Premortem Chronic Traumatic Encephalopathy Diagnoses in Professional Football

American-style football (ASF) has gained attention because of possible links between repetitive head injury and neurodegenerative diseases. Although postmortem pathologic changes consistent with chronic traumatic encephalopathy (CTE) have been reported in ASF players, there are currently no establis...

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Detalhes bibliográficos
Autores: Grashow, Rachel, Weisskopf, Marc G.|||0000-0001-6961-0243, Baggish, Aaron, Speizer, Frank E., Whittington, Alicia J.|||0000-0001-5075-3033, Nadler, Lee M., Connor, Ann, Keske, Robyn, Taylor, Herman, Zafonte, Ross|||0000-0002-1050-796X, Pascual Leone, Álvaro|||0000-0001-8975-0382
Formato: artículo
Fecha de publicación:2020
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:231206
Acesso em linha:https://ddd.uab.cat/record/231206
https://dx.doi.org/urn:doi:10.1002/ana.25747
Access Level:acceso abierto
Palavra-chave:Adult
Aged
Athletes
Chronic Traumatic Encephalopathy
Cognitive Dysfunction
Diagnosis
Football
Injuries
Psychology
Descrição
Resumo:American-style football (ASF) has gained attention because of possible links between repetitive head injury and neurodegenerative diseases. Although postmortem pathologic changes consistent with chronic traumatic encephalopathy (CTE) have been reported in ASF players, there are currently no established premortem diagnostic criteria for CTE. Nevertheless, presented with symptoms of cognitive impairment, clinicians treating former players may be inclined to suggest CTE without a thorough exploration of comorbid factors that demonstrate similar clinical phenotypes to putative CTE. A survey of 3,913 former ASF players aged 24 to 89 was conducted for those who responded by March 2019. Despite being a postmortem diagnosis, 108 players (2.8%) self-reported clinician-diagnosed CTE. The percentage of players under age 60 years reporting a CTE diagnosis was 2.3% versus 3.7% in participants age 60 or older. Comorbidities in participants self-reporting CTE were significantly more common, including sleep apnea, hypercholesterolemia, obesity, indicators of past or current depression, hypertension, prescription pain medication use, heart conditions, and low testosterone when compared to non-CTE respondents. Patterns of reporting for obesity, hypertension, heart conditions, or hypercholesterolemia differed between older and younger participants. Cognitive impairment symptoms were significantly higher in participants self-reporting CTE. Some former professional football players have been clinically diagnosed with CTE, a postmortem condition. Comorbidities that can affect cognition were associated with CTE diagnoses in both older and younger players. Although underlying neuropathology cannot be ruled out, treatable conditions should be explored in former athletes demonstrating CTE-linked clinical phenotypes or symptoms as a means of improving cognitive health in these patients. ANN NEUROL 2020 ANN NEUROL 2020;88:106-112.