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Patterns of neurodegeneration produced by TBI can be compared to AD and aging using volumetric MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 55 patients after moderate to severe TBI (median age 40), 45 with AD (median age 69), and 61 healthy volunteers underwent magnetic resonance imaging over 2 years. Atrophy patterns were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>AD patients had markedly lower baseline volumes. TBI was associated with increased white matter (WM) atrophy, particularly involving corticospinal tracts and callosum, whereas AD rates were increased across white and gray matter (GM). Subcortical WM loss was shared in AD\/TBI, but deep WM atrophy was TBI\u2010specific and cortical atrophy AD\u2010specific. Post\u2010TBI atrophy patterns were distinct from aging, which resembled AD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Post\u2010traumatic neurodegeneration 1.9\u20134.0 years (median) following moderate\u2010severe TBI is distinct from aging\/AD, predominantly involving central WM. This likely reflects distributions of axonal injury, a neurodegeneration trigger.<\/jats:p><\/jats:sec><jats:sec><jats:title>Highlights<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>We compared patterns of brain atrophy longitudinally after moderate to severe TBI in late\u2010onset AD and healthy aging.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Patients after TBI had abnormal brain atrophy involving the corpus callosum and other WM tracts, including corticospinal tracts, in a pattern that was specific and distinct from AD and aging.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>This pattern is reminiscent of axonal injury following TBI, and atrophy rates were predicted by the extent of axonal injury on diffusion tensor imaging, supporting a relationship between early axonal damage and chronic neurodegeneration.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1002\/alz.12934","type":"journal-article","created":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T12:27:55Z","timestamp":1674649675000},"page":"3065-3077","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Distinct patterns of neurodegeneration after TBI and in Alzheimer's disease"],"prefix":"10.1002","volume":"19","author":[{"given":"Neil S.N.","family":"Graham","sequence":"first","affiliation":[{"name":"Department of Brain Sciences Imperial College London  London UK"},{"name":"UK Dementia Research Institute Centre for Care Research and Technology at Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James H.","family":"Cole","sequence":"additional","affiliation":[{"name":"Dementia Research Centre UCL Queen Square Institute of Neurology  London UK"},{"name":"Centre for Medical Image Computing UCL  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niall J.","family":"Bourke","sequence":"additional","affiliation":[{"name":"Department of Brain Sciences Imperial College London  London UK"},{"name":"UK Dementia Research Institute Centre for Care Research and Technology at Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Schott","sequence":"additional","affiliation":[{"name":"Dementia Research Centre UCL Queen Square Institute of Neurology  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Sharp","sequence":"additional","affiliation":[{"name":"Department of Brain Sciences Imperial College London  London UK"},{"name":"UK Dementia Research Institute Centre for Care Research and Technology at Imperial College London  London UK"},{"name":"Centre for Injury Studies Imperial College London  London 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