It is presently unknown whether military service members are at risk for chronic traumatic encephalopathy (CTE) or Alzheimer’s disease (AD) pathology, due to traumatic brain injury (TBI). Studies with respect to AD have had mixed results with respect to mild TBI, although an increased risk of clinical AD with moderate and severe TBI is more consistently demonstrated. No studies to date have demonstrated a longitudinal progression from TBI to autopsy. We therefore initiated a cross-sectional survey of former military service members. 18 brain specimens have been examined to date that had extensive sampling, with an additional 64 specimens with limited sampling. The mean age was 68.4 years across all cases. Of these 82 cases, 26% were combat veterans. 13% noted a TBI history, either on active duty or in civilian life. 53% had a history of psychiatric problems, including 20% with post-traumatic stress disorder (PTSD). 17% reported neurological problems. No cases had CTE pathology. Assessment for proteinopathy by Braak staging and modified CERAD plaque scores showed averages of 2.41 and 0.78, respectively, which was essentially identical to age-matched controls (2.46 and 0.77, respectively). In the extensively sampled cases, there was no relationship between p-tau in the amygdala and psychiatric signs, including PTSD.ThesedatasuggestthatmilitaryserviceperseisnotariskfactorforCTEpathologyorneurodegenerativeproteinopathy. More research is needed to study the relationship, if any, between TBI and neurodegenerative proteinopathy.
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