title: Imaging chronic traumatic brain injury as a risk factor for neurodegeneration.
abstract: Population-based studies have supported the hypothesis that a positive history of traumatic brain injury (TBI) is associated with an increased incidence of neurological disease and psychiatric comorbidities, including chronic traumatic encephalopathy, Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis. These epidemiologic studies, however, do not offer a clear definition of that risk, and leave unanswered the bounding criteria for greater lifetime risk of neurodegeneration. Key factors that likely mediate the degree of risk of neurodegeneration include genetic factors, significant premorbid and comorbid medical history (e.g. depression, multiple head injuries and repetitive subconcussive impact to the brain, occupational risk, age at injury, and severity of brain injury). However, given the often-described concerns in self-report accuracy as it relates to history of multiple TBIs, low frequency of patient presentation to a physician in the case of mild brain injuries, and challenges with creating clear distinctions between injury severities, disentangling the true risk for neurodegeneration based solely on population-based studies will likely remain elusive. Given this reality, multiple modalities and approaches must be combined to characterize who are at risk so that appropriate interventions to alter progression of neurodegeneration can be evaluated. This article presents data from a study that highlights uses of neuroimaging and areas of needed research in the link between TBI and neurodegenerative disease.
authors.affiliation: BaylorScott&White Health, Temple, TX, USA; Texas A&M University Health Sciences, Temple, TX, USA. Electronic address: deborahmlittle@gmail.com.
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Little
authors.affiliation: Northshore Health System, Evanston, IL, USA.
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Geary
authors.affiliation: West Virginia School of Osteopathic Medicine, Lewisburg, WV, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Moynihan
authors.affiliation: Advocate Christ Medical Center, Chicago, IL, USA.
authors.forename: Aristides
authors.initials: A
authors.lastname: Alexander
authors.affiliation: BaylorScott&White Health, Temple, TX, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Pennington
authors.affiliation: University of Oregon, Eugene, OR, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Glang
authors.affiliation: Saint Louis University, St. Louis, MO, USA.
authors.forename: Evan T
authors.initials: ET
authors.lastname: Schulze
authors.affiliation: National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Dretsch
authors.affiliation: Telemedicine & Advanced Technology Research Center, U.S. Army Medical Research and Materiel Command, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Pacifico
authors.affiliation: BaylorScott&White Health, Temple, TX, USA; Texas A&M University Health Sciences, Temple, TX, USA.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Davis
authors.affiliation: BaylorScott&White Health, Temple, TX, USA; Texas A&M University Health Sciences, Temple, TX, USA.
authors.forename: Alan B
authors.initials: AB
authors.lastname: Stevens
authors.affiliation: BaylorScott&White Health, Temple, TX, USA; Texas A&M University Health Sciences, Temple, TX, USA.
authors.forename: Jason H
authors.initials: JH
authors.lastname: Huang
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D001930:Brain Injuries / Q000453:epidemiology / Q000473:pathology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019636:Neurodegenerative Diseases / Q000453:epidemiology*; D009483:Neuropsychological Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Dementia; Neuroimaging; Repetitive TBI; Traumatic brain injury