Imaging Predicts Risk of Alzheimer’s Disease in Patients With Mild-to-Moderate Traumatic Brain Injury: Presented at AANS

By Brandon M. May

CHICAGO -- May 11, 2016 -- Early 18F-AV-45 (florbetapir F18) positron emission tomography (PET) imaging may provide a sensitive biomarker for predicting outcomes in patients who have had a mild-to-moderate traumatic brain injury (TBI), according to results from a case series presented at the 84th Annual Meeting of the American Association of Neurological Surgeons (AANS).

“Memory dysfunction and heightened symptoms are experienced 12 months post-injury in TBI patients, with early, substantial increases in brain amyloid deposition,” stated investigator Joshua Gatson, PhD, The University of Texas Southwestern Medical Center, Dallas, Texas, speaking here as a poster session honoree. “F18 PET imaging is a sensitive biomarker for outcome prediction with patients diagnosed with mild-to-moderate TBI.”

Severe injury presents a higher risk for beta amyloid protein deposition within the brain. Deposition of amyloid protein is a key element in the pathogenesis of Alzheimer's disease. Patients with substantial increases in brain amyloid plaque have poor outcomes in regards to memory deficits and heightened symptoms such as headaches and difficulty concentrating.

In this study, 7 patients with mild-to-moderate TBI underwent imaging 2 weeks and 12 months following initial injury, with only 1 patient revealing moderate injury. The investigators measured amyloid plaque levels in the cerebral cortex. The team administered the symbol match test 12 months following brain injury to screen for cognitive impairment and memory deficits.

The patients had a 10% increase in amyloid plaque within the cerebral cortex 2 weeks following injury. Three subjects with poor outcomes, when stratified by cognitive outcomes, experienced a 20% and 13% increase in cerebral-concentrated amyloid plaque compared with healthy controls and TBI patients with positive outcomes, respectively.

Precisely 1 year following TBI, patients exhibiting poor outcomes demonstrated a negative correlation between amyloid plaque load and cognitive performance. Conversely, a positive correlation existed between increased brain amyloid load and symptom scores at 1 year.

The researchers concluded that F18 PET imaging is important for predicting potential outcomes in these patients, but further research is required to determine precise outcomes in specific cases.

[Presentation title: Amyloid Deposition After TBI Correlates With Cognitive Deficits and Symptom Worsening.]

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