Quantification of multi-lumen blood vessel pathology in chronic traumatic encephalopathy
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BACKGROUND: Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disorder that had been largely ignored for decades since its initial characterization in 1928 by Dr. H. Martland. Within the last several years, a dramatic increase of attention in the media has been given to the subject and is now a household term. As a consequence of repetitive concussive and subconcussive events, CTE has been clearly distinguished form other neurodegenerative disorders such as Alzheimer’s Disease and Parkinson’s. Its prominence in military personnel and professional athletes has established the importance for its characterization in order to develop preventative approaches and regulations. Recently, characterization and staging of CTE has been achieved and interventional approaches are already being implemented in response to this increased understanding. However, not everything is known about the pathology and its underlying mechanisms. No known studies have been done to quantify the connection between MLV pathology and CTE. OBJECTIVE: To determine if MLV pathology observed in CTE may serve as a potential biomarker. METHODS: The white and grey matter of brains from subjects with CTE and control subjects without CTE were analyzed for the presence and characteristics of multilumen vessels (MLVs) in the dorsolateral frontal cortex (DLFC). A total of 123 slides were analyzed, 88 from CTE cases and 35 from Non-CTE cases. The quantification of overrepresented MLVs and their features was the primary endpoint of the study. Associations were then made between the characteristics of multilumen vessels and controlling factors such as age at death and years of exposure to repetitive head injuries (RHIs). Finally, regression analysis was used to test for the predictive qualities of the density and average number of lumen for stage of CTE while controlling for age at death and years of exposure. RESULTS: It was found that MLVs are overrepresented in the CTE cohort in comparison to the Non-CTE cohort. There is also a possible connection between the presence of MLVs with their pathologic observable features to the progressive nature of CTE. In addition, the MLVs found in CTE have observable characteristics that are dissociable from MLVs in Non-CTE. Furthermore, for increased confidence of the findings, results remain significant even with the application of stricter parameters for defining MLVs. Finally, there was evidence of a connection between the development of MLVs to the progression of CTE. CONCLUSIONS: The findings suggest there is a strong relationship between age of death and the frequency of MLVs. Furthermore, the development of MLVs is likely positively impacted by the progression of CTE.