Brain and blood biomarkers of tauopathy and neuronal injury in humans and rats with neurobehavioral syndromes following blast exposure

Dara L. Dickstein, Rita De Gasperi, Miguel A. Gama Sosa, Georgina Perez-Garcia, Jennifer A. Short, Heidi Sosa, Gissel M. Perez, Anna E. Tschiffely, Kristen Dams-O’Connor, Mariel Y. Pullman, Karin Knesaurek, Andrew Knutsen, Dzung L. Pham, Lale Soleimani, Barry D. Jordan, Wayne A. Gordon, Bradley N. Delman, Gleb Shumyatsky, Pashtun Poh Shahim, Steven T. DeKoskyJames R. Stone, Elaine Peskind, Kaj Blennow, Henrik Zetterberg, Steven A. Chance, Mario Torso, Lale Kostakoglu, Mary Sano, Patrick R. Hof, Stephen T. Ahlers, Sam Gandy*, Gregory A. Elder*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Traumatic brain injury (TBI) is a risk factor for the later development of neurodegenerative diseases that may have various underlying pathologies. Chronic traumatic encephalopathy (CTE) in particular is associated with repetitive mild TBI (mTBI) and is characterized pathologically by aggregation of hyperphosphorylated tau into neurofibrillary tangles (NFTs). CTE may be suspected when behavior, cognition, and/or memory deteriorate following repetitive mTBI. Exposure to blast overpressure from improvised explosive devices (IEDs) has been implicated as a potential antecedent for CTE amongst Iraq and Afghanistan Warfighters. In this study, we identified biomarker signatures in rats exposed to repetitive low-level blast that develop chronic anxiety-related traits and in human veterans exposed to IED blasts in theater with behavioral, cognitive, and/or memory complaints. Rats exposed to repetitive low-level blasts accumulated abnormal hyperphosphorylated tau in neuronal perikarya and perivascular astroglial processes. Using positron emission tomography (PET) and the [18F]AV1451 (flortaucipir) tau ligand, we found that five of 10 veterans exhibited excessive retention of [18F]AV1451 at the white/gray matter junction in frontal, parietal, and temporal brain regions, a typical localization of CTE tauopathy. We also observed elevated levels of neurofilament light (NfL) chain protein in the plasma of veterans displaying excess [18F]AV1451 retention. These findings suggest an association linking blast injury, tauopathy, and neuronal injury. Further study is required to determine whether clinical, neuroimaging, and/or fluid biomarker signatures can improve the diagnosis of long-term neuropsychiatric sequelae of mTBI.

Original languageEnglish
Pages (from-to)5940-5954
Number of pages15
JournalMolecular Psychiatry
Issue number10
StatePublished - Oct 2021
Externally publishedYes


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