Spinal Cord Tau and Protein Copathologies Associated With Chronic Traumatic Encephalopathy

Are phosphorylated tau (p-tau) and other misfolded protein pathologies present in the spinal cord of individuals with repetitive head impact (RHI) exposure or chronic traumatic encephalopathy neuropathologic change (CTE-NC)?In this case-control study, p-tau pathology in the spinal cord was observed in all CTE-NC cases with RHI, and older cases frequently exhibited phosphorylated TAR DNA-binding protein 43 (64%), amyloid-β (93%), and α-synuclein (50%) pathology; all these pathologies were more prevalent than in controls. Severity of p-tau pathology was associated with clinical symptoms and microglial activation in the spinal cord.These findings suggest that the concept of CTE-NC may need to be expanded to encompass chronic trauma–induced encephalomyelopathy.

Corresponding Author: Gabor G. Kovacs, MD, PhD, Tanz Centre for Research in Neurodegenerative Disease, Krembil Discovery Tower, University of Toronto, 60 Leonard Ave, Toronto, ON M5T 0S8, Canada (gabor.kovacs@uhn.ca).

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