Open AccessA population‐based study of head injury, cognitive function and pathological markers
Author(s) -
James SarahNaomi,
Nicholas Jennifer M.,
Lane Christopher A.,
Parker Thomas D.,
Lu Kirsty,
Keshavan Ashvini,
Buchanan Sarah M.,
Keuss Sarah E.,
MurraySmith Heidi,
Wong Andrew,
Cash David M.,
Malone Ian B.,
Barnes Josephine,
Sudre Carole H.,
Coath William,
Prosser Lloyd,
Ourselin Sebastien,
Modat Marc,
Thomas David L.,
Cardoso Jorge,
Heslegrave Amanda,
Zetterberg Henrik,
Crutch Sebastian J.,
Schott Jonathan M.,
Richards Marcus,
Fox Nick C.
Publication year - 2021
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.51331
Subject(s) - medicine , pathological , cognition , head injury , population , pathology , surgery , psychiatry , environmental health
Objective To assess associations between head injury (HI) with loss of consciousness (LOC), ageing and markers of later‐life cerebral pathology; and to explore whether those effects may help explain subtle cognitive deficits in dementia‐free individuals. Methods Participants ( n = 502, age = 69–71) from the 1946 British Birth Cohort underwent cognitive testing (subtests of Preclinical Alzheimer Cognitive Composite), 18 F‐florbetapir A β ‐PET and MR imaging. Measures include A β ‐PET status, brain, hippocampal and white matter hyperintensity (WMH) volumes, normal appearing white matter (NAWM) microstructure, Alzheimer’s disease (AD)‐related cortical thickness, and serum neurofilament light chain (NFL). LOC HI metrics include HI occurring: (i) >15 years prior to the scan (ii) anytime up to age 71. Results Compared to those with no evidence of an LOC HI, only those reporting an LOC HI>15 years prior (16%, n = 80) performed worse on cognitive tests at age 69–71, taking into account premorbid cognition, particularly on the digit‐symbol substitution test (DSST). Smaller brain volume (BV) and adverse NAWM microstructural integrity explained 30% and 16% of the relationship between HI and DSST, respectively. We found no evidence that LOC HI was associated with A β load, hippocampal volume, WMH volume, AD‐related cortical thickness or NFL (all p > 0.01). Interpretation Having a LOC HI aged 50’s and younger was linked with lower later‐life cognitive function at age ~70 than expected. This may reflect a damaging but small impact of HI; explained in part by smaller BV and different microstructure pathways but not via pathology related to AD (amyloid, hippocampal volume, AD cortical thickness) or ongoing neurodegeneration (serum NFL).