Neuroimaging of Cognitive Dysfunction and Depression in Aging Retired National Football League Players A Cross-sectional Study

JAMA neurology 01/2013; 70(3):1-10. DOI: 10.1001/2013.jamaneurol.340
Source: PubMed


OBJECTIVES To assess cognitive impairment and depression in aging former professional football (National Football League [NFL]) players and to identify neuroimaging correlates of these dysfunctions. DESIGN We compared former NFL players with cognitive impairment and depression, cognitively normal retired players who were not depressed, and matched healthy control subjects. SETTING Research center in the North Texas region of the United States. PATIENTS Cross-sectional sample of former NFL players with and without a history of concussion recruited from the North Texas region and age-, education-, and IQ-matched controls. Thirty-four retired NFL players (mean age, 61.8 years) underwent neurological and neuropsychological assessment. A subset of 26 players also underwent detailed neuroimaging; imaging data in this subset were compared with imaging data acquired in 26 healthy matched controls. MAIN OUTCOME MEASURES Neuropsychological measures, clinical diagnoses of depression, neuroimaging mea-sures of white matter pathology, and a measure of cerebral blood flow. RESULTS Of the 34 former NFL players, 20 were cognitively normal. Four were diagnosed as having a fixed cognitive deficit; 8, mild cognitive impairment; 2, dementia; and 8, depression. Of the subgroup in whom neuroimaging data were acquired, cognitively impaired participants showed the greatest deficits on tests of naming, word finding, and visual/verbal episodic memory. We found significant differences in white matter abnormalities in cognitively impaired and depressed retired players compared with their respective controls. Regional blood flow differences in the cognitively impaired group (left temporal pole, inferior parietal lobule, and superior temporal gyrus) corresponded to regions associated with impaired neurocognitive performance (problems with memory, naming, and word finding). CONCLUSIONS Cognitive deficits and depression appear to be more common in aging former NFL players compared with healthy controls. These deficits are correlated with white matter abnormalities and changes in regional cerebral blood flow.

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Available from: Jeremy F Strain, Mar 24, 2014
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    Neuropsychology 07/2015; DOI:10.1037/neu0000202 · 3.27 Impact Factor
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    • "Athletes involved in high impact sports also show evidence of disproportionate cortical thinning and lateral ventricle enlargement, neurometabolic imbalance (Tremblay et al., 2013), abnormal cerebral blood perfusion , (Hart et al., 2013), decreased white matter integrity (i.e. fractional anisotropy) (Hart et al., 2013; Tremblay et al., 2014), as well as accelerated motor and cognitive function decline (De Beaumont et al., 2009; Moretti et al., 2012) beyond what is observed with ageing in otherwise comparable peers. Some of the changes to white matter are similar to those that have been described as occurring with ageing (Nomura et al., 1994; Courchesne et al., 2000; Nusbaum et al., 2001; Salat et al., 2005a, b; Burzynska et al., 2010; Westlye et al., 2010; Lebel et al., 2012) suggesting that a history of blunt head trauma may exacerbate any pathological burden typically associated with the ageing process. "
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    Brain 06/2015; 138(Pt 8). DOI:10.1093/brain/awv139 · 9.20 Impact Factor
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    • "Therefore, whole-brain white matter anomalies patterns affecting specific tracts can be related to particular cognitive/motor impairments in clinical populations. Multiple groups trying to uncover the nature of acute and chronic symptoms in concussed athletes have applied this technique (Zhang et al., 2010; Cubon et al., 2011; Koerte et al., 2012; Chamard et al., 2013; Hart et al., 2013; Strain et al., 2013) or older techniques (Zhang et al., 2003, 2006; Chappell et al., 2006; Henry et al., 2011; Bazarian et al., 2012; Marchi et al., 2013; Virji-Babul et al., 2013). Diffuse anomalies during the acute and sub-acute periods are described in most cases along various major interhemispheric, associative, and projection fibre tracts, although no consistent spatial pattern of injury seems to emerge from those studies (Gardner et al., 2012). "
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