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Disparate Associations of Years of Football Participation and a Metric of Head Impact Exposure with Neurobehavioral Outcomes in Former Collegiate Football Players

Published online by Cambridge University Press:  10 February 2021

Benjamin L. Brett Open the ORCID record for Benjamin L. Brett [Opens in a new window] ,
Amy M. Nader ,
Zachary Y. Kerr ,
Avinash Chandran ,
Samuel R. Walton ,
J. D. DeFreese ,
Kevin M. Guskiewicz  and
Michael McCrea
Benjamin L. Brett*
Affiliation:
Department of Neurosurgery, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA Department of Neurology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
Amy M. Nader
Affiliation:
Department of Neurosurgery, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
Zachary Y. Kerr
Affiliation:
Department of Exercise and Sport Science, University of North Carolina, Fetzer Hall, 210 South Rd, Chapel Hill, NC 27514, USA
Avinash Chandran
Affiliation:
Department of Exercise and Sport Science, University of North Carolina, Fetzer Hall, 210 South Rd, Chapel Hill, NC 27514, USA Datalys Center for Sports Injury Research and Prevention, 401 W Michigan St #500, Indianapolis, IN 46202 USA
Samuel R. Walton
Affiliation:
Department of Exercise and Sport Science, University of North Carolina, Fetzer Hall, 210 South Rd, Chapel Hill, NC 27514, USA
J. D. DeFreese
Affiliation:
Department of Exercise and Sport Science, University of North Carolina, Fetzer Hall, 210 South Rd, Chapel Hill, NC 27514, USA
Kevin M. Guskiewicz
Affiliation:
Department of Exercise and Sport Science, University of North Carolina, Fetzer Hall, 210 South Rd, Chapel Hill, NC 27514, USA
Michael McCrea
Affiliation:
Department of Neurosurgery, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA Department of Neurology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
*
*Correspondence and reprint requests to: Benjamin L. Brett, Assistant Professor, Department of Neurosurgery, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI53226, USA. E-mail: [email protected]
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Abstract

Objectives:

Years of sport participation (YoP) is conventionally used to estimate cumulative repetitive head impacts (RHI) experienced by contact sport athletes. The relationship of this measure to other estimates of head impact exposure and the potential associations of these measures with neurobehavioral functioning are unknown. We investigated the association between YoP and the Head Impact Exposure Estimate (HIEE), and whether associations between the two estimates of exposure and neurobehavioral functioning varied.

Methods:

Former American football players (N = 58; age = 37.9 ± 1.5 years) completed in-person evaluations approximately 15 years following sport discontinuation. Assessments consisted of neuropsychological assessment and structured interviews of head impact history (i.e., HIEE). General linear models were fit to test the association between YoP and the HIEE, and their associations with neurobehavioral outcomes.

Results:

YoP was weakly correlated with the HIEE, p = .005, R2 = .13. Higher YoP was associated with worse performance on the Symbol Digit Modalities Test, p = .004, R2 = .14, and Trail Making Test-B, p = .001, R2 = .18. The HIEE was associated with worse performance on the Delayed Recall trial of the Hopkins Verbal Learning Test-Revised, p = .020, R2 = .09, self-reported cognitive difficulties (Neuro-QoL Cognitive Function), p = .011, R2 = .10, psychological distress (Brief Symptom Inventory-18), p = .018, R2 = .10, and behavioral regulation (Behavior Rating Inventory of Executive Function for Adults), p = .017, R2 = .10.

Conclusions:

YoP was marginally associated with the HIEE, a comprehensive estimate of head impacts sustained over a career. Associations between each exposure estimate and neurobehavioral functioning outcomes differed. Findings have meaningful implications for efforts to accurately quantify the risk of adverse long-term neurobehavioral outcomes potentially associated with RHI.

Keywords

Contact sport participationRepetitive head impactsHead injuryTBIConcussion
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 28 , Issue 1 , January 2022 , pp. 22 - 34
Copyright
Copyright © INS. Published by Cambridge University Press, 2021

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