Interactive Effects of Racial Identity and Repetitive Head Impacts on Cognitive Function, Structural MRI-Derived Volumetric Measures, and Cerebrospinal Fluid Tau and Aβ

Abstract

Background: Factors of increased prevalence among individuals with Black racial identity (e.g., cardiovascular disease, CVD) may influence the association between exposure to repetitive head impacts (RHI) from American football and later-life neurological outcomes. Here, we tested the interaction between racial identity and RHI on neurobehavioral outcomes, brain volumetric measures, and cerebrospinal fluid (CSF) total tau (t-tau), phosphorylated tau (p-tau 181), and Aβ 1−42 in symptomatic former National Football League (NFL) players. Methods: 68 symptomatic male former NFL players (ages 40-69; n = 27 Black, n = 41 White) underwent neuropsychological testing, structural MRI, and lumbar puncture. FreeSurfer derived estimated intracranial volume (eICV), gray matter volume (GMV),

Premortem Chronic Traumatic Encephalopathy Diagnoses in Professional Football

“…Additionally, because black players are more likely to play high‐impact positions, presumed exposure may be driving the suggestion of CTE in clinical contexts. A recent study of symptomatic former professional football players has noted that black players had significantly higher indices of head injury, higher blood pressure, higher BMI, and lower right hippocampal volume than white participants . In our study, participants who played between 5 and 9 seasons showed a higher percentage of self‐reported CTE than those who played both fewer and more seasons.…”

“…A recent study of symptomatic former professional football players has noted that black players had significantly higher indices of head injury, higher blood pressure, higher BMI, and lower right hippocampal volume than white participants. 34 In our study, participants who played between 5 and 9 seasons showed a higher percentage of self-reported CTE than those who played both fewer and more seasons. Although we cannot say for certain why this is, it is possible that healthy worker bias may be at play where the most injured players aren't represented in populations of players with longer careers.…”

Developing methods to detect and diagnose chronic traumatic encephalopathy during life: rationale, design, and methodology for the DIAGNOSE CTE Research Project

“…One limitation of this approach is that the NFL has not publicly released, nor have there been published reports of HIT System or other head impact sensor data from NFL players, thus resulting in the need to rely on college player HIT System data in these PEMs. We will combine the PEM with each participant’s football history (i.e., age of first exposure, level[s] and duration of play, position[s] played) to develop participant-specific estimates of cumulative exposure to head impacts [ 27 , 61 , 160 , 161 ]. Additional methods of estimating repetitive head impact exposure will be included as they become available.…”

Impaired visual working memory and reduced connectivity in undergraduates with a history of mild traumatic brain injury

“…For consistency, we automated the process using Multiple Artifact Rejection Algorithm 94,95 . Subsequent analyses were done in Fieldtrip 96 separately in the delta (1-5 Hz), theta (5)(6)(7)(8), alpha (8)(9)(10)(11)(12), beta (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), and low gamma (30-80 Hz) bands [97][98][99] .…”

“…However, the data on cognitive outcomes long after mTBI (> 3 months) are mixed. For example, recent reviews reported no lasting cognitive deficits 18 – 20 , whereas athletes and veterans at > 1-year post-injury have lasting executive dysfunction 21 – 40 , and impaired working memory (WM) 41 , 42 . In these populations, effects may be heightened by blast injury 43 , and/or repeated head injury 44 .…”