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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Acta+Neuropathol
2017 ; 133
(3
): 353-366
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Localized cortical chronic traumatic encephalopathy pathology after single,
severe axonal injury in human brain
#MMPMID27885490
Shively SB
; Edgerton SL
; Iacono D
; Purohit DP
; Qu BX
; Haroutunian V
; Davis KL
; Diaz-Arrastia R
; Perl DP
Acta Neuropathol
2017[Mar]; 133
(3
): 353-366
PMID27885490
show ga
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease associated
with repetitive mild impact traumatic brain injury from contact sports. Recently,
a consensus panel defined the pathognomonic lesion for CTE as accumulations of
abnormally hyperphosphorylated tau (p-tau) in neurons (neurofibrillary tangles),
astrocytes and cell processes distributed around small blood vessels at sulcal
depths in irregular patterns within the cortex. The pathophysiological mechanism
for this lesion is unknown. Moreover, a subset of CTE cases harbors cortical
?-amyloid plaques. In this study, we analyzed postmortem brain tissues from five
institutionalized patients with schizophrenia and history of surgical leucotomy
with subsequent survival of at least another 40 years. Because leucotomy involves
severing axons bilaterally in prefrontal cortex, this surgical procedure
represents a human model of single traumatic brain injury with severe axonal
damage and no external impact. We examined cortical tissues at the leucotomy site
and at both prefrontal cortex rostral and frontal cortex caudal to the leucotomy
site. For comparison, we analyzed brain tissues at equivalent neuroanatomical
sites from non-leucotomized patients with schizophrenia, matched in age and
gender. All five leucotomy cases revealed severe white matter damage with dense
astrogliosis at the axotomy site and also neurofibrillary tangles and p-tau
immunoreactive neurites in the overlying gray matter. Four cases displayed p-tau
immunoreactivity in neurons, astrocytes and cell processes encompassing blood
vessels at cortical sulcal depths in irregular patterns, similar to CTE. The
three cases with apolipoprotein E ?4 haplotype showed scattered ?-amyloid plaques
in the overlying gray matter, but not the two cases with apolipoprotein E ?3/3
genotype. Brain tissue samples from prefrontal cortex rostral and frontal cortex
caudal to the leucotomy site, and all cortical samples from the non-leucotomized
patients, showed minimal p-tau and ?-amyloid pathology. These findings suggest
that chronic axonal damage contributes to the unique pathology of CTE over time.