Risk for Later-Life Cognitive Impairment, Neurobehavioral Dysregulation, and Dementia in Former Soccer and American Football Players: The Head Impact and Trauma Surveillance Study (HITSS)

前足球和美式橄榄球运动员晚年认知障碍、神经行为失调和痴呆的风险：头部撞击和创伤监测研究 (HITSS)

• 批准号: 10563183
• 负责人: Michael Alosco
• 金额: $ 79.42万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-01 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10563183
• 关键词: Acceleration; Address; Advertising; Age; Alzheimer' s Disease; Alzheimer' s disease related dementia; American; Area; Behavioral; Black race; Blood Vessels; Brain Concussion; Brain Health Registry; California; Caregivers; Cognitive; Country; Craniocerebral Trauma; Data; Data Set; Dementia; Development; Elderly; Emotional; Enrollment; Epidemiologic Methods; Episodic memory; Exhibits; Exposure to; Female; Frequencies; Functional disorder; Future; Goals; Health; Health behavior; Impaired cognition; Impairment; Impulsivity; Knowledge; Longitudinal Studies; Manufactured football; Measures; Medical; Mental Depression; Moods; Neurodegenerative Disorders; Neurologic; Outcome; Participant; Patient Self-Report; Persons; Play; Positioning Attribute; Prevalence; Questionnaires; Race; Readiness; Recording of previous events; Registries; Reporting; Research; Research Personnel; Risk; Risk Factors; Sampling; San Francisco; Scientific Advances and Accomplishments; Scoring Method; Severities; Soccer; Standardization; Substance Use Disorder; Substance abuse problem; Testing; Traumatic Brain Injury; Universities; Woman; chronic traumatic encephalopathy; cognitive reserve; cognitive testing; college; comparison group; contact sports; dementia risk; demographics; design; enhancing factor; executive function; follow-up; functional status; head impact; high school; informant; interest; male; neurobehavioral; neurodegenerative dementia; neuropsychiatric symptom; neuropsychiatry; online registry; outreach; performance tests; poor sleep; recruit; risk mitigation; sex; sleep quality; social media; subconcussion; surveillance study; vascular risk factor; web site

Exposure to repetitive head impacts (RHI) through participation in contact and collision sports (CCS) can result in symptomatic concussions and asymptomatic subconcussions and may increase risk for later-life cognitive decline and neuropsychiatric dysfunction, as well as dementia from neurodegenerative disease, including chronic traumatic encephalopathy. Despite many scientific advances in this area, critical knowledge gaps exist due to: small samples, cross-sectional designs, focus on male professional American football players, recruitment biases, and reliance on retrospective reports from informants. Many questions remain, such as: What aspects of RHI are most pertinent to these risks? Are there non-RHI factors that enhance or mitigate risk? Do the risks generalize to women and to soccer players? Our goal is to address these limitations and examine risk factors for, and characterize the frequency, severity, and profile of cognitive impairment, neurobehavioral dysregulation (e.g., explosiveness, impulsivity, “short fuse”), and dementia, in female and male former soccer players and male former American football players. We will create the Head Impact and Trauma Surveillance Study (HITSS) by leveraging the Brain Health Registry (BHR) at the University of California, San Francisco. BHR is an online registry for the longitudinal study of people interested in participating in Alzheimer’s disease (AD) and related dementias (ADRD) research, with ~70,000 participants currently enrolled. BHR participants complete demographic and health questionnaires, medical and neurologic histories, depression scales, subjective cognitive complaint measures, and two validated online cognitive tests. They can also have a study partner complete additional online measures of the participant’s cognitive and functional status and neuropsychiatric symptoms. A HITSS Module will be developed and added to BHR to assess CCS history, RHI exposure (e.g., positions played, age of first exposure, duration of play, era of play, soccer heading), and standardized neuropsychiatric measures. Participants will be recruited into HITSS through an extensive national advertising and social media outreach. We will enroll 1800 former soccer (900 female, 900 male) and 1800 male former American football players into HITSS, across levels of play (high school, college, or elite/professional), ages 40- 75. Using the existing BHR dataset, two comparison groups (n = 1800 each) of current BHR participants without a CCS or TBI history will be propensity-matched to the former soccer and former American football players. We will test the hypothesis that greater cumulative RHI exposure from soccer and American football increases risk for cognitive impairment, neurobehavioral dysregulation, and dementia, and that non-RHI factors (e.g., TBI history, sex, race, vascular risk, cognitive reserve) will modify the effect. Data will be shared with researchers worldwide. Findings will advance research on risk of later-life cognitive decline, neurobehavioral dysregulation, and dementia from CCS involvement. Development of HITSS will also create: (1) a self-sustaining mechanism for follow-up of participants in other CCS studies; (2) a longitudinal, sharable dataset of thousands of female and male, active and former CCS athletes; and (3) a readiness registry of CCS athletes for future research.

通过参与接触和碰撞运动（CCS）暴露于重复性头部撞击（RHI）可能导致 在有症状的脑震荡和无症状的亚脑震荡中， 衰退和神经精神功能障碍，以及神经退行性疾病引起的痴呆，包括 慢性创伤性脑病尽管在这一领域取得了许多科学进展，但仍然存在着严重的知识差距 由于：小样本，横截面设计，专注于男性职业美式足球运动员， 招聘偏见，以及依赖于线人的回顾性报告。许多问题仍然存在，例如： RHI的各个方面与这些风险最相关？是否存在增强或减轻风险的非RHI因素？做 这种风险也普遍存在于女性和足球运动员身上吗我们的目标是解决这些局限性并检查风险 认知功能障碍、神经行为障碍和神经行为障碍的频率、严重程度和特征的因素， 失调（例如，爆炸性、冲动性、“脾气暴躁”）和痴呆症，在女性和男性前足球运动员中 球员和前美国足球运动员。我们将建立头部撞击和创伤监测系统 研究（HITSS）通过利用加州大学旧金山弗朗西斯科的脑健康登记（BHR）。BHR 是一个在线注册的纵向研究的人有兴趣参与阿尔茨海默病（AD） 和相关痴呆症（ADRD）研究，目前有约70，000名参与者。BHR参与者完成 人口统计学和健康问卷，病史和神经病史，抑郁量表，主观 认知抱怨措施，和两个验证的在线认知测试。他们也可以有一个学习伙伴 完成参与者的认知和功能状态以及神经精神状态的额外在线测量 症状将开发一个HITSS模块，并将其添加到BHR中，以评估CCS历史、RHI暴露（例如， 位置，第一次接触的年龄，比赛的持续时间，比赛的时代，足球头球），和标准化 神经精神测量。参与者将通过广泛的全国广告招募到HITSS 和社交媒体推广我们将招募1800名前足球运动员（900名女性，900名男性）和1800名男性前 进入HITSS的美式橄榄球运动员，不同级别的比赛（高中，大学或精英/专业），年龄40- 75.使用现有的BHR数据集，两个比较组（每组n = 1800）的当前BHR参与者没有 CCS或TBI历史将与前足球运动员和前美式足球运动员的倾向相匹配。我们 将检验这一假设，即足球和美式足球的RHI累积暴露增加风险 认知障碍、神经行为失调和痴呆，以及非RHI因素（例如，TBI 病史、性别、种族、血管风险、认知储备）将改变效果。数据将与研究人员共享 国际吧这些发现将推动对晚年认知能力下降、神经行为失调、 和痴呆症的症状HITSS的发展还将创造：（1）自我维持的机制 用于其他CCS研究参与者的随访;（2）数千名女性和 男性，现役和前CCS运动员;和（3）CCS运动员的准备登记，以供未来研究。