A quantitative study of tau pathology in eleven cases of chronic traumatic encephalopathy

R.A. Armstrong, A.C. McKee, T.D. Stein, V.E. Alvarez, N.J. Cairns

Research output: Contribution to journalArticlepeer-review


AIMS: To quantify tau pathology of chronic traumatic encephalopathy (CTE) and investigate influence of dot-like lesions (DL), brain region, co-morbidity, and sporting career length.

METHODS: Densities of neurofibrillary tangles (NFT), astrocytic tangles (AT), DL, oligodendroglial inclusions (GI), neuropil threads (NT), vacuoles, neurons, and enlarged neurons (EN) were measured in tau-immunoreactive sections of upper cortical laminae of frontal and temporal lobe, hippocampus (HC), amygdala, and substantia nigra (SN) of eleven cases of CTE.

RESULTS: DL were a consistent finding in CTE. Densities of NFT, NT and DL were greatest in sectors CA1 and CA2 of the HC. Densities of AT were lower than NFT, small numbers of GI were recorded in temporal lobe, and low densities of vacuoles and EN were consistently present. β-amyloid containing neuritic plaques (NP) also occurred at low density. Densities of NFT, NT, DL, and AT were greater in sulci than gyri while vacuole density was greater in gyri. Principal components analysis (PCA) suggested that sporting career length and densities of NFT in entorhinal cortex, NT in CA2 and SN, and vacuolation in the DG were significant sources of variation among cases.

CONCLUSION: DL are frequent in CTE suggesting affinity with argyrophilic grain disease (AGD) and Parkinson's disease dementia (PD-Dem). Densities of AT in all regions and NT/DL in sectors CA2/4 were consistent features of CTE. The eleven cases are neuropathologically heterogeneous which may result from genetic diversity, and variation in anatomical pathways subjected to trauma. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)154-166
JournalNeuropathology and Applied Neurobiology
Issue number2
Early online date15 Apr 2016
Publication statusPublished - 1 Feb 2017

Bibliographical note

This is the peer reviewed version of the following article: Armstrong, R. A., McKee, A. C., Stein, T. D., Alvarez, V. E., & Cairns, N. J. (2016). A quantitative study of tau pathology in eleven cases of chronic traumatic encephalopathy. Neuropathology and Applied Neurobiology, Early view, which has been published in final form at http://dx.doi.org/10.1111/nan.12323. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.


  • chronic traumatic encephalopathy
  • tau
  • neurofibrillary tangle
  • astrocytic tangle
  • principal component analysis


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