title: Progressive Focal Gray Matter Volume Loss in a Former High School Football Player: A Possible Magnetic Resonance Imaging Volumetric Signature for Chronic Traumatic Encephalopathy.
abstract: Here a case is presented of a 51-year-old former high school football player with multiple concussions, including one episode with loss of consciousness. The patient experienced 6 years of cognitive and mood decline, and his wife corroborated increasing memory loss, attentional difficulties, and depressed mood without suicidal ideation. He had been unable to maintain full-time employment because of progressive decline. Based on his presentation, he had been previously diagnosed with attention deficit hyperactivity disorder and bipolar disorder, type II. Neuropsychological tests indicated domain-specific cognitive impairment, and longitudinal volumetric magnetic resonance imaging (MRI) of the brain showed progressive brainstem, diencephalic, and frontal lobe atrophy. This regional volume loss correlated with the increased signal seen on tau and amyloid imaging (FDDNP-PET scan) of a separate case of suspected chronic traumatic encephalopathy (CTE). Visual assessment of the MRI also showed evidence of old petechial hemorrhages in the frontal and temporal-parietal lobe white matter. This case raises the possibility of distinct quantitative and visual brain MRI findings in suspected CTE.
authors: Departments of Radiology, David Geffen School of Medicine at University of California, Los Angeles, CLA, Los Angeles, CA. Electronic address: cyrusraji@gmail.com.
authors: Cyrus A
authors: CA
authors: Raji
authors: Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, CLA, Los Angeles, CA.
authors: David A
authors: DA
authors: Merrill
authors: Molecular and Medical Pharmacology, David Geffen School of Medicine at University of California, Los Angeles, CLA, Los Angeles, CA.
authors: Jorge R
authors: JR
authors: Barrio
authors: Department of Pathology, University of California Davis Medical Center, Davis, CA.
authors: Bennet
authors: B
authors: Omalu
authors: Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, CLA, Los Angeles, CA.
authors: Gary W
authors: GW
authors: Small
mesh_terms: D000682:Amyloid / Q000378:metabolism; D001284:Atrophy; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D001933:Brain Stem / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging; D000070627:Chronic Traumatic Encephalopathy / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology / Q000523:psychology; D060825:Cognitive Dysfunction / Q000523:psychology; D003866:Depressive Disorder / Q000523:psychology; D004027:Diencephalon / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D018450:Disease Progression; D005538:Football / Q000293:injuries*; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D066128:Gray Matter / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D049268:Positron-Emission Tomography; D066127:White Matter / Q000000981:diagnostic imaging; D016875:tau Proteins / Q000378:metabolism
chemical_list: D000682:Amyloid; C054369:MAPT protein, human; D016875:tau Proteins
keywords: CTE; FDDNP; Neuroreader; brain PET; volumetric MRI