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Alzheimers Dement (N Y). 2017 Jun;3(2):177-188. doi: 10.1016/j.trci.2017.02.005.

Effects of traumatic brain injury and posttraumatic stress disorder on development of Alzheimer's disease in Vietnam Veterans using the Alzheimer's Disease Neuroimaging Initiative: Preliminary Report.

Author information

Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San, Francisco, CA, USA.
Department of Radiology, University of California, San Francisco, CA, USA.
Department of Medicine, University of California, San Francisco, CA, USA.
Department of Psychiatry, University of California, San Francisco, CA, USA.
Department of Neurology, University of California, San Francisco, CA, USA.
Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, CA, USA.
Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA.
Alzheimer's Therapeutic Research Institute, University of Southern California, San Diego, CA, USA.
Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Imaging of Dementia and Aging (IDeA) Laboratory, Department of Neurology and Center for Neuroscience, University of California, Davis, CA, USA.
Indiana Alzheimer Disease Center, Department of Radiology and Imaging Sciences, Indiana University, School of Medicine, Indianapolis, IN, USA.
Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA.
Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center, Feinberg School of Medicine and Department of Psychology, Northwestern University, Chicago, IL, USA.



Traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) have previously been reported to be associated with increased risk of Alzheimer's disease (AD). We are using biomarkers to study Vietnam Veterans with/without mild cognitive impairment with a history of at least one TBI and/or ongoing PTSD to determine whether these contribute to the development of AD.


Potential subjects identified by Veterans Administration records underwent an initial telephone screen. Consented subjects underwent clinical evaluation, lumbar puncture, structural MRI and amyloid PET scans.


We observed worse cognitive functioning in PTSD and TBI + PTSD groups, worse global cognitive functioning in the PTSD group, lower superior parietal volume in the TBI + PTSD group, and lower amyloid positivity in the PTSD group, but not the TBI group compared to controls without TBI/PTSD. Medial temporal lobe atrophy was not increased in the PTSD and/or TBI groups.


Preliminary results do not indicate that TBI or PTSD increase the risk for AD measured by amyloid PET. Additional recruitment, longitudinal follow-up, and tau PET scans will provide more information in the future.

Conflict of interest statement

Conflicts of Interest: Michael W. Weiner has served on the scientific advisory boards for Lilly, Araclon and Institut Catala de Neurociencies Aplicades, Gulf War Veterans Illnesses Advisory Committee, VACO, Biogen Idec, and Pfizer; has served as a consultant for Astra Zeneca, Araclon, Medivation/Pfizer, Ipsen, TauRx Therapeutics LTD, Bayer Healthcare, Biogen Idec, Exonhit Therapeutics, SA, Servier, Synarc, Pfizer, and Janssen; has received funding for travel from NeuroVigil, Inc., CHRU-Hopital Roger Salengro, Siemens, AstraZeneca, Geneva University Hospitals, Lilly, University of California, San Diego – ADNI, Paris University, Institut Catala de Neurociencies Aplicades, University of New Mexico School of Medicine, Ipsen, CTAD (Clinical Trials on Alzheimer's Disease), Pfizer, AD PD meeting, Paul Sabatier University, Novartis, Tohoku University; has served on the editorial advisory boards for Alzheimer's & Dementia and MRI; has received honoraria from NeuroVigil, Inc., Insitut Catala de Neurociencies Aplicades, PMDA/Japanese Ministry of Health, Labour, and Welfare, and Tohoku University; has received commercial research support from Merck and Avid; has received government research support from DOD and VA; has stock options in Synarc and Elan; and declares the following organizations as contributors to the Foundation for NIH and thus to the NIA funded Alzheimer's Disease Neuroimaging Initiative: Abbott, Alzheimer's Association, Alzheimer's Drug Discovery Foundation, Anonymous Foundation, AstraZeneca, Bayer Healthcare, BioClinica, Inc. (ADNI 2), Bristol-Myers Squibb, Cure Alzheimer's Fund, Eisai, Elan, Gene Network Sciences, Genentech, GE Healthcare, GlaxoSmithKline, Innogenetics, Johnson & Johnson, Eli Lilly & Company, Medpace, Merck, Novartis, Pfizer Inc., Roche, Schering Plough, Synarc, and Wyeth. Dr. Jack has provided consulting services for Eli Lily and Pfizer and owns stock in Johnson and Johnson. He receives research funding from the National Institutes of Health (R01-AG011378, RO1-AG041851, U01-AG06786, U01-AG024904, R01-AG37551, R01-AG043392, R01-NS092625), and the Alexander Family Alzheimer's Disease Research Professorship of the Mayo Clinic. Dr. Landau has consulted for Genentech and Biogen. Dr. Saykin received support from multiple NIA, NCI, NSF and DoD grants, Eli Lilly (collaborative research project), Avid Radiopharmaceuticals (AV1451 precursor), and Arkley BioTek (SBIR grant). Dr. Neylan serves on the Scientific Advisory Board for Resilience Therapeutics. Dr Petersen's consults for Roche, Inc., Merck, Inc., Genentech, Inc., Biogen, Inc. and Eli Lilly and Company: consultant/adviser.

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