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Leonard B Jung

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Arciniega H, Baucom ZH, Tuz-Zahra F, Tripodis Y, John O, Carrington H, Kim N, Knyazhanskaya EE, Jung LB, Breedlove K, Wiegand TLT, Daneshvar DH, Rushmore RJ, Billah T, Pasternak O, Coleman MJ, Adler CH, Bernick C, Balcer LJ, Alosco ML, Koerte IK, Lin AP, Cummings JL, Reiman EM, Stern RA, Shenton ME, Bouix S. Brain morphometry in former American football players: Findings from the DIAGNOSE CTE research project. Brain 2024:awae098. [PMID: 38533783 DOI: 10.1093/brain/awae098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 02/16/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open

Abstract

Exposure to repetitive head impacts (RHIs) in contact sports is associated with neurodegenerative disorders including chronic traumatic encephalopathy (CTE) which currently can be diagnosed only at postmortem. American football players are at higher risk of developing CTE given their exposure to RHIs. One promising approach for diagnosing CTE in vivo is to explore known neuropathological abnormalities at postmortem in living individuals using structural magnetic resonance imaging (MRI). MRI brain morphometry was evaluated in 170 male former American football players ages 45-74 years (n = 114 professional; n = 56 college) and 54 same-age unexposed asymptomatic male controls (n = 58 age range 45-74). Cortical thickness and volume of regions of interest were selected based on established CTE pathology findings and were assessed using FreeSurfer. Group differences and interactions with age and exposure factors were evaluated using a generalized least squares model. A separate logistic regression and independent multinomial model were performed to predict each Traumatic Encephalopathy Syndrome (TES) diagnosis core clinical features and provisional level of certainty for CTE pathology using brain regions of interest. Former college and professional American football players (combined) showed significant cortical thickness and/or volume reductions compared to unexposed asymptomatic controls in the hippocampus amygdala entorhinal cortex parahippocampal gyrus insula temporal pole and superior frontal gyrus. Post-hoc analyses identified group-level differences between former professional players and unexposed asymptomatic controls in the hippocampus amygdala entorhinal cortex parahippocampal gyrus insula and superior frontal gyrus. Former college players showed significant volume reductions in the hippocampus amygdala and superior frontal gyrus compared to the unexposed asymptomatic controls. We did not observe age-by-group interactions for brain morphometric measures. Interactions between morphometry and exposure measures were limited to a single significant positive association between the age of first exposure to organized tackle football and right insular volume. We found no significant relationship between brain morphometric measures and the TES diagnosis core clinical features and provisional level of certainty for CTE pathology outcomes. These findings suggest that MRI morphometrics detects abnormalities in individuals with a history of RHI exposure that resemble the anatomic distribution of pathological findings from postmortem CTE studies. The lack of findings associating MRI measures with exposure metrics (except for one significant relationship) or TES diagnosis and core clinical features suggests that brain morphometry must be complemented by other types of measures to characterize individuals with RHIs.

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Affiliation(s)

Hector Arciniega Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02145, USA Department of Rehabilitation Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA NYU Concussion Center, NYU Langone Health, New York, NY 10016, USA
Zachary H Baucom Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
Fatima Tuz-Zahra Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
Yorghos Tripodis Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
Omar John Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02145, USA Department of Rehabilitation Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA NYU Concussion Center, NYU Langone Health, New York, NY 10016, USA
Holly Carrington Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02145, USA
Nicholas Kim Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02145, USA
Evdokiya E Knyazhanskaya Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02145, USA
Leonard B Jung Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02145, USA cBRAIN, Department of Child and Adolescent Psychiatry Psychosomatics and Psychotherapy, University Hospital Ludwig-Maximilians-Universität, 80336 Munich, Bavaria, Germany
Katherine Breedlove Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
Tim L T Wiegand Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02145, USA cBRAIN, Department of Child and Adolescent Psychiatry Psychosomatics and Psychotherapy, University Hospital Ludwig-Maximilians-Universität, 80336 Munich, Bavaria, Germany
Daniel H Daneshvar Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA 02114, USA Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA 02129, USA
R Jarrett Rushmore Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02145, USA Department of Anatomy and Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
Tashrif Billah Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02145, USA
Ofer Pasternak Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02145, USA Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
Michael J Coleman Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02145, USA
Charles H Adler Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona Scottsdale, AZ 85259, USA
Charles Bernick Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV 89106, USA Department of Neurology, University of Washington, Seattle, WA 98195, USA
Laura J Balcer Department of Neurology, NYU Grossman School of Medicine, New York, NY 10017, USA Department of Population Health, NYU Grossman School of Medicine, New York, NY 10017, USA Department of Ophthalmology, NYU Grossman School of Medicine, New York, NY,10017, USA
Michael L Alosco Department of Neurology, Boston University Alzheimer's Disease Research Center and CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
Inga K Koerte Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02145, USA cBRAIN, Department of Child and Adolescent Psychiatry Psychosomatics and Psychotherapy, University Hospital Ludwig-Maximilians-Universität, 80336 Munich, Bavaria, Germany Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA Graduate School of Systemic Neurosciences, Ludwig-Maximilians-Universität, 82152 Munich, Bavaria, Germany
Alexander P Lin Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
Jeffrey L Cummings Chambers-Grundy Center for Transformative Neuroscience, Pam Quirk Brain Health and Biomarker Laboratory, Department of Brain Health School of Integrated Health Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
Eric M Reiman Banner Alzheimer's Institute and Arizona Alzheimer's Consortium, Phoenix, AZ 85006, USA Department of Psychiatry, University of Arizona, Phoenix, AZ 85004, USA Department of Psychiatry, Arizona State University, Phoenix, AZ 85008, USA Neurogenomics Division, Translational Genomics Research Institute and Alzheimer's Consortium, Phoenix, AZ 85004, USA
Robert A Stern Department of Anatomy and Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA Department of Neurology, Boston University Alzheimer's Disease Research Center and CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA Department of Neurosurgery, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
Martha E Shenton Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02145, USA Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
Sylvain Bouix Department of Software Engineering and Information Technology, École de technologie supérieure, Université du Québec, Montréal, QC, H3C 1K3, Canada

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Pankatz L, Rojczyk P, Seitz-Holland J, Bouix S, Jung LB, Wiegand TLT, Bonke EM, Sollmann N, Kaufmann E, Carrington H, Puri T, Rathi Y, Coleman MJ, Pasternak O, George MS, McAllister TW, Zafonte R, Stein MB, Marx CE, Shenton ME, Koerte IK. Adverse Outcome Following Mild Traumatic Brain Injury Is Associated with Microstructure Alterations at the Gray and White Matter Boundary. J Clin Med 2023;12:5415. [PMID: 37629457 PMCID: PMC10455493 DOI: 10.3390/jcm12165415] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/31/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open

Affiliation(s)

Lara Pankatz Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.) cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
Philine Rojczyk Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.) cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
Johanna Seitz-Holland Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.) Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
Sylvain Bouix Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.) Département de génie logiciel et TI, École de Technologie Supérieure, Université du Québec, Montreal, QC H3C 1K3, Canada
Leonard B. Jung Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.) cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
Tim L. T. Wiegand Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.) cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
Elena M. Bonke Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.) cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany Graduate School of Systemic Neuroscience, Ludwig-Maximilians-Universität, 82152 Planegg, Germany
Nico Sollmann Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.) cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany Department of Diagnostic and Interventional Radiology, University Hospital Ulm, 89081 Ulm, Germany Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
Elisabeth Kaufmann Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.) cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany Department of Neurology, University Hospital, LMU, 81377 Munich, Germany
Holly Carrington Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.) Brain Injury Research Center of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Twishi Puri Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
Yogesh Rathi Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
Michael J. Coleman Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.)
Ofer Pasternak Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.) Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
Mark S. George Psychiatry Department, Medical University of South Carolina, Charleston, SC 29425, USA; Ralph H. Johnson VA Medical Center, Charleston, SC 29401, USA
Thomas W. McAllister Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202, USA;
Ross Zafonte Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA 02129, USA; Department of Physical Medicine and Rehabilitation, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
Murray B. Stein Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA; School of Public Health, University of California San Diego, La Jolla, CA 92093, USA Psychiatry Service, VA San Diego Healthcare System, San Diego, CA 92161, USA
Christine E. Marx VA Mid-Atlantic Mental Illness Research and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavior Sciences, Duke University School of Medicine, Durham, NC 27710, USA
Martha E. Shenton Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.) Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
Inga K. Koerte Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA 02145, USA; (L.P.); (P.R.); (J.S.-H.); (S.B.); (L.B.J.); (T.L.T.W.); (E.M.B.); (N.S.); (E.K.); (H.C.); (T.P.); (Y.R.); (M.J.C.); (O.P.); (M.E.S.) cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, 80336 Munich, Germany Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA Graduate School of Systemic Neuroscience, Ludwig-Maximilians-Universität, 82152 Planegg, Germany

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B. Jung L, A. Gudera J, L. T. Wiegand* T, Allmendinger S, Dimitriadis K, K. Koerte I. ChatGPT Passes German State Examination in Medicine With Picture Questions Omitted. Dtsch Arztebl Int 2023;120:373-374. [PMID: 37530052 PMCID: PMC10413971 DOI: 10.3238/arztebl.m2023.0113] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 03/14/2023] [Accepted: 04/25/2023] [Indexed: 08/03/2023]

Affiliation(s)

Leonard B. Jung * The authors share joint first authorship cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität München, München (Jung, Wiegand, Koerte) Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA (Jung, Wiegand, Koerte)
Jonas A. Gudera * The authors share joint first authorship LMU AIM, Ludwig-Maximilians-Universität, München (Gudera, Wiegand) Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-Universität, München (Gudera) Dana-Farber/Boston Children‘s Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA (Gudera)
Tim L. T. Wiegand* * The authors share joint first authorship cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität München, München (Jung, Wiegand, Koerte) Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA (Jung, Wiegand, Koerte) LMU AIM, Ludwig-Maximilians-Universität, München (Gudera, Wiegand)
Simeon Allmendinger Karlsruhe Institute of Technology, Karlsruhe (Allmendinger)
Konstantinos Dimitriadis Neurological Clinic and Policlinic, Großhadern Hospital, Ludwig-Maximilians-Universität, München (Dimitriadis) Institute for Stroke and Dementia Research (ISD), Ludwig-Maximilians-Universität, München
Inga K. Koerte * The authors share joint first authorship cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität München, München (Jung, Wiegand, Koerte) Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA (Jung, Wiegand, Koerte) Graduate School of Systemic Neurosciences, Ludwig-Maximilians-Universität, München (Koerte) Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA (Koerte)

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