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Fig. 2 | Acta Neuropathologica Communications

Fig. 2

From: Identifying degenerative effects of repetitive head trauma with neuroimaging: a clinically-oriented review

Fig. 2

Representative slices of antemortem structural T1 magnetic resonance imaging (T1 MRI), FDG-PET, Aβ-PET (PIB), and tau-PET (FTP) for 2 clinically impaired adults with prior repetitive head trauma meeting criteria for “Probable CTE” (see text for case descriptions). Patient #1 had a primary neuropathologic diagnosis of CTE (Stage IV) with contributing hippocampal sclerosis and left subiculum microinfarct (no AD pathology observed). Patient #2 had a primary neuropathologic diagnosis of FTLD-tau (corticobasal degeneration) with contributing hippocampal sclerosis and unclassifiable FTLD-TDP-43 inclusions (no CTE or AD pathology observed). For FDG-PET, cooler colors represent areas of decreased glucose uptake (hypometabolism). For PIB-PET, warmer colors represent increased tracer uptake. A positive Aβ-PET scan is represented by increased tracer uptake diffusely throughout the cortex. In both patients, Aβ tracer uptake is restricted to the white matter, which is considered non-specific and represents a negative Aβ-PET scan. For FTP-PET, warmer colors represent areas of increased tracer binding. A “positive” scan for AD neurofibrillary tangles requires contiguous neocortical uptake in the posterolateral temporal, occipital, or parietal/precuneus regions with or without frontal uptake. Neither patient showed a typical AD pattern of FTP tracer uptake, while both showed evidence of nonspecific, scattered frontotemporal uptake and non-specific increased signal in the basal ganglia. Slices were chosen to highlight cavum septum pellucidum (T1 MRI) or representative areas of hypometabolism (FDG-PET) and Aβ/tau tracer uptake. Additional brain slices for PET scans from each case are provided in supplemental material

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