The following is a summary of “Linking Type and Extent of Head Trauma to Cavum Septum Pellucidum in Older Adults With and Without Alzheimer Disease and Related Dementias,” published in the March 2024 issue of Neurology by Asken, et al.

Researchers conducted a retrospective study to assess how CSP evolves and its presence in healthy versus clinically impaired older adults, all with a documented history of head injuries.

They conducted an observational cohort study at the University of California, San Francisco Memory and Aging Center involving participants categorized as HCs, those with Alzheimer’s disease or related dementias (ADRDs), and a subset with traumatic encephalopathy syndrome (TES). Traumatic brain injury (TBI) and repetitive head impacts (RHI) from contact/collision sports were assessed. Study groups were classified based on RHI/TBI history: no RHI/TBI, prior TBI only, prior RHI only, and prior RHI + TBI. Further analysis delved into TBI (1, 2, or 3+) and RHI (1–4, 5–10, and 11+ years) subgroups. A baseline MRI was performed on all participants, with 67% undergoing a second MRI after a median follow-up of 5.4 years. Measures of CSP included grade (0–4) and length (millimeters). Logistic regression compared groups based on CSP likelihood (ORs) and AUC analysis evaluated CSP length discrimination among groups.

The results showed  266 participants (N = 160 HCs, N = 106 with ADRD or TES), with an average age of 66.8 ± 8.2 years and 45.3% female. Among them, 49.8% had no RHI/TBI, 21.1% had TBI only, 16.6% had RHI only, 12.6% had RHI + TBI, and 7.5% were classified as having TES. Compared to no RHI/TBI, RHI + TBI (OR 3.11 [1.23–7.88]) and TES (OR 11.6 [2.46–54.8]) had increased odds of CSP. Participants with 5–10 years (OR 2.96 [1.13–7.77]) and 11+ years of RHI (OR 3.14 [1.06–9.31]) also had higher odds of CSP. CSP length effectively differentiated participants with 5–10 years (AUC 0.63 [0.51–0.75]) and 11+ years of prior RHI (AUC 0.69 [0.55–0.84]) from those with no RHI/TBI (cut point = 6 mm). Strong associations were observed in analyses of American football participation. Longitudinally, CSP grade remained unchanged at 91.7%, and length remained unchanged at 95.5% of participants.

They concluded that in older adults, RHI over the years, particularly in American football, was a stronger predictor of CSP than the number of diagnosed TBIs.

Source: neurology.org/doi/10.1212/WNL.0000000000209183