Medical Conditions in Former Professional American-Style Football Players Are Associated With Self-Reported Clinical Features of Traumatic Encephalopathy Syndrome.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_5834A3297387
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Medical Conditions in Former Professional American-Style Football Players Are Associated With Self-Reported Clinical Features of Traumatic Encephalopathy Syndrome.
Journal
Neurotrauma reports
Author(s)
Grashow R., Eagle S.R., Terry D.P., DiGregorio H., Baggish A.L., Weisskopf M.G., Kontos A., Okonkwo D.O., Zafonte R.
ISSN
2689-288X (Electronic)
ISSN-L
2689-288X
Publication state
Published
Issued date
2024
Peer-reviewed
Oui
Volume
5
Number
1
Pages
376-386
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Consensus criteria for traumatic encephalopathy syndrome (TES) specify that at least one core clinical feature of cognitive impairment (CI; e.g., difficulties with memory, executive function) or neurobehavioral dysregulation (ND; e.g., explosiveness, rage, and mood lability) be present and not fully accounted for by other health disorders. Associations between self-reported symptoms that mirror the core clinical features of TES-and how they may be related to concomitant medical conditions-remain unclear. The purpose of this study was to evaluate the association of medical conditions and football exposures with TES clinical features (CI <sup>+/-</sup> , ND <sup>+/-</sup> ) in 1741 former professional American-style football (ASF) players (age, 57.7 ± 13.9 years; professional seasons, 6.6 ± 3.9 years). Demographics (age, race/ethnicity, current body mass index, age of first football exposure, use of performance-enhancing drugs, position played, and past concussion symptoms), self-reported medical conditions (anxiety, depression, attention-deficit hyperactivity disorder [ADHD], sleep apnea, headache, stroke, hypertension, heart disease, high cholesterol, erectile dysfunction, and low testosterone) were collected. Of 1741 participants, 7.4% were CI <sup>+</sup> and/or ND <sup>+</sup> (n = 129). Participants who were CI <sup>+</sup> or ND <sup>+</sup> were more likely to report one or more coexisting medical conditions than participants who did not report CI or ND (odds ratio [OR] = 2.04; 95% confidence interval: 1.25-3.47; p = 0.003). Separate general linear models for each medical condition that adjusted for demographics and football-related factors identified significant associations between ADHD, diabetes, erectile dysfunction, headaches, sleep apnea, anxiety, and low testosterone and CI <sup>+</sup> and/or ND <sup>+</sup> (ORs = 1.8-6.0). Chi-square automatic interaction detection (CHAID) multi-variable decision tree models that incorporated medical conditions and football exposures accurately differentiated former players meeting either CI or ND clinical criteria from those meeting none (accuracy = 91.2-96.6%). CHAID identified combinations of depression, headache, sleep apnea, ADHD, and upper quartiles of concussion symptom history as most predictive of CI <sup>+</sup> and/or ND <sup>+</sup> status. CI <sup>+</sup> and/or ND <sup>+</sup> players were more likely to report medical conditions known to cause cognitive symptoms. Concussion exposure and medical conditions significantly increased the likelihood that a former ASF player would demonstrate cognitive or neurobehavioral dysfunction. Clinicians engaged with this population should consider whether treatable coexisting condition(s) could account for some portion of the clinical picture associated with TES presentation.
Keywords
Cellular and Molecular Neuroscience, Developmental Neuroscience, chronic traumatic encephalopathy, comorbidities, concussion, encephalopathy syndrome, football, traumatic encephalopathy syndrome
Pubmed
Web of science
Open Access
Yes
Create date
19/04/2024 12:57
Last modification date
09/08/2024 14:59
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