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December 26, 2013Article

Head trauma and in vivo measures of amyloid and neurodegeneration in a population-based study

Michelle M. Mielke, Rodolfo Savica, Heather J. Wiste, Stephen D. Weigand, Prashanthi Vemuri, David S. Knopman, Val J. Lowe, Rosebud O. Roberts, Mary M. Machulda, Yonas E. Geda, Ronald C. Petersen, Clifford R. Jack
First published December 26, 2013, DOI: https://doi.org/10.1212/01.wnl.0000438229.56094.54
Michelle M. Mielke
From the Divisions of Epidemiology (M.M.Mielke, R.O.R., R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (H.J.W., S.D.W.), Department of Health Sciences Research; Departments of Neurology (R.S., D.S.K., R.O.R, R.C.P.), Psychiatry and Psychology (M.M.Machulda), and Radiology (P.V., V.J.L, C.R.J.), Mayo Clinic, Rochester, MN; and Departments of Psychiatry, Psychology, and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
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Rodolfo Savica
From the Divisions of Epidemiology (M.M.Mielke, R.O.R., R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (H.J.W., S.D.W.), Department of Health Sciences Research; Departments of Neurology (R.S., D.S.K., R.O.R, R.C.P.), Psychiatry and Psychology (M.M.Machulda), and Radiology (P.V., V.J.L, C.R.J.), Mayo Clinic, Rochester, MN; and Departments of Psychiatry, Psychology, and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
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Heather J. Wiste
From the Divisions of Epidemiology (M.M.Mielke, R.O.R., R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (H.J.W., S.D.W.), Department of Health Sciences Research; Departments of Neurology (R.S., D.S.K., R.O.R, R.C.P.), Psychiatry and Psychology (M.M.Machulda), and Radiology (P.V., V.J.L, C.R.J.), Mayo Clinic, Rochester, MN; and Departments of Psychiatry, Psychology, and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
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Stephen D. Weigand
From the Divisions of Epidemiology (M.M.Mielke, R.O.R., R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (H.J.W., S.D.W.), Department of Health Sciences Research; Departments of Neurology (R.S., D.S.K., R.O.R, R.C.P.), Psychiatry and Psychology (M.M.Machulda), and Radiology (P.V., V.J.L, C.R.J.), Mayo Clinic, Rochester, MN; and Departments of Psychiatry, Psychology, and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
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Prashanthi Vemuri
From the Divisions of Epidemiology (M.M.Mielke, R.O.R., R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (H.J.W., S.D.W.), Department of Health Sciences Research; Departments of Neurology (R.S., D.S.K., R.O.R, R.C.P.), Psychiatry and Psychology (M.M.Machulda), and Radiology (P.V., V.J.L, C.R.J.), Mayo Clinic, Rochester, MN; and Departments of Psychiatry, Psychology, and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
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David S. Knopman
From the Divisions of Epidemiology (M.M.Mielke, R.O.R., R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (H.J.W., S.D.W.), Department of Health Sciences Research; Departments of Neurology (R.S., D.S.K., R.O.R, R.C.P.), Psychiatry and Psychology (M.M.Machulda), and Radiology (P.V., V.J.L, C.R.J.), Mayo Clinic, Rochester, MN; and Departments of Psychiatry, Psychology, and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
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Val J. Lowe
From the Divisions of Epidemiology (M.M.Mielke, R.O.R., R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (H.J.W., S.D.W.), Department of Health Sciences Research; Departments of Neurology (R.S., D.S.K., R.O.R, R.C.P.), Psychiatry and Psychology (M.M.Machulda), and Radiology (P.V., V.J.L, C.R.J.), Mayo Clinic, Rochester, MN; and Departments of Psychiatry, Psychology, and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
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Rosebud O. Roberts
From the Divisions of Epidemiology (M.M.Mielke, R.O.R., R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (H.J.W., S.D.W.), Department of Health Sciences Research; Departments of Neurology (R.S., D.S.K., R.O.R, R.C.P.), Psychiatry and Psychology (M.M.Machulda), and Radiology (P.V., V.J.L, C.R.J.), Mayo Clinic, Rochester, MN; and Departments of Psychiatry, Psychology, and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
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Mary M. Machulda
From the Divisions of Epidemiology (M.M.Mielke, R.O.R., R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (H.J.W., S.D.W.), Department of Health Sciences Research; Departments of Neurology (R.S., D.S.K., R.O.R, R.C.P.), Psychiatry and Psychology (M.M.Machulda), and Radiology (P.V., V.J.L, C.R.J.), Mayo Clinic, Rochester, MN; and Departments of Psychiatry, Psychology, and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
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Yonas E. Geda
From the Divisions of Epidemiology (M.M.Mielke, R.O.R., R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (H.J.W., S.D.W.), Department of Health Sciences Research; Departments of Neurology (R.S., D.S.K., R.O.R, R.C.P.), Psychiatry and Psychology (M.M.Machulda), and Radiology (P.V., V.J.L, C.R.J.), Mayo Clinic, Rochester, MN; and Departments of Psychiatry, Psychology, and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
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Ronald C. Petersen
From the Divisions of Epidemiology (M.M.Mielke, R.O.R., R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (H.J.W., S.D.W.), Department of Health Sciences Research; Departments of Neurology (R.S., D.S.K., R.O.R, R.C.P.), Psychiatry and Psychology (M.M.Machulda), and Radiology (P.V., V.J.L, C.R.J.), Mayo Clinic, Rochester, MN; and Departments of Psychiatry, Psychology, and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
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Clifford R. Jack Jr
From the Divisions of Epidemiology (M.M.Mielke, R.O.R., R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (H.J.W., S.D.W.), Department of Health Sciences Research; Departments of Neurology (R.S., D.S.K., R.O.R, R.C.P.), Psychiatry and Psychology (M.M.Machulda), and Radiology (P.V., V.J.L, C.R.J.), Mayo Clinic, Rochester, MN; and Departments of Psychiatry, Psychology, and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
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Citation
Head trauma and in vivo measures of amyloid and neurodegeneration in a population-based study
Michelle M. Mielke, Rodolfo Savica, Heather J. Wiste, Stephen D. Weigand, Prashanthi Vemuri, David S. Knopman, Val J. Lowe, Rosebud O. Roberts, Mary M. Machulda, Yonas E. Geda, Ronald C. Petersen, Clifford R. Jack
Neurology Dec 2013, 10.1212/01.wnl.0000438229.56094.54; DOI: 10.1212/01.wnl.0000438229.56094.54

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Abstract

Objectives: We determined whether head trauma was associated with amyloid deposition and neurodegeneration among individuals who were cognitively normal (CN) or had mild cognitive impairment (MCI).

Methods: Participants included 448 CN individuals and 141 individuals with MCI from the Mayo Clinic Study of Aging who underwent Pittsburgh compound B (PiB)-PET, fluorodeoxyglucose-PET, and MRI. Head trauma was defined as a self-reported brain injury with at least momentary loss of consciousness or memory. Regression models examined whether head trauma was associated with each neuroimaging variable (assessed as continuous and dichotomous measures) in both CN and MCI participants, controlling for age and sex.

Results: Among 448 CN individuals, 74 (17%) self-reported a head trauma. There was no difference in any neuroimaging measure between CN subjects with and without head trauma. Of 141 participants with MCI, 25 (18%) self-reported a head trauma. MCI participants with a head trauma had higher amyloid levels (by an average 0.36 standardized uptake value ratio units, p = 0.002).

Conclusions: Among individuals with MCI, but not CN individuals, self-reported head trauma with at least momentary loss of consciousness or memory was associated with greater amyloid deposition, suggesting that head trauma may be associated with Alzheimer disease–related neuropathology. Differences between CN individuals and individuals with MCI raise questions about the relevance of head injury–PET abnormality findings in those with MCI.

  • Received June 27, 2013.
  • Accepted in final form September 18, 2013.
  • © 2013 American Academy of Neurology

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