Premium
Validity of the 2014 traumatic encephalopathy syndrome criteria for CTE pathology
Author(s) -
Mez Jesse,
Alosco Michael L.,
Daneshvar Daniel H.,
Saltiel Nicole,
Baucom Zachary,
Abdolmohammadi Bobak,
Uretsky Madeline,
Nicks Raymond,
Martin Brett M.,
Palmisano Joseph N.,
Nowinski Christopher J.,
Montenigro Philip,
Solomon Todd M.,
Mahar Ian,
Cherry Jonathan D.,
Alvarez Victor E.,
Dwyer Brigid,
Goldstein Lee E.,
Katz Douglas I.,
Cantu Robert C.,
Kowall Neil W.,
Tripodis Yorghos,
Huber Bertrand R.,
Stein Thor D.,
Stern Robert A.,
McKee Ann C.
Publication year - 2021
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.12338
Subject(s) - chronic traumatic encephalopathy , medicine , medical diagnosis , odds ratio , depression (economics) , traumatic brain injury , physical therapy , mood , pediatrics , pathology , poison control , concussion , psychiatry , injury prevention , emergency medicine , economics , macroeconomics
Abstract Introduction Validity of the 2014 traumatic encephalopathy syndrome (TES) criteria, proposed to diagnose chronic traumatic encephalopathy (CTE) in life, has not been assessed. Methods A total of 336 consecutive brain donors exposed to repetitive head impacts from contact sports, military service, and/or physical violence were included. Blinded to clinical information, neuropathologists applied National Institute on Neurological Disorders and Stroke/National Institute of Biomedical Imaging and Bioengineering CTE criteria. Blinded to neuropathological information, clinicians interviewed informants and reviewed medical records. An expert panel adjudicated TES diagnoses. Results A total of 309 donors were diagnosed with TES; 244 donors had CTE pathology. TES criteria demonstrated sensitivity and specificity of 0.97 and 0.21, respectively. Cognitive (odds ratio [OR] = 3.6; 95% confidence interval [CI]: 1.2–5.1), but not mood/behavior or motor symptoms, were significantly associated with CTE pathology. Having Alzheimer's disease (AD) pathology was significantly associated with reduced TES accuracy (OR = 0.27; 95% CI: 0.12–0.59). Discussion TES criteria provided good evidence to rule out, but limited evidence to rule in, CTE pathology. Requiring cognitive symptoms in revised criteria and using AD biomarkers may improve CTE pathology prediction.