THE RELATIONSHIP BETWEEN REPETITIVE HEAD IMPACT EXPOSURE AND CHRONIC TRAUMATIC ENCEPHALOPATHY IN AMERICAN FOOTBALL PLAYERS

2017 ◽  
Vol 13 (7) ◽  
pp. P1469-P1470
Author(s):  
Jesse Mez ◽  
Daniel H. Daneshvar ◽  
Bobak Abdolmohammadi ◽  
Patrick T. Kiernan ◽  
Michael L. Alosco ◽  
...  
Keyword(s):  
Chronic Traumatic Encephalopathy ◽  
Head Impact ◽  
American Football ◽  
Football Players ◽  
The Relationship

Effect of Turf Toe on Foot Contact Pressures in Professional American Football Players

2009 ◽  
Vol 30 (5) ◽  
pp. 405-409 ◽  
Author(s):  
Robert H. Brophy ◽  
Seth C. Gamradt ◽  
Scott J. Ellis ◽  
Ronnie P. Barnes ◽  
Scott A. Rodeo ◽  
...  
Keyword(s):  
Body Mass Index ◽  
National Football League ◽  
Peak Pressure ◽  
American Football ◽  
Football Players ◽  
Plantar Pressures ◽  
History Of ◽  
Turf Toe ◽  
The Relationship ◽  
Contact Pressures

Background: The relationship between turf toe and plantar foot pressures has not been extensively studied. Two hypotheses were tested in a cohort of professional American football players: first, that a history of turf toe is associated with increased peak hallucal and first metatarsophalangeal (MTP) plantar pressures; second, that decreased range of motion (ROM) of the first MTP correlates with increased peak hallucal and first MTP plantar pressures. Materials and Methods: Forty-four athletes from one National Football League (NFL) team were screened for a history of turf toe during preseason training. Dorsal passive MTP ROM and dynamic plantar pressures were measured in both feet of each player. Anatomical masking was used to assess peak pressure at the first MTP and hallux. Results: First MTP dorsiflexion was significantly lower in halluces with a history of turf toe (40.6 ± 15.1 degrees versus 48.4 ± 12.8 degrees, p = 0.04). Peak hallucal pressures were higher in athletes with turf toe (535 ± 288 kPa versus 414 ± 202 kPa, p = 0.05) even after normalizing for athlete body mass index ( p = 0.0003). Peak MTP pressure was not significantly different between the two groups tested. First MTP dorsiflexion did not correlate with peak hallucal or first MTP pressures. Conclusion: This study showed that turf toe is associated with decreased MTP motion. In addition, increased peak hallucal pressures were found. Further study is warranted to determine whether these pressures correlate with the severity of symptoms or progression of turf toe to first MTP arthritis.

Association Between Antemortem FLAIR White Matter Hyperintensities and Neuropathology in Brain Donors Exposed to Repetitive Head Impacts

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013012
Author(s):  
Madeline Uretsky ◽  
Sylvain Bouix ◽  
Ronald J. Killiany ◽  
Yorghos Tripodis ◽  
Brett Martin ◽  
...  
Keyword(s):  
White Matter ◽  
White Matter Hyperintensities ◽  
Microvascular Disease ◽  
Head Impact ◽  
American Football ◽  
Football Players ◽  
Head Impacts ◽  
Repetitive Head Impacts ◽  
Pathological Correlation ◽  
Daily Function

Background and Objectives:Late neuropathologies of repetitive head impacts from contact sports can include chronic traumatic encephalopathy (CTE) and white matter degeneration. White matter hyperintensities (WMH) on fluid attenuated inversion recovery (FLAIR) MRI scans are often viewed as microvascular disease from vascular risk, but might have unique underlying pathologies and risk factors in the setting of repetitive head impacts. We investigated the neuropathological correlates of antemortem WMH in brain donors exposed to repetitive head impacts. The association between WMH, and repetitive head impact exposure and informant-reported cognitive and daily function were tested.Methods:This imaging-pathological correlation study included symptomatic deceased men exposed to repetitive head impacts. Donors had antemortem FLAIR scans from medical records and were without evidence of CNS neoplasm, large vessel infarcts, hemorrhage, and/or encephalomalacia. WMH were quantified using log-transformed values for total lesion volume (TLV), calculated using the lesion prediction algorithm from the Lesion Segmentation Toolbox. Neuropathological assessments included semi-quantitative ratings of white matter rarefaction, cerebrovascular disease, p-tau severity (CTE stage, dorsolateral frontal cortex), and Aβ. Among football players, years of play was a proxy for repetitive head impact exposure. Retrospective informant-reported cognitive and daily function were assessed using the Cognitive Difficulties Scale (CDS) and Functional Activities Questionnaire (FAQ). Regression models controlled for demographics, diabetes, hypertension, and MRI resolution. Statistical significance was defined as p<0.05.Results:The sample included 75 donors: 67 football players and 8 non-football contact sport athletes and/or military veterans. Dementia was the most common MRI indication (64%). Fifty-three (70.7%) had CTE at autopsy. Log-TLV was associated with white matter rarefaction (OR=2.32, 95% CI=1.03,5.24, p=0.04), arteriolosclerosis (OR=2.38, 95% CI=1.02,5.52, p=0.04), CTE stage (OR=2.58, 95% CI=1.17,5.71, p=0.02), and dorsolateral frontal p-tau severity (OR=3.03, 95% CI=1.32,6.97, p=0.01). There was no association with Aβ. More years of football play was associated with log-TLV (b=0.04, 95% CI=0.01,0.06, p=0.01). Greater log-TLV correlated with higher FAQ (unstandardized beta=4.94, 95% CI=0.42,8.57, p=0.03) and CDS scores (unstandardized beta=15.35, 95% CI=-0.27,30.97, p=0.05).Discussion:WMH might capture long-term white matter pathologies from repetitive head impacts, including those from white matter rarefaction and p-tau, in addition to microvascular disease. Prospective imaging-pathological correlation studies are needed.Classification of Evidence:This study provides Class IV evidence of associations between FLAIR white matter hyperintensities, and neuropathological changes (white matter rarefaction, arteriolosclerosis, p-tau accumulation), years of American football play, and reported cognitive symptoms in symptomatic brain donors exposed to repetitive head impacts.

scholarly journals Similar head impact acceleration measured using instrumented ear patches in a junior rugby union team during matches in comparison with other sports

2016 ◽  
Vol 18 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Doug A. King ◽  
Patria A. Hume ◽  
Conor Gissane ◽  
Trevor N. Clark
Keyword(s):  
Injury Risk ◽  
Linear Acceleration ◽  
Rugby Union ◽  
Head Impact ◽  
American Football ◽  
Football Players ◽  
Head Impacts ◽  
Impact Acceleration ◽  
The Impact ◽  
Rugby Players

OBJECTIVE Direct impact with the head and the inertial loading of the head have been postulated as major mechanisms of head-related injuries, such as concussion. METHODS This descriptive observational study was conducted to quantify the head impact acceleration characteristics in under-9-year-old junior rugby union players in New Zealand. The impact magnitude, frequency, and location were collected with a wireless head impact sensor that was worn by 14 junior rugby players who participated in 4 matches. RESULTS A total of 721 impacts > 10g were recorded. The median (interquartile range [IQR]) number of impacts per player was 46 (IQR 37–58), resulting in 10 (IQR 4–18) impacts to the head per player per match. The median impact magnitudes recorded were 15g (IQR 12g–21g) for linear acceleration and 2296 rad/sec2 (IQR 1352–4152 rad/sec2) for rotational acceleration. CONCLUSIONS There were 121 impacts (16.8%) above the rotational injury risk limit and 1 (0.1%) impact above the linear injury risk limit. The acceleration magnitude and number of head impacts in junior rugby union players were higher than those previously reported in similar age-group sports participants. The median linear acceleration for the under-9-year-old rugby players were similar to 7- to 8-year-old American football players, but lower than 9- to 12-year-old youth American football players. The median rotational accelerations measured were higher than the median and 95th percentiles in youth, high school, and collegiate American football players.

Head impact exposure and time to recovery in youth american football players diagnosed with a concussion

2017 ◽  
Vol 51 (11) ◽  
pp. A16.2-A16
Author(s):  
Verle D Valentine ◽  
Jason C Dorman ◽  
Thayne A Munce
Keyword(s):  
Head Impact ◽  
American Football ◽  
Football Players

The Neuropathology of Chronic Traumatic Encephalopathy: The Status of the Literature

2020 ◽  
Vol 40 (04) ◽  
pp. 359-369
Author(s):  
Ann C. McKee
Keyword(s):  
White Matter ◽  
Head Trauma ◽  
Chronic Traumatic Encephalopathy ◽  
The Elderly ◽  
Brain Regions ◽  
American Football ◽  
Cumulative Exposure ◽  
Football Players ◽  
Tau Pathology ◽  
The Status

AbstractChronic traumatic encephalopathy (CTE) is a tauopathy associated with repetitive mild head trauma, including concussion and asymptomatic subconcussive impacts. CTE was first recognized in boxers almost a century ago and has been identified more recently in contact sports athletes, military veterans exposed to blast, and victims of domestic violence. Like most neurodegenerative diseases, CTE is diagnosed conclusively by a neuropathological examination of brain tissue. CTE is characterized by the buildup of hyperphosphorylated tau (p-tau) in neurofibrillary tangles (NFTs), neurites, and, sometimes, astrocytes, surrounding small blood vessels in a patchy distribution at the sulcal depths of the cerebral cortex. In 2015, using the McKee proposed criteria for the neuropathological diagnosis of CTE, a consensus panel of expert neuropathologists confirmed CTE as a unique neurodegenerative disease with a pathognomonic lesion and published the preliminary NINDS (National Institute of Neurological Disorders and Stroke) criteria for CTE. Since that time, the NINDS criteria for CTE have been implemented and validated in multiple international publications. Using the NINDS criteria, the largest clinicopathological series of CTE to date was reported that included 177 former American football players, including 110 (99%) of 111 former National Football League players, 48 (91%) of 53 former college football players, and 3 (21%) of 14 former high school players. Studies have also shown a significant association between cumulative exposure to repetitive head trauma, as judged by the length of American football playing career, and risk for and severity of CTE. There is also a significant relationship of the length of football playing career with p-tau pathology, inflammation, white matter rarefaction, and age at death in CTE. While p-tau pathology, inflammation, white matter rarefaction, and arteriolosclerosis contribute to dementia in CTE, whether they also influence the behavioral and mood symptoms in CTE has yet to be determined. There have been several instances of aging-related tau astrogliopathy (ARTAG), a common astrocytic pathology in the elderly, misdiagnosed as CTE in the recent literature, provoking claims that CTE pathology is present in people not known to have experienced repetitive head trauma. Although ARTAG is often found in CTE, the pathognomonic lesion of CTE is a neuronal lesion consisting of NFTs and neurites, with or without p-tau immunoreactive astrocytes. Some authors consider β-amyloid (Aβ) to be a primary feature of CTE, yet the data indicate that CTE is a primary tauopathy, with Aβ deposition a function of age and inheritance of the ApoEe4 allele. Some authors also question the progressive nature of CTE pathology, although there is clear evidence in most individuals that p-tau pathology increases in density and affects more brain regions with survival. This review is intended to outline the status of the evidence-based literature regarding CTE neuropathology and to address the misrepresentations and confusions that have arisen in recent reviews and a letter of correspondence.

scholarly journals Chronic Traumatic Encephalopathy in Professional American Football Players: Where Are We Now?

2018 ◽  
Vol 9 ◽  
Author(s):  
Tharmegan Tharmaratnam ◽  
Mina A. Iskandar ◽  
Tyler C. Tabobondung ◽  
Iqdam Tobbia ◽  
Prasaanthan Gopee-Ramanan ◽  
...  
Keyword(s):  
Chronic Traumatic Encephalopathy ◽  
American Football ◽  
Football Players

scholarly journals Sports Level and the Personality of American Football Players in Poland

2021 ◽  
Vol 18 (24) ◽  
pp. 13026
Author(s):  
Paweł Piepiora ◽  
Damian Kwiatkowski ◽  
Justyna Bagińska ◽  
Dimitris Agouridas
Keyword(s):  
Big Five ◽  
Divergent Thinking ◽  
Openness To Experience ◽  
American Football ◽  
Football Players ◽  
Big Five Personality ◽  
Personality Questionnaire ◽  
Personality Tests ◽  
Football Clubs ◽  
The Relationship

Research on personality in sport is very popular as it allows prediction of the behavior of players in the starting situation. Hence, verifications of players due to their sports level may turn out to be crucial. Due to the dynamic development of American football in Poland, we undertook research to verify the relationship between the sports level and the personality of these players. The Big Five personality study that we carried out involved players aged from 20 to 29—the representatives of American football clubs in Poland (N = 140) from three league games levels: LFA 1 (n = 75), LFA 2 (n = 40), and LFA 9 (n = 25). The NEO-FFI personality questionnaire was used as a research tool. The players from the top-level games were characterized by their openness to experience, the level of which decreases along with the decrease in the players’ sports levels. The differences in openness to experience were revealed, first of all, in divergent thinking and creativity. It was ascertained that openness to experience is a characteristic personality trait for American football players in Poland. Therefore, systematic conduct of personality tests among American football players in Poland, in the process of selecting candidates for the highest levels of football competition, would be recommended. This might significantly affect the development of the sports level of this discipline in Poland. The obtained results of research on personality may, moreover, prove to be useful in selecting players and improving the predictions of important sports behaviors in American football in Poland.

195 Chronic Traumatic Encephalopathy (CTE): Clinical and Pathological Insights

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 252-252
Author(s):  
Domenic P Esposito
Keyword(s):  
Mental Status ◽  
Clinical Symptoms ◽  
Chronic Traumatic Encephalopathy ◽  
Memory Loss ◽  
American Football ◽  
Football Players ◽  
Post Mortem ◽  
Clinical Dementia Rating ◽  
Progressive Dementia ◽  
Boston University

Abstract INTRODUCTION Introduction: Chronic Traumatic Ence-phalopathy (CTE) is a progressive degenerative disease of the brain found in athletes and military veterans with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head. The diagnosis, at this time, can only be made by post-mortem examination of brain and is based on the presence of hyperphosphorylated tau protein andneurofibrillary tangles around small blood vessels at the depths of the cortical sulci... Originally, CTE was thought to only occur in boxers however recent research has shown that other athletes, such as American football players, are at risk for the disorder. The diagnosis of CTE was first reported by Dr Bennet Omalu in 2005..Dr Ann McKee and researchers at Boston University have reported to date on 92 of 96 former NFL players diagnosed with CTE. Clinical symptoms of CTE include memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, and, eventually, progressive dementia. METHODS This presentation will concentrate on the clinical evaluation of 50 + former NFL players with suspected CTE 2 of whom were also evaluated post mortem by Dr Ann McKee and researchers at Boston University. All subjects provided detailed general medical, concussion and sub concussive event, and sports medicine histories. All subjects underwent detailed neurological examinations including mini-mental status exams, clinical dementia rating scores, and extensive neuropsychological testing. Post-mortem neuropathological examinations were performed on 2 subjects. RESULTS >Analysis of pertinent historical events, results of neurological examination, clinical mental status testing, detailed neuropsychological scoring on the 50 + subjects will be presented as well as the neuropathological results on 2 overlapping subjects. Pathological grading of the 96 players examined at autopsy will also be reviewed and coorelated with clinical grading of the 50 + patients evaluated clinically. CONCLUSION The constellation of neurological, neuropsychological and pathological findings found in this large cohort of former American football players and the neuropathological findings will be discussed.

Behavioral Tackling Interventions Decrease Head Impact Frequency in American Football Players: A Critically Appraised Topic

2020 ◽  
pp. 1-7
Author(s):  
Ashley E. Evans ◽  
Madeline Curtis ◽  
Marguerite (Meg) Montjoy ◽  
Erica Beidler
Keyword(s):  
High School ◽  
Injury Prevention ◽  
Head Impact ◽  
American Football ◽  
Football Players ◽  
Clinical Question ◽  
Impact Frequency ◽  
Bottom Line ◽  
Head Impacts ◽  
Different Types

Context: The rate of sport-related concussion diagnosis has significantly increased in recent years, which has created a need for injury prevention initiatives. There have been efforts put forth by researchers and American football organizations to teach athletes how to tackle properly in order to decrease the number of subconcussive head impacts and concussions. Clinical Question: Does the implementation of a behavioral tackling intervention decrease the head impact frequency in American football players? Clinical Bottom Line: There is moderate SORT Level B evidence to support the use of behavioral tackling interventions as a means for reducing head impact frequency in football athletes. All four included studies found a significant reduction in head impacts following a behavioral tackling intervention with study findings ranging from a 26–33% reduction in impact frequency. These findings were consistent in youth, high school, and college football players and for different types of behavioral tackling interventions. Therefore, these results indicate that behavioral tackling interventions have the potential to reduce the number of head impacts sustained by American football players, which may ultimately lead to a reduction in concussion occurrence as well.

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