18F-MK-6240 tau PET in patients at-risk for chronic traumatic encephalopathy

Abstract Background Molecular biomarkers of chronic traumatic encephalopathy (CTE) are lacking. We evaluated 18F-MK-6240 tau PET as a biomarker for CTE. Two studies were done: (1) 3H-MK-6240 autoradiography and an in-vitro brain homogenate binding studies on postmortem CTE tissue, (2) an in-vivo 18F...

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Main Authors: Michael L. Alosco, Jhony Mejía Pérez, Julia E. Culhane, Ranjani Shankar, Christopher J. Nowinski, Samantha Bureau, Nidhi Mundada, Karen Smith, Alinda Amuiri, Breton Asken, Jenna R. Groh, Annalise Miner, Erika Pettway, Sydney Mosaheb, Yorghos Tripodis, Charles Windon, Gustavo Mercier, Robert A. Stern, Lea T. Grinberg, David N. Soleimani-Meigooni, Bradley T. Christian, Tobey J. Betthauser, Thor D. Stein, Ann C. McKee, Chester A. Mathis, Eric E. Abrahamson, Milos D. Ikonomovic, Sterling C. Johnson, Jesse Mez, Renaud La Joie, Daniel Schonhaut, Gil D. Rabinovici
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Language:English
Published: BMC 2025-02-01
Series:Molecular Neurodegeneration
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Online Access:https://doi.org/10.1186/s13024-025-00808-1
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author Michael L. Alosco
Jhony Mejía Pérez
Julia E. Culhane
Ranjani Shankar
Christopher J. Nowinski
Samantha Bureau
Nidhi Mundada
Karen Smith
Alinda Amuiri
Breton Asken
Jenna R. Groh
Annalise Miner
Erika Pettway
Sydney Mosaheb
Yorghos Tripodis
Charles Windon
Gustavo Mercier
Robert A. Stern
Lea T. Grinberg
David N. Soleimani-Meigooni
Bradley T. Christian
Tobey J. Betthauser
Thor D. Stein
Ann C. McKee
Chester A. Mathis
Eric E. Abrahamson
Milos D. Ikonomovic
Sterling C. Johnson
Jesse Mez
Renaud La Joie
Daniel Schonhaut
Gil D. Rabinovici
author_facet Michael L. Alosco
Jhony Mejía Pérez
Julia E. Culhane
Ranjani Shankar
Christopher J. Nowinski
Samantha Bureau
Nidhi Mundada
Karen Smith
Alinda Amuiri
Breton Asken
Jenna R. Groh
Annalise Miner
Erika Pettway
Sydney Mosaheb
Yorghos Tripodis
Charles Windon
Gustavo Mercier
Robert A. Stern
Lea T. Grinberg
David N. Soleimani-Meigooni
Bradley T. Christian
Tobey J. Betthauser
Thor D. Stein
Ann C. McKee
Chester A. Mathis
Eric E. Abrahamson
Milos D. Ikonomovic
Sterling C. Johnson
Jesse Mez
Renaud La Joie
Daniel Schonhaut
Gil D. Rabinovici
author_sort Michael L. Alosco
collection DOAJ
description Abstract Background Molecular biomarkers of chronic traumatic encephalopathy (CTE) are lacking. We evaluated 18F-MK-6240 tau PET as a biomarker for CTE. Two studies were done: (1) 3H-MK-6240 autoradiography and an in-vitro brain homogenate binding studies on postmortem CTE tissue, (2) an in-vivo 18F-MK-6240 tau PET study in former American football players. Methods Autoradiography and in-vitro binding studies were done using 3H-MK-6240 on frozen temporal and frontal cortex tissue from six autopsy cases with stage III CTE compared to Alzheimer’s disease. Thirty male former National Football League (NFL) players with cognitive concerns (mean age = 58.9, SD = 7.8) completed tau (18F-MK-6240) and Aβ (18F-Florbetapir) PET. Controls included 39 Aβ-PET negative, cognitively normal males (mean age = 65.7, SD = 6.3). 18F-MK-6240 SUVr images were created using 70–90 min post-injection data with inferior cerebellar gray matter as the reference. We compared SUVr between players and controls using voxelwise and region-of-interest approaches. Correlations between 18F-MK-6240 SUVr and cognitive scores were tested. Results All six CTE stage III cases had Braak NFT stage III but no neuritic plaques. Two had Thal Phase 1 for Aβ; one showed a laminar pattern of 3H-MK-6240 autoradiography binding in the superior temporal cortex and less so in the dorsolateral frontal cortex, corresponding to tau-immunoreactive lesions detected using the AT8 antibody (pSer202/pThr205 tau) in adjacent tissue sections. The other CTE cases had low frequencies of cortical tau-immunoreactive deposits and no well-defined autoradiography binding. In-vitro 3H-MK-6240 binding studies to CTE brain homogenates in the case with autoradiography signal indicated high binding affinity (KD = 2.0 ± 0.9 nM, Bmax = 97 ± 24 nM, n = 3). All NFL players had negative Aβ-PET. There was variable, low-to-intermediate intensity 18F-MK-6240 uptake across participants: 16 had no cortical signal, 7 had medial temporal lobe (MTL) uptake, 2 had frontal uptake, and 4 had MTL and frontal uptake. NFL players had higher SUVr in the entorhinal cortex (d = 0.86, p = 0.001), and the parahippocampal gyrus (d = 0.39, p = 0.08). Voxelwise regressions showed increased uptake in NFL players in two bilateral anterior MTL clusters (p < 0.05 FWE). Higher parahippocampal and frontal–temporal SUVrs correlated with worse memory (r = -0.38, r = -0.40) and semantic fluency (r = -0.38, r = -0.48), respectively. Conclusion We present evidence of 3H-MK-6240 in-vitro binding to post-mortem CTE tissue homogenates and in vivo 18F-MK-6240 PET binding in the MTL among a subset of participants. Additional studies in larger samples and PET-to-autopsy correlations are required to further elucidate the potential of 18F-MK-6240 to detect tau pathology in CTE.
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spelling doaj-art-a661bb9efba04976bec858a99dcc85ac2025-08-20T03:03:23ZengBMCMolecular Neurodegeneration1750-13262025-02-0120111910.1186/s13024-025-00808-118F-MK-6240 tau PET in patients at-risk for chronic traumatic encephalopathyMichael L. Alosco0Jhony Mejía Pérez1Julia E. Culhane2Ranjani Shankar3Christopher J. Nowinski4Samantha Bureau5Nidhi Mundada6Karen Smith7Alinda Amuiri8Breton Asken9Jenna R. Groh10Annalise Miner11Erika Pettway12Sydney Mosaheb13Yorghos Tripodis14Charles Windon15Gustavo Mercier16Robert A. Stern17Lea T. Grinberg18David N. Soleimani-Meigooni19Bradley T. Christian20Tobey J. Betthauser21Thor D. Stein22Ann C. McKee23Chester A. Mathis24Eric E. Abrahamson25Milos D. Ikonomovic26Sterling C. Johnson27Jesse Mez28Renaud La Joie29Daniel Schonhaut30Gil D. Rabinovici31Department of Neurology, Boston University Alzheimer’s Disease Research Center, Boston University CTE Center, Boston University, Chobanian & Avedisian School of MedicineDepartment of Neurology, Alzheimer’s Disease Research Center, Memory & Aging Center, University of California San FranciscoDepartment of Neurology, Boston University Alzheimer’s Disease Research Center, Boston University CTE Center, Boston University, Chobanian & Avedisian School of MedicineDepartment of Neurology, Alzheimer’s Disease Research Center, Memory & Aging Center, University of California San FranciscoConcussion Legacy FoundationConcussion Legacy FoundationDepartment of Neurology, Alzheimer’s Disease Research Center, Memory & Aging Center, University of California San FranciscoDepartment of Neurology, Alzheimer’s Disease Research Center, Memory & Aging Center, University of California San FranciscoDepartment of Neurology, Alzheimer’s Disease Research Center, Memory & Aging Center, University of California San FranciscoDepartment of Clinical & Health Psychology, 1Florida Alzheimer’s Disease Research Center, Fixel Institute for Neurological Diseases, University of FloridaDepartment of Neurology, Boston University Alzheimer’s Disease Research Center, Boston University CTE Center, Boston University, Chobanian & Avedisian School of MedicineDepartment of Neurology, Boston University Alzheimer’s Disease Research Center, Boston University CTE Center, Boston University, Chobanian & Avedisian School of MedicineDepartment of Neurology, Boston University Alzheimer’s Disease Research Center, Boston University CTE Center, Boston University, Chobanian & Avedisian School of MedicineDepartment of Neurology, Boston University Alzheimer’s Disease Research Center, Boston University CTE Center, Boston University, Chobanian & Avedisian School of MedicineDepartment of Biostatistics, Boston University School of Public HealthDepartment of Neurology, Alzheimer’s Disease Research Center, Memory & Aging Center, University of California San FranciscoMolecular Imaging and Nuclear Medicine, Boston Medical CenterDepartment of Neurology, Boston University Alzheimer’s Disease Research Center, Boston University CTE Center, Boston University, Chobanian & Avedisian School of MedicineDepartment of Neurology, Alzheimer’s Disease Research Center, Memory & Aging Center, University of California San FranciscoDepartment of Neurology, Alzheimer’s Disease Research Center, Memory & Aging Center, University of California San FranciscoWisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-MadisonWisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-MadisonDepartment of Neurology, Boston University Alzheimer’s Disease Research Center, Boston University CTE Center, Boston University, Chobanian & Avedisian School of MedicineDepartment of Neurology, Boston University Alzheimer’s Disease Research Center, Boston University CTE Center, Boston University, Chobanian & Avedisian School of MedicineDepartment of Radiology, University of Pittsburgh School of MedicineDepartment of Neurology, University of Pittsburgh School of MedicineDepartment of Neurology, University of Pittsburgh School of MedicineWisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-MadisonDepartment of Neurology, Boston University Alzheimer’s Disease Research Center, Boston University CTE Center, Boston University, Chobanian & Avedisian School of MedicineDepartment of Neurology, Alzheimer’s Disease Research Center, Memory & Aging Center, University of California San FranciscoDepartment of Neurology, Alzheimer’s Disease Research Center, Memory & Aging Center, University of California San FranciscoDepartment of Neurology, Alzheimer’s Disease Research Center, Memory & Aging Center, University of California San FranciscoAbstract Background Molecular biomarkers of chronic traumatic encephalopathy (CTE) are lacking. We evaluated 18F-MK-6240 tau PET as a biomarker for CTE. Two studies were done: (1) 3H-MK-6240 autoradiography and an in-vitro brain homogenate binding studies on postmortem CTE tissue, (2) an in-vivo 18F-MK-6240 tau PET study in former American football players. Methods Autoradiography and in-vitro binding studies were done using 3H-MK-6240 on frozen temporal and frontal cortex tissue from six autopsy cases with stage III CTE compared to Alzheimer’s disease. Thirty male former National Football League (NFL) players with cognitive concerns (mean age = 58.9, SD = 7.8) completed tau (18F-MK-6240) and Aβ (18F-Florbetapir) PET. Controls included 39 Aβ-PET negative, cognitively normal males (mean age = 65.7, SD = 6.3). 18F-MK-6240 SUVr images were created using 70–90 min post-injection data with inferior cerebellar gray matter as the reference. We compared SUVr between players and controls using voxelwise and region-of-interest approaches. Correlations between 18F-MK-6240 SUVr and cognitive scores were tested. Results All six CTE stage III cases had Braak NFT stage III but no neuritic plaques. Two had Thal Phase 1 for Aβ; one showed a laminar pattern of 3H-MK-6240 autoradiography binding in the superior temporal cortex and less so in the dorsolateral frontal cortex, corresponding to tau-immunoreactive lesions detected using the AT8 antibody (pSer202/pThr205 tau) in adjacent tissue sections. The other CTE cases had low frequencies of cortical tau-immunoreactive deposits and no well-defined autoradiography binding. In-vitro 3H-MK-6240 binding studies to CTE brain homogenates in the case with autoradiography signal indicated high binding affinity (KD = 2.0 ± 0.9 nM, Bmax = 97 ± 24 nM, n = 3). All NFL players had negative Aβ-PET. There was variable, low-to-intermediate intensity 18F-MK-6240 uptake across participants: 16 had no cortical signal, 7 had medial temporal lobe (MTL) uptake, 2 had frontal uptake, and 4 had MTL and frontal uptake. NFL players had higher SUVr in the entorhinal cortex (d = 0.86, p = 0.001), and the parahippocampal gyrus (d = 0.39, p = 0.08). Voxelwise regressions showed increased uptake in NFL players in two bilateral anterior MTL clusters (p < 0.05 FWE). Higher parahippocampal and frontal–temporal SUVrs correlated with worse memory (r = -0.38, r = -0.40) and semantic fluency (r = -0.38, r = -0.48), respectively. Conclusion We present evidence of 3H-MK-6240 in-vitro binding to post-mortem CTE tissue homogenates and in vivo 18F-MK-6240 PET binding in the MTL among a subset of participants. Additional studies in larger samples and PET-to-autopsy correlations are required to further elucidate the potential of 18F-MK-6240 to detect tau pathology in CTE.https://doi.org/10.1186/s13024-025-00808-1Alzheimer’s diseaseBiomarkersChronic traumatic encephalopathyMK-6240Repetitive head impactsTau PET
spellingShingle Michael L. Alosco
Jhony Mejía Pérez
Julia E. Culhane
Ranjani Shankar
Christopher J. Nowinski
Samantha Bureau
Nidhi Mundada
Karen Smith
Alinda Amuiri
Breton Asken
Jenna R. Groh
Annalise Miner
Erika Pettway
Sydney Mosaheb
Yorghos Tripodis
Charles Windon
Gustavo Mercier
Robert A. Stern
Lea T. Grinberg
David N. Soleimani-Meigooni
Bradley T. Christian
Tobey J. Betthauser
Thor D. Stein
Ann C. McKee
Chester A. Mathis
Eric E. Abrahamson
Milos D. Ikonomovic
Sterling C. Johnson
Jesse Mez
Renaud La Joie
Daniel Schonhaut
Gil D. Rabinovici
18F-MK-6240 tau PET in patients at-risk for chronic traumatic encephalopathy
Molecular Neurodegeneration
Alzheimer’s disease
Biomarkers
Chronic traumatic encephalopathy
MK-6240
Repetitive head impacts
Tau PET
title 18F-MK-6240 tau PET in patients at-risk for chronic traumatic encephalopathy
title_full 18F-MK-6240 tau PET in patients at-risk for chronic traumatic encephalopathy
title_fullStr 18F-MK-6240 tau PET in patients at-risk for chronic traumatic encephalopathy
title_full_unstemmed 18F-MK-6240 tau PET in patients at-risk for chronic traumatic encephalopathy
title_short 18F-MK-6240 tau PET in patients at-risk for chronic traumatic encephalopathy
title_sort 18f mk 6240 tau pet in patients at risk for chronic traumatic encephalopathy
topic Alzheimer’s disease
Biomarkers
Chronic traumatic encephalopathy
MK-6240
Repetitive head impacts
Tau PET
url https://doi.org/10.1186/s13024-025-00808-1
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