Clinical and Neuropathological Correlates of Substance Use in American Football Players.

IF 3.4 3区医学 Q2 NEUROSCIENCES

Journal of Alzheimer's Disease Pub Date : 2024-09-07 DOI:10.3233/jad-240300

Michael Walsh,Madeline Uretsky,Yorghos Tripodis,Christopher J Nowinski,Abigail Rasch,Hannah Bruce,Megan Ryder,Brett M Martin,Joseph N Palmisano,Douglas I Katz,Brigid Dwyer,Daniel H Daneshvar,Alexander Y Walley,Theresa W Kim,Lee E Goldstein,Robert A Stern,Victor E Alvarez,Bertrand Russell Huber,Ann C McKee,Thor D Stein,Jesse Mez,Michael L Alosco

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引用次数: 0

Abstract

Background Chronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy more frequently found in deceased former football players. CTE has heterogeneous clinical presentations with multifactorial causes. Previous literature has shown substance use (alcohol/drug) can contribute to Alzheimer's disease and related tauopathies pathologically and clinically. Objective To examine the association between substance use and clinical and neuropathological endpoints of CTE. Methods Our sample included 429 deceased male football players. CTE was neuropathologically diagnosed. Informant interviews assessed features of substance use and history of treatment for substance use to define indicators: history of substance use treatment (yes vs no, primary variable), alcohol severity, and drug severity. Outcomes included scales that were completed by informants to assess cognition (Cognitive Difficulties Scale, BRIEF-A Metacognition Index), mood (Geriatric Depression Scale-15), behavioral regulation (BRIEF-A Behavioral Regulation Index, Barratt Impulsiveness Scale-11), functional ability (Functional Activities Questionnaire), as well as CTE status and cumulative p-tau burden. Regression models tested associations between substance use indicators and outcomes. Results Of the 429 football players (mean age = 62.07), 313 (73%) had autopsy confirmed CTE and 100 (23%) had substance use treatment history. Substance use treatment and alcohol/drug severity were associated with measures of behavioral regulation (FDR-p-values<0.05, ΔR2 = 0.04-0.18) and depression (FDR-p-values<0.05, ΔR2 = 0.02-0.05). Substance use indicators had minimal associations with cognitive scales, whereas p-tau burden was associated with all cognitive scales (p-values <0.05). Substance use treatment had no associations with neuropathological endpoints (FDR-p-values>0.05). Conclusions Among deceased football players, substance use was common and associated with clinical symptoms.

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美式橄榄球运动员使用药物的临床和神经病理学相关性。

背景慢性创伤性脑病（CTE）是一种神经退行性牛磺酸病，多见于已故的前橄榄球运动员。CTE 的临床表现多种多样，其病因是多因素的。以前的文献表明，使用药物（酒精/毒品）在病理和临床上可能会导致阿尔茨海默病和相关的牛磺酸病。目的研究使用药物与 CTE 的临床和神经病理学终点之间的关系。我们的样本包括 429 名已故的男性足球运动员，他们均经神经病理学诊断为 CTE。知情者访谈评估了药物使用特征和药物使用治疗史，以确定指标：药物使用治疗史（是与否，主要变量）、酒精严重程度和药物严重程度。结果包括由信息提供者完成的量表，用于评估认知（认知困难量表、BRIEF-A 元认知指数）、情绪（老年抑郁量表-15）、行为调节（BRIEF-A 行为调节指数、Barratt 冲动量表-11）、功能能力（功能活动问卷）以及 CTE 状态和累积 p-tau 负担。回归模型检验了药物使用指标与结果之间的关联。结果在 429 名足球运动员（平均年龄 = 62.07 岁）中，313 人（73%）经尸检证实患有 CTE，100 人（23%）有药物使用治疗史。药物使用治疗和酒精/毒品严重程度与行为调节指标相关（FDR-p 值为 0.05）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Alzheimer's Disease 医学-神经科学

CiteScore

6.40

自引率

7.50%

发文量

1327

审稿时长

2 months

期刊介绍： The Journal of Alzheimer''s Disease (JAD) is an international multidisciplinary journal to facilitate progress in understanding the etiology, pathogenesis, epidemiology, genetics, behavior, treatment and psychology of Alzheimer''s disease. The journal publishes research reports, reviews, short communications, hypotheses, ethics reviews, book reviews, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research that will expedite our fundamental understanding of Alzheimer''s disease.