, Kenneth L Marek¹³, Michael D McClean¹⁴, Ann C McKee^{2

15}, Jesse Mez^{2

8}, Daniel H Daneshvar¹⁶, Joseph N Palmisano¹⁷, Elaine R Peskind¹⁸, Robert W Turner 2nd¹⁹, Jennifer V Wethe²⁰, Gil Rabinovici²¹, Keith Johnson²², Yorghos Tripodis^{2

23}, Jeffrey L Cummings²⁴, Martha E Shenton¹¹, Robert A Stern², Eric M Reiman^{1

25}; DIAGNOSE CTE Research Project Investigators

Affiliations

¹ Banner Alzheimer's Institute and Arizona Alzheimer's Consortium, Phoenix, Arizona, USA.
² Department of Neurology, Boston University Alzheimer's Disease Research Center, Boston University CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.
³ Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA.
⁴ Departments of Neurology, NYU Grossman School of Medicine, New York, New York, USA.
⁵ Department of Population Health and Ophthalmology, NYU Grossman School of Medicine, New York, New York, USA.
⁶ Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, Nevada, USA.
⁷ Department of Neurology, University of Washington, Seattle, Washington, USA.
⁸ Framingham Heart Study, Framingham, Massachusetts, USA.
⁹ Slone Epidemiology Center; Departments of Anatomy & Neurobiology, Neurology, and Medicine, Department of Epidemiology, Boston University Chobanian & Avedisian School of Medicine; Boston University School of Public Health, Boston, Massachusetts, USA.
¹⁰ Departments of Neuroscience and Psychiatry, University of California, San Diego, California, USA.
¹¹ Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
¹² Encompass Health Braintree Rehabilitation Hospital, Braintree, Massachusetts, USA.
¹³ Institute for Neurodegenerative Disorders, Invicro, LLC, New Haven, Connecticut, USA.
¹⁴ Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA.
¹⁵ VA Boston Healthcare System, Boston, Massachusetts, USA.
¹⁶ Department of Physical Medicine & Rehabilitation, Massachusetts General Hospital, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, Massachusetts, USA.
¹⁷ Boston University Alzheimer's Disease Research Center, Boston University CTE Center, Biostatistics and Epidemiology Data Analytics Center (BEDAC), Boston University School of Public Health, Boston, Massachusetts, USA.
¹⁸ Department of Psychiatry and Behavioral Sciences, VA Northwest Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System; University of Washington School of Medicine, Seattle, Washington, USA.
¹⁹ Department of Clinical Research & Leadership, The George Washington University School of Medicine & Health Sciences, Washington, District of Columbia, USA.
²⁰ Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA.
²¹ Department of Neurology, University of California San Francisco, San Francisco, California, USA.
²² Gordon Center for Medical Imaging, Mass General Research Institute, Harvard Medical School, Boston, Massachusetts, USA.
²³ Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA.
²⁴ Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas, Las Vegas, Nevada, USA.
²⁵ University of Arizona, Arizona State University, Translational Genomics Research Institute, Phoenix, Arizona, USA.

Abstract

Introduction: Tau is a key pathology in chronic traumatic encephalopathy (CTE). Here, we report our findings in tau positron emission tomography (PET) measurements from the DIAGNOSE CTE Research Project.

Method: We compare flortaucipir PET measures from 104 former professional players (PRO), 58 former college football players (COL), and 56 same-age men without exposure to repetitive head impacts (RHI) or traumatic brain injury (unexposed [UE]); characterize their associations with RHI exposure; and compare players who did or did not meet diagnostic criteria for traumatic encephalopathy syndrome (TES).

Results: Significantly elevated flortaucipir uptake was observed in former football players (PRO+COL) in prespecified regions (p < 0.05). Association between regional flortaucipir uptake and estimated cumulative head impact exposure was only observed in the superior frontal region in former players over 60 years old. Flortaucipir PET was not able to differentiate TES groups.

Discussion: Additional studies are needed to further understand tau pathology in CTE and other individuals with a history of RHI.

Keywords: CTE; PET; Tau; flortaucipir; football.

MeSH terms

Brain Injuries, Traumatic* / complications
Carbolines*
Chronic Traumatic Encephalopathy* / diagnostic imaging
Chronic Traumatic Encephalopathy* / pathology
Football* / injuries
Humans
Male
Middle Aged
Positron-Emission Tomography
tau Proteins

Substances

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

Abstract

MeSH terms

Substances

Grants and funding