Estimated Age of First Exposure to American Football and Neurocognitive Performance Amongst NCAA Male Student-Athletes: A Cohort Study

Caccese, Jaclyn B.; DeWolf, Ryan; Kaminski, Thomas W.; Broglio, Steven P.; McAllister, Thomas W.; McCrea, Michael; Buckley, Thomas A.

doi:10.1007/s40279-019-01069-x

Cited by 43 publications

(61 citation statements)

References 65 publications

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“…Our findings also accord with the broader literature on the benefits of adolescent physical activity [60]: regular physical activity during adolescence may decrease the risk of diabetes [61] and obesity [62], improve psychological and social health [26], and may even protect against later-life neurodegeneration [63]. Additionally, our finding that any adverse adolescent football participation might not manifest in early adulthood is similar to [64] finding that participating in tackle football before age 12 may not result in short-term neurocognitive deficits in college.…”

Section: Plos Onesupporting

confidence: 89%

The association between adolescent football participation and early adulthood depression

et al. 2020

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Concerned about potentially increased risk of neurodegenerative disease, several health professionals and policy makers have proposed limiting or banning youth participation in American-style tackle football. Given the large affected population (over 1 million boys play high school football annually), careful estimation of the long-term health effects of playing football is necessary for developing effective public health policy. Unfortunately, existing attempts to estimate these effects tend not to generalize to current participants because they either studied a much older cohort or, more seriously, failed to account for potential confounding. We leverage data from a nationally representative cohort of American men who were in grades 7-12 in the 1994-95 school year to estimate the effect of playing football in adolescent on depression in early adulthood. We control for several potential confounders related to subjects' health, behavior, educational experience, family background, and family health history through matching and regression adjustment. We found no evidence of even a small harmful effect of football participation on scores on a version of the Center for Epidemiological Studies Depression scale (CES-D) nor did we find evidence of adverse associations with several secondary outcomes including anxiety disorder diagnosis or alcohol dependence in early adulthood. For men who were in grades 7-12 in the 1994-95 school year, participating or intending to participate in school football does not appear to be a major risk factor for early adulthood depression.

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Section: Plos Onesupporting

confidence: 89%

The association between adolescent football participation and early adulthood depression

et al. 2020

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“…There were no differences in gain to vision (p = 0.857, η2 = 0.001), GVS (p = 0.971, η2 = 0.000), or vibration (p = 0.974, η2 = 0.000) between groups. There were no differences in sensory reweighting for upright stance between AFE ≤ 10 and AFE > 10, suggesting that soccer heading during early adolescence is not associated with balance deficits in collegeaged soccer players, notwithstanding potential deficits in other markers of neurological function gress with increased exposure to repetitive head impacts throughout and beyond collegiate play [11]. These studies were limited to American football players, and although this cohort may have the highest exposure to repetitive head impacts, other sports, such as soccer, also involve repetitive hits to the head [13,14].…”

Section: Age Of First Exposure To Soccer Heading and Sensory Reweightmentioning

confidence: 87%

“…Younger age of first exposure (AFE) to American football has been associated with later-life impairments in cognitive function, altered corpus callosum white matter microstructure, decreased thalamic volume, greater behavioral and mood symptoms and earlier age of neurobehavioral symptom onset in former National Football League and amateur players [5][6][7][8][9]. In current high school and collegiate American football players, younger AFE is not associated with deficits in behavioral, cognitive, psychological or physical performance [10][11][12]. Together, these studies suggest that consequences of early exposure to repetitive head impacts do not manifest until later in life or symptoms of neurological impairment pro-…”

Section: Introductionmentioning

confidence: 99%

Age of First Exposure to Soccer Heading and Sensory Reweighting for Upright Stance

et al. 2020

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US Soccer eliminated soccer heading for youth players ages 10 years and younger and limited soccer heading for children ages 11–13 years. Limited empirical evidence associates soccer heading during early adolescence with medium-to-long-term behavioral deficits. The purpose of this study was to compare sensory reweighting for upright stance between college-aged soccer players who began soccer heading ages 10 years and younger (AFE ≤ 10) and those who began soccer heading after age 10 (AFE > 10). Thirty soccer players self-reported age of first exposure (AFE) to soccer heading. Sensory reweighting was compared between AFE ≤ 10 and AFE > 10. To evaluate sensory reweighting, we simultaneously perturbed upright stance with visual, vestibular, and proprioceptive stimulation. The visual stimulus was presented at two different amplitudes to measure the change in gain to vision, an intra-modal effect; and change in gain to galvanic vestibular stimulus (GVS) and vibration, both inter-modal effects. There were no differences in gain to vision (p=0.857, η2=0.001), GVS (p=0.971, η2=0.000), or vibration (p=0.974, η2=0.000) between groups. There were no differences in sensory reweighting for upright stance between AFE ≤ 10 and AFE > 10, suggesting that soccer heading during early adolescence is not associated with balance deficits in college-aged soccer players, notwithstanding potential deficits in other markers of neurological function

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“…Nonetheless, and as mentioned previously, research in young, active, and healthy elite contact sport athletes and American football players has also not observed an association between AFE and cognitive function. 66,67 The aforementioned studies from BU also contained findings that were not straightforward, including the lack of association of AFE to football with the BTACT (the objective telephone-based assessment of cognitive function) in the LEGEND study, 71 as well as with CTE risk and pathological severity in the UNITE study. 30,33 That said, evidence continues to implicate age of exposure to head trauma as an important modifier, even in the concussion realm.…”

Section: Age Of First Exposurementioning

confidence: 99%

Risk Factors for Chronic Traumatic Encephalopathy: A Proposed Framework

et al. 2020

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Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that has been neuropathologically diagnosed in contact and collision sport athletes, military veterans, and others with a history of exposure to repetitive head impacts (RHI). Identifying methods to diagnose and prevent CTE during life is a high priority. Timely diagnosis and implementation of treatment and preventative strategies for neurodegenerative diseases, including CTE, partially hinge upon early and accurate risk characterization. Here, we propose a framework of risk factors that influence the neuropathological development of CTE. We provide an up-to-date review of the literature examining cumulative exposure to RHI as the environmental trigger for CTE. Because not all individuals exposed to RHI develop CTE, the direct and/or indirect influence of nonhead trauma exposure characteristics (e.g., age, sex, race, genetics) on the pathological development of CTE is reviewed. We conclude with recommendations for future directions, as well as opinions for preventative strategies that could mitigate risk.

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Estimated Age of First Exposure to American Football and Neurocognitive Performance Amongst NCAA Male Student-Athletes: A Cohort Study

Cited by 43 publications

References 65 publications

The association between adolescent football participation and early adulthood depression

The association between adolescent football participation and early adulthood depression

Age of First Exposure to Soccer Heading and Sensory Reweighting for Upright Stance

Risk Factors for Chronic Traumatic Encephalopathy: A Proposed Framework

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