Premortem Chronic Traumatic Encephalopathy Diagnoses in Professional Football
Grashow, Rachel (Harvard Medical School)
Weisskopf, Marc G. (Harvard Medical School)
Baggish, Aaron (Harvard Medical School)
Speizer, Frank E. (Harvard Medical School)
Whittington, Alicia J. (Harvard Medical School)
Nadler, Lee M (Dana-Farber Cancer Institute (Boston, Estats Units d'Amèrica))
Connor, Ann (Harvard Medical School)
Keske, Robyn (Harvard Medical School)
Taylor, Herman (Morehouse School of Medicine, Atlanta)
Zafonte, Ross (Massachusetts General Hospital (Boston))
Pascual Leone, Álvaro (Institut Germans Trias i Pujol. Institut Guttmann)
Universitat Autònoma de Barcelona

Fecha:	2020
Resumen:	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.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Adult ; Aged ; Athletes ; Chronic Traumatic Encephalopathy ; Cognitive Dysfunction ; Diagnosis ; Football ; Injuries ; Psychology
Publicado en:	Annals of neurology, Vol. 88 (may 2020) , p. 106-112, ISSN 1531-8249

DOI: 10.1002/ana.25747
PMID: 32281676

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