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Early-Onset Dementia in War Veterans: Brain Polypathology and Clinicopathologic Complexity
Diego Iacono1,2,3,4,5, Patricia Lee1,4, Brian L Edlow1,6
1Brain Tissue Repository & Neuropathology Core, Center for Neuroscience and Regenerative Medicine (CNRM), Uniformed Services University (USU), Bethesda, Maryland.
Journal of Neuropathology and Experimental Neurology
|December 19, 2019
Summary
Military veterans with early-onset dementia exhibit unique brain pathologies, not fitting classic diagnoses like Alzheimer's disease. These complex lesions, including white matter injury, highlight the need for further research into TBI and stress impacts.
Area of Science:
- Neuropathology
- Neurodegenerative Diseases
- Military Health
Background:
- Cognitive decline in military personnel after traumatic brain injury (TBI) and chronic stress is poorly understood.
- Limited research exists on clinicopathologic correlations between neurodegenerative markers, neuroinflammation, white matter lesions, and neuropsychiatric disorders in veterans.
Purpose of the Study:
- To describe clinicopathologic findings in four military veterans with early-onset dementia (EOD).
- To investigate correlations between TBI history, cognitive decline, behavioral abnormalities, and neuropathology.
Main Methods:
- Case series describing clinicopathologic findings in four military veterans with EOD.
- Analysis of neuropathology including phosphorylated-tau tangles, beta-amyloid plaques, neuroinflammation, and white matter lesions.
- Ultrahigh resolution ex vivo MRI was used to examine brain tissue in two cases.
Main Results:
- Pathologic lesions did not fit classic diagnoses (Alzheimer's disease, CTE, TAI).
- Observed a mixture of polypathology with unusual patterns compared to AD or other dementias.
- Revealed atypical patterns of periventricular white matter injury in two cases.
Conclusions:
- Military EOD cases present with atypical combinations and distributions of brain lesions.
- Findings differ from pathologies typically seen in non-military populations.
- Further prospective studies are needed to elucidate clinicopathologic correlations in military EOD.
Keywords:
Brain co-occurring pathologiesChronic stressCombat-TBIHistologic distributionShort- and long-terms neuropsychiatric manifestations in veteransWar settingsMore Related Videos
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