Duration of American Football Play and Chronic Traumatic Encephalopathy
Duration of American Football Play and Chronic Traumatic Encephalopathy
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DOI：
10.1002/ana.25611
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发表时间：
2019-11-23
影响因子：
11.2
通讯作者：
McKee, Ann C.
中科院分区：
文献类型：
--
作者：
Mez, Jesse;Daneshvar, Daniel H.;McKee, Ann C.
目的慢性创伤性脑病（CTE）是一种与橄榄球等接触性运动有关的神经退行性疾病。我们假设了橄榄球运动持续时间与CTE风险和严重程度之间的剂量反应关系。方法在一个方便的样本中，266名已故的美国橄榄球运动员从退伍军人事务，波士顿大学脑震荡遗产基金会和心脏研究脑银行，我们估计了多年的橄榄球与CTE的病理状态和严重程度的关联。我们评估了使用受试者工作特征曲线分析对CTE状态进行分类的能力。模拟分析了可能导致选择偏差的量化条件。结果266例受试者中，223例符合CTE的神经病理学诊断标准。足球运动年限越长，CTE的发生率越高（比值比[OR] = 1.30/年，95%置信区间[CI] = 1.19-1.41; p = 3.8 x 10 - 9），CTE的严重程度也越高（重度vs轻度; OR = 1.14/年，95% CI = 1.07-1.22; p = 3.1 x 10 - 4）。与未患CTE的参与者相比，患CTE的参与者有1/10的可能打了14.5年（阳性LR = 10.2，95% CI = 9.8-10.7）。灵敏度和特异性在11岁时达到最大。模拟表明，年发挥仍然与CTE状态的不利影响时，年发挥和CTE状态都与脑银行的选择在广泛的场景。解释CTE的几率每2.6年增加一倍的足球。在考虑了脑库选择后，游戏年限和CTE状态之间的关系程度保持一致。2019年安神经
Objective Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease associated with exposure to contact and collision sports, including American football. We hypothesized a dose-response relationship between duration of football played and CTE risk and severity. Methods In a convenience sample of 266 deceased American football players from the Veterans Affairs-Boston University-Concussion Legacy Foundation and Framingham Heart Study Brain Banks, we estimated the association of years of football played with CTE pathological status and severity. We evaluated the ability of years played to classify CTE status using receiver operating characteristic curve analysis. Simulation analyses quantified conditions that might lead to selection bias. Results In total, 223 of 266 participants met neuropathological diagnostic criteria for CTE. More years of football played were associated with having CTE (odds ratio [OR] = 1.30 per year played, 95% confidence interval [CI] = 1.19-1.41; p = 3.8 x 10(-9)) and with CTE severity (severe vs mild; OR = 1.14 per year played, 95% CI = 1.07-1.22; p = 3.1 x 10(-4)). Participants with CTE were 1/10th as likely to have played 14.5 years (positive LR = 10.2, 95% CI = 9.8-10.7) compared with participants without CTE. Sensitivity and specificity were maximized at 11 years played. Simulation demonstrated that years played remained adversely associated with CTE status when years played and CTE status were both related to brain bank selection across widely ranging scenarios. Interpretation The odds of CTE double every 2.6 years of football played. After accounting for brain bank selection, the magnitude of the relationship between years played and CTE status remained consistent. ANN NEUROL 2019