From the Tanz Centre for Research in Neurodegenerative Diseases (F.T., N.M., M.C.T.), Department of Rehabilitation Sciences (R. Green, B.C.), Institute of Medical Science (R. Green, R.W., D.M., K.D.D., C.T., B.L., M.C.T.), Department of Surgery (K.D.D.), and Department of Psychology and Neurology (B.L.), University of Toronto; Canadian Concussion Center (F.T., A.T., S.A.N., M.K., R. Green, B.C., R.W., D.M., K.D.D., R. Goswami, C.T., M.C.T.) and Division of Neurosurgery (C.T.), Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network; Division of Neurology (A.T., S.A.N., R.W., M.C.T.) and Division of Neuroradiology (D.M.), Joint Department of Medical Imaging, University Health Network; and Rotman Research Institute at Baycrest (C.E.), Toronto, Ontario, Canada.
Neurology. 2019 Jun 4;92(23):e2717-e2726. doi: 10.1212/WNL.0000000000007608. Epub 2019 May 8.
To identify CSF biomarkers that are related to decreased white matter (WM) integrity and poor cognitive performance in former professional athletes with a history of multiple concussions.
Concentrations of phosphorylated tau181, total tau (t-tau), and β-amyloid in the CSF were measured in 3 groups: 22 former professional athletes with multiple concussions (mean ± SD age 55.9 ± 12.2 years), 5 healthy controls (age 57.4 ± 5.2 years), and 12 participants (age 60.0 ± 6.6 years) diagnosed with Alzheimer disease (AD). All participants in the former athletes group underwent diffusion tensor imaging to determine WM tract integrity and completed neuropsychological testing. We divided the former athletes group into those with normal (<300 pg/mL) and high (>300 pg/mL) CSF t-tau.
CSF t-tau in the former athletes group was significantly higher than in the healthy control group (349.3 ± 182.6 vs 188.8 ± 39.9 pg/mL, = 0.003) and significantly lower than in the patients with AD (349.3 ± 182.6 vs 857.0 ± 449.3 pg/mL, = 0.007). Fractional anisotropy values across all the tracts were significantly lower in the high CSF t-tau group compared to the normal CSF t-tau group ( = 0.036). Participants in the high CSF t-tau group scored significantly lower on the Trail Making Test (TMT) Part B compared to the normal CSF t-tau group ( scores 45.6 ± 18.8 vs 62.3 ± 10.1, = 0.017).
Our findings indicate that former athletes with multiple concussions are at increased risk of elevated levels of CSF t-tau and that high CSF t-tau is associated with reduced WM integrity and worse scores on the TMT Part B.
确定与曾多次脑震荡的职业运动员的脑白质（WM）完整性降低和认知表现不佳相关的 CSF 生物标志物。
在 3 组人群中测量了 CSF 中磷酸化 tau181、总 tau（t-tau）和 β-淀粉样蛋白的浓度：22 名曾多次脑震荡的前职业运动员（平均年龄 55.9 ± 12.2 岁）、5 名健康对照者（年龄 57.4 ± 5.2 岁）和 12 名诊断为阿尔茨海默病（AD）的参与者（年龄 60.0 ± 6.6 岁）。前运动员组的所有参与者均接受了弥散张量成像以确定 WM 束完整性，并完成了神经心理学测试。我们将前运动员组分为 CSF t-tau 正常（<300 pg/mL）和高（>300 pg/mL）两组。
前运动员组的 CSF t-tau 明显高于健康对照组（349.3 ± 182.6 vs 188.8 ± 39.9 pg/mL， = 0.003），明显低于 AD 患者（349.3 ± 182.6 vs 857.0 ± 449.3 pg/mL， = 0.007）。与 CSF t-tau 正常组相比，高 CSF t-tau 组所有束的分数各向异性值均显著降低（ = 0.036）。与 CSF t-tau 正常组相比，高 CSF t-tau 组在连线测试（TMT）B 部分的得分明显更低（ 得分 45.6 ± 18.8 vs 62.3 ± 10.1， = 0.017）。
我们的研究结果表明，多次脑震荡的前运动员 CSF t-tau 水平升高的风险增加，并且高 CSF t-tau 与 WM 完整性降低和 TMT B 部分得分降低有关。
