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57 Traumatic Brain Injury and Concussion in Patients with Frontotemporal Dementia Spectrum Diagnoses

Published online by Cambridge University Press:  21 December 2023

Jessica Bove*
Affiliation:
University of Florida, Gainesville, FL, USA.
Marguerite Knudtson
Affiliation:
University of California, San Francisco, San Francisco, CA, USA.
Michelle You
Affiliation:
University of California, San Francisco, San Francisco, CA, USA.
Michael L Alosco
Affiliation:
Boston University School of Medicine, Boston, MA, USA
Jesse Mez
Affiliation:
Boston University School of Medicine, Boston, MA, USA
Bruce L Miller
Affiliation:
University of California, San Francisco, San Francisco, CA, USA.
Howie J Rosen
Affiliation:
University of California, San Francisco, San Francisco, CA, USA.
Maria Luisa Gorno-Tempini
Affiliation:
University of California, San Francisco, San Francisco, CA, USA.
William W Seeley
Affiliation:
University of California, San Francisco, San Francisco, CA, USA.
Joel H Kramer
Affiliation:
University of California, San Francisco, San Francisco, CA, USA.
Russell M Bauer
Affiliation:
University of Florida, Gainesville, FL, USA.
Breton M Asken
Affiliation:
University of Florida, Gainesville, FL, USA. University of California, San Francisco, San Francisco, CA, USA.
*
Correspondence: Jessica Bove, University of Florida, Department of Clinical and Health Psychology, bovej@ufl.edu
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Abstract

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Objective:

Traumatic brain injury (TBI) and concussion are associated with increased dementia risk. Accurate TBI/concussion exposure estimates are relatively unknown for less common neurodegenerative conditions like frontotemporal dementia (FTD). We evaluated lifetime TBI and concussion frequency in patients diagnosed with a range of FTD spectrum conditions and related prior head trauma to cavum septum pellucidum (CSP) characteristics observable on MRI.

Participants and Methods:

We administered the Ohio State University TBI Identification and Boston University Head Impact Exposure Assessment to 108 patients (age 69.5 ± 8.0, 35% female, 93% white or unknown race) diagnosed at the UCSF Memory and Aging Center with one of the following FTD or related conditions: behavioral variant frontotemporal dementia (N=39), semantic variant primary progressive aphasia (N=16), nonfluent variant PPA (N=23), corticobasal syndrome (N=14), or progressive supranuclear palsy (N=16). Data were also obtained from 217 controls (“HC”; age 76.8 ± 8.0, 53% female, 91% white or unknown race). CSP characteristics were defined based on width or “grade” (0-1 vs. 2+) and length of anterior-posterior separation (millimeters). We first describe frequency of any and multiple (2+) prior TBI based on different but commonly used definitions: TBI with loss of consciousness (LOC), TBI with LOC or posttraumatic amnesia (LOC/PTA), TBI with LOC/PTA or other symptoms like dizziness, nausea, “seeing stars,” etc. (“concussion”). TBI/concussion frequency was then compared between FTD and HC using chi-square. Associations between TBI/concussion and CSP characteristics were analyzed with chi-square (CSP grade) and Mann-Whitney U tests (CSP length). We explored sex differences due to typically higher rates of TBI among males.

Results:

History of any TBI with LOC (FTD=20.0%, HC=19.2%), TBI with LOC/PTA (FTD:32.2%, HC=31.5%), and concussion (FTD: 50.0%, HC=44.3%) was common but not different between study groups (p’s>.4). In both FTD and HC, prior TBI/concussion was nominally more frequent in males but not significantly greater than females. Frequency of repeat TBI/concussion (2+) also did not differ significantly between FTD and HC (repeat TBI with LOC: 6.7% vs. 3.3%, TBI with LOC/PTA: 12.2% vs. 10.3%, concussion: 30.2% vs. 28.7%; p’s>.2). Prior TBI/concussion was not significantly related to CSP grade or length in the total sample or within the FTD or HC groups.

Conclusions:

TBI/concussion rates depend heavily on the symptom definition used for classifying prior injury. Lifetime symptomatic TBI/concussion is common but has an unclear impact on risk for FTD-related diagnoses. Larger samples are needed to appropriately evaluate sex differences, to evaluate whether TBI/concussion rates differ between specific FTD phenotypes, and to understand the rates and effects of more extensive repetitive head trauma (symptomatic and asymptomatic) in patients with FTD.

Type
Poster Session 01: Medical | Neurological Disorders | Neuropsychiatry | Psychopharmacology
Copyright
Copyright © INS. Published by Cambridge University Press, 2023