Chronic Traumatic Encephalopathy in a Routine Neuropathology Service in Australia.

Area of Science:

• Neuropathology
• Neuroscience
• Forensic Pathology

Background:

• Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease characterized by abnormal tau protein accumulation.
• Diagnosis is definitive only through postmortem examination of brain tissue.
• Current diagnostic protocols may not consistently identify all CTE cases.

Purpose of the Study:

• To evaluate the utility of a routine 3-block p-tau immunohistochemistry screening protocol for identifying CTE in autopsy brains.
• To determine the prevalence of low-stage CTE in a consecutive autopsy series.
• To explore the association between head injury history and CTE diagnosis.

Main Methods:

• Implementation of a departmental protocol for CTE screening using p-tau immunohistochemistry on frontal, temporal, and parietal neocortical blocks.
• Analysis of 180 consecutive autopsy cases.
• Review of clinical histories for documented or suspected traumatic brain injury.

Main Results:

• Four cases of low-stage CTE were identified from 180 autopsies (2.2% prevalence).
• Two CTE cases had documented head injury history; two others had histories of epilepsy suggesting potential undocumented injuries.
• The 3-block screening strategy proved effective in detecting CTE in routine practice.

Conclusions:

• Routine 3-block p-tau screening is a valuable tool for identifying CTE in autopsy practice.
• The findings reinforce the link between head trauma and CTE.
• CTE can occur in the general population, even with non-documented head injuries.