Neurotrauma: 2024 update

Abstract

2023 was an important year for research in traumatic brain injury (TBI), particularly as it concerned interests in neuropathology. After reviewing the literature, we present the advancements that we felt were of particular importance to the neuropathology community. Highlighted are articles that report upon: (1) the first large-cohort assessment for the neuropathology of intimate partner violence, (2) the assessment of chronic traumatic encephalopathy (CTE) in young athletes, (3) the observation of cortical sulcal depth vascular changes in CTE, (4) a proposal for a tau immunohistochemical panel to evaluate complex cases of CTE in the context of multiple tauopathies, (5) the relationship of TBI and/or CTE with TDP-43 pathology, (6) repetitive TBI inducing pathology in C9orf72-transgenic mice, (7) radiologic patterns of head and neck injury following vehicular underbody blast exposure, (8) chronic alterations in brain metal content following repetitive impact TBI, (9) neurovascular unit injury following low-level blast exposure, and finally (10) an assessment of Muhammad Ali's clinical history leading to the conclusion that he suffered from young-onset, idiopathic Parkinson Disease. We close our writing with in memoriam to Dr. Byron A. Kakulas, a renowned figure in the neuropathology of spinal cord injury who we lost in 2023.

Keywords: Blast; Chronic traumatic encephalopathy; Intimate partner violence; Neurovascular; TDP43; Traumatic brain injury.

Figure 1

Figure 1. Total PubMed listings regarding intimate partner violence (IPV) and related terms, by year. Medical research interest in IPV has grown substantially in recent years, particularly in the most recent decade, as is easily demonstrated by the dramatic increases in annual publications for IPV and related terms (domestic violence, domestic abuse) indexed by PubMed. Within the box are the proportions of the total number of publications regarding a given term that have been published within the last decade, i.e. though the first publication listed in PubMed utilizing the term IPV appeared in 1976, 63.5 % of the total studies using this term have emerged only in the last decade.

Figure 2

Figure 2. Chronic traumatic encephalopathy (CTE) overlap with Alzheimer disease. CTE neuropathology overlapping with Alzheimer neuropathologic change in the brain of a 72 year-old man with a history of repetitive impact-type traumatic brain injury. A: AT8 immunohistochemical stain (scale bar = 4 mm) performed on a sample from the orbitofrontal cortex demonstrating phosphorylated tau aggregation throughout the cortex in a pattern consistent with Alzheimer disease, overlapped by sulcal depth aggregations corresponding to CTE. B: AT8 immunohistochemical stain (scale bar = 200 μm) performed on a sample from the dorsolateral prefrontal cortex demonstrating extensive perivascular phosphorylated tau aggregation; this was identified at a sulcal depth. C: 4G8 immunohistochemical stain (scale bar = 4 mm) performed on a sample from the orbitofrontal cortex demonstrating florid involvement by Aβ plaques.

Figure 3

Figure 3. In memory of Dr. Byron Kakulas Dr. Kakulas (left) can be seen here along with his wife, Valerie (middle), and Dr. Daniel Perl (right).