Journal of neurotrauma最新文献

{"title":"Exploring Ketamine in Traumatic Brain Injury: A Narrative Review of Its Current Emerging Perspectives from Clinical and Preclinical Studies.","authors":"Thamer Alaifan, Abdulrahman M Khojah, Abdulrazak Sakhakhni, Ali Alkhaibary, Eman A Alraddad, Elaf Alqurashi, Shadell Alghamdi, Sereen Kazim, Ahmed Attar, Ahmed Alkhani","doi":"10.1177/08977151261474398","DOIUrl":"https://doi.org/10.1177/08977151261474398","url":null,"abstract":"<p><p>The management of traumatic brain injury (TBI) involves various strategies, with sedation playing a pivotal role. Historically, ketamine has been discouraged in TBI management due to concerns regarding its negative impact on cerebral physiology. However, emerging evidence is challenging this perspective. This narrative review was conducted through a comprehensive literature search utilizing key terms such as \"ketamine\" and \"traumatic brain injury.\" This investigation involved querying multiple medical and scientific databases. Data on the effects of ketamine on intracranial pressure (ICP), cerebral perfusion pressure, systemic hemodynamics, neuroprotection, and neuroinflammation in TBI conditions were collected. Current evidence suggests that ketamine does not significantly affect cerebral hemodynamics compared with other sedatives. Furthermore, preclinical studies have indicated that ketamine exhibits neuroprotective and anti-neuroinflammatory effects. Research endeavors are warranted to explore the effects of ketamine on patients with high-risk ICP and the dose-dependent and combination responses. Moreover, the investigation of the neuroprotective properties of ketamine is encouraged to elucidate its full potential. Reevaluation of ketamine's use is recommended, as it demonstrates comparable efficacy to other sedatives.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261474398"},"PeriodicalIF":3.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Sleep Changes and Symptom Recovery Following Pediatric Concussion.","authors":"Paniz Tavakoli, Andree-Anne Ledoux, Keith Yeates, Ken Tang, Gurinder Sangha, Stephen B Freedman, Jocelyn Gravel, Isabelle Gagnon, William Craig, Emma Burns, Timothy Ramsay, Kathy Boutis, Darcy Beer, Roger Zemek, Rebecca Robillard","doi":"10.1177/08977151261475259","DOIUrl":"https://doi.org/10.1177/08977151261475259","url":null,"abstract":"<p><p>Concussions are one of the most common causes of neurological morbidities in children. In addition to physical, cognitive, and emotional symptoms, a common complaint after concussion is the presence of sleep disturbances, such as trouble falling asleep. The present study sought to longitudinally assess the nature of sleep changes and their association with symptom recovery following concussion in a pediatric sample. Secondary analyses were conducted on a prospective, longitudinal, multicenter cohort study involving 2,991 children and adolescents (5-17 years) who presented to an emergency department within 48 h of a head trauma and who met diagnostic criteria for concussion consistent with the consensus statement prevailing at the time of data collection. Ratings of post-concussive symptoms and sleep disturbances were obtained at 5 pre-defined time points following concussion (weeks 1, 2, 4, 8, and 12), using the Post-Concussion Symptom Inventory (PCSI) and the sleep item of the Pediatric Quality of Life Inventory, respectively. Linear mixed models were fitted separately for the PCSI total score and the physical, cognitive, and emotional symptom subscales, adjusting for random participant effects. Model predictors included sleep, time, and time <i>x</i> sleep interaction. The model accounted for age, sex, maximum duration of previous concussion symptoms for individuals who had a previous concussion, prior diagnosis of developmental disorder, depression, and anxiety, and prior diagnosis of sleep disorders, as they are known risk factors for prolonged recovery. There was significant improvement in both sleep quality ratings (mean values per time point: week 1 = 76.3, SD = 30.1; week 2 = 81.6, SD = 28; week 4 = 82.4, SD = 27.4; week 8 = 86.6, SD = 24.2; week 12 = 89, SD = 22.8) and post-concussive symptoms across time points (mean delta values per time point: week 1 = 0.40, SD = 0.77; week 2 = 0.39, SD = 0.76; week 4 = 0.38, SD = 0.76; week 8 = 0.38, SD = 0.76; week 12 = 0.38, SD = 0.76) (all <i>p</i> < 0.001). Significant sleep*time interactions showed that better sleep was significantly associated with reduced global (β = 0.003, <i>p</i> = 0.030, 95% CI [0.00003, 0.0006]) and physical post-concussion symptoms (β = 0.007, <i>p</i> = 0.035, 95% CI [0.0005, 0.01]) after the injury relative to pre-injury levels, especially in early phases of recovery. Better sleep, regardless of the recovery period, was associated with greater reductions in patient-reported cognitive (β = -0.26, <i>p</i> = 0.0001, 95% CI [-0.34, -0.18]) and emotional symptoms (β = -0.28, <i>p</i> = 0.0001, 95% CI [-0.35, -0.20]) after concussion. The present findings indicate that better sleep is linked to more favorable post-concussion recovery as reflected by different clusters of symptoms. These results highlight the importance of investigating whether safeguarding sleep in children and adolescents with concussion may facilitate recovery.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261475259"},"PeriodicalIF":3.8,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Open Data Commons for Traumatic Brain Injury: An Interagency Community Platform for Pre-Clinical Data Management and Sharing.","authors":"Maryann E Martone, J Russell Huie, P J Axtman, Alexys Maliga Davis, Gene G Gurkoff, Abel Torres-Espin, Jeffrey S Grethe, Adam R Ferguson","doi":"10.1177/08977151261475261","DOIUrl":"10.1177/08977151261475261","url":null,"abstract":"<p><p>The Open Data Commons for Traumatic Brain Injury (ODC-TBI.org) was launched in 2018 to support data sharing in pre-clinical TBI. As data science and artificial intelligence continue to advance, open sharing of high-quality, FAIR (Findable, Accessible, Interoperable, and Reusable) data has assumed critical importance to propel discovery science and as a countermeasure to some of the rigor and reproducibility problems plaguing translational research across biomedicine. Researcher-led specialist repositories such as ODC-TBI serve as important hubs through which biomedical communities come together to define data sharing requirements for their respective domains in support of new requirements by funders and journals for routine data sharing. ODC-TBI is now the recognized data repository for pre-clinical TBI research, listed on the National Library of Medicine-recommended repository listing, and is supported by the National Institute on Neurological Disorders and Stroke. ODC-TBI forms one of the critical infrastructure components of the <u>PRE C</u>linical <u>I</u>nteragency re<u>S</u>earch resourc<u>E</u>-TBI (PRECISE-TBI) project, an interagency effort to promote and support data sharing, rigor, and reproducibility in pre-clinical TBI research. Through PRECISE-TBI, the ODC-TBI has conducted broad outreach, starting in 2022, resulting in a significant increase in the number of users, datasets uploaded and public data releases. PRECISE-TBI has facilitated the establishment of an Editorial Board providing community oversight of ODC-TBI policies and recommendations, for example, the use of standards such as common data elements (CDEs). Here we describe the current state of the ODC-TBI, including its organization, operation, and governance. We perform a detailed overview of public datasets to provide insight into data sharing practices, including the use of CDEs and ancillary practices such as providing links to publications and citing data. We examine the impact of the ODC-TBI by providing statistics on downloads per datasets and reuse of ODC-TBI data in published studies. The results not only provide insight into the growth trajectory of ODC-TBI and data sharing behaviors in pre-clinical TBI, but also point to areas where increased outreach, communication, and training are needed to firmly establish a culture of data sharing.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261475261"},"PeriodicalIF":3.8,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Region-Specific Brain Imaging Correlates of Repetitive Head Impact Exposure in Nonconcussed High School Football Players.","authors":"James M Holcomb, Natalie M Bell, Logan E Miller, Yin Xi, Cameron C Johnson, Ben C Wagner, Fabricio S Feltrin, Alexander K Powers, Jillian E Urban, Christopher T Whitlow, Joel D Stitzel, Joseph A Maldjian, Elizabeth M Davenport","doi":"10.1177/08977151261474842","DOIUrl":"https://doi.org/10.1177/08977151261474842","url":null,"abstract":"<p><p>Repetitive, nonconcussive head impacts in collision sports are associated with lasting neurophysiological effects. This study investigates region-specific changes in neocortical mean diffusivity (MD) and resting-state functional magnetic resonance imaging (fMRI) power spectral density (fMRI-PSD) that correlate with cumulative nonconcussive linear risk-weighted exposure (RWE-Lin) sustained over one high school football season. Pre- to postseason percent changes in MD (%ΔMD) and fMRI-PSD (%ΔfMRI-PSD) were calculated for football players without diagnosed concussions during the season of observation (<i>n</i> = 87 player-seasons). Voxelwise linear regression analyses examined relationships between RWE-Lin with neocortical %ΔMD and %ΔfMRI-PSD. False discovery rate-corrected alpha thresholds of 0.0125 accounted for multiple comparisons and directionality within each test. While controlling for age, body mass index, days between scans, position group (skill vs. line), level (junior varsity vs. varsity), and concussion history, RWE-Lin was significantly positively correlated with %ΔMD (<i>p</i> = 1.12 × 10^-5) and inversely correlated with %ΔfMRI-PSD in the frontal cortex (<i>p</i> = 7.36 × 10^-4). Football players were stratified into high RWE-Lin (<i>n</i> = 13) and low RWE-Lin (<i>n</i> = 37) groups using the Jenks natural breaks algorithm. Noncollision athletes (NCAs, <i>n</i> = 11) served as external controls. When comparing imaging measures across the three groups, the high RWE-Lin football group showed significant differences from both NCA and low RWE-Lin football groups in frontal %ΔMD and %ΔfMRI-PSD (<i>p</i> < 0.05). No significant imaging differences were observed between NCA and low RWE-Lin football groups. Biomechanical modeling localized high-risk impact regions that have high spatial correspondence to the observed imaging abnormalities. Exploratory <i>post hoc</i> voxelwise analyses of magnetoencephalography spectral power detected no significant voxelwise associations with RWE-Lin. In the absence of diagnosed concussion, high-impact football players exhibit abnormal structural and neurovascular changes in the frontal cortex. These regions overlap with those identified to be at greatest risk from biomechanical modeling and those implicated in the pathogenesis of chronic traumatic encephalopathy. Importantly, these imaging abnormalities were not generally observed in football players with lower RWE-Lin. These findings suggest that limiting the number and severity of head impacts may be an effective strategy to mitigate subclinical brain injury in American football.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261474842"},"PeriodicalIF":3.8,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter:</i> Recovery from Traumatic Brain Injury Takes Months; Our Care Systems Last Weeks.","authors":"Scott Hamilton","doi":"10.1177/08977151261476964","DOIUrl":"https://doi.org/10.1177/08977151261476964","url":null,"abstract":"","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261476964"},"PeriodicalIF":3.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing the Prevalence of Dementia Risk Factors in Moderate-to-Severe Traumatic Brain Injury.","authors":"Gershon Spitz, Ruby Phyland, Matthew P Pase, Meng Law, Jennie L Ponsford, Amelia J Hicks","doi":"10.1177/08977151261475258","DOIUrl":"https://doi.org/10.1177/08977151261475258","url":null,"abstract":"<p><p>In the current study, we aimed to determine whether adults with a history of moderate-to-severe traumatic brain injury (TBI) carry a greater burden of modifiable dementia risk factors than demographically matched healthy controls. This was a cross-sectional observational study. Participants were recruited from a pre-existing database of individuals who had previously undergone inpatient rehabilitation at a private hospital in Melbourne, Australia. The study included 106 individuals with a history of moderate-to-severe TBI and 106 demographically matched healthy controls with no TBI history. Participants in the TBI group were at least 1-year post-injury. The groups were matched on age, sex, and years of education. Self-report measures were used to assess a range of modifiable dementia risk factors, including sensory (hearing), mental health (depressive symptoms), lifestyle (social engagement, physical activity, smoking, sleep quality), and cardiometabolic factors. A 14-item composite score was calculated to index the overall modifiable-risk burden. Compared to controls, the TBI group reported significantly poorer hearing, greater depressive symptoms, lower social engagement, higher lifetime smoking prevalence, and poorer sleep quality. However, vascular and metabolic health profiles were similar between groups. The overall composite risk score did not significantly differ between the TBI group and the control group. Individuals with a history of moderate-to-severe TBI demonstrate a distinct profile of modifiable dementia risks rather than a globally elevated risk burden. These findings suggest a need for targeted post-injury surveillance and interventions that focus on auditory health, mental well-being, social participation, smoking cessation, and sleep to help mitigate future dementia risk.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261475258"},"PeriodicalIF":3.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventral Epidural Stimulation Restores Forelimb Function and Reduces Microglial Activation after Subacute Cervical Spinal Cord Injury.","authors":"Matthew K Hogan, Allison M Frazier, Daisy Delgado, Ana G Gutierrez, Cinzia Stigliano, Julio A Mejia, Isis Y Torres, Theresa Tran, Akosh C Kakumanu, Joseph M Zambelas, Sean M Barber, Gavin W Britz, Philip J Horner","doi":"10.1177/08977151261474845","DOIUrl":"10.1177/08977151261474845","url":null,"abstract":"<p><p>Neuromodulation has recently garnered attention as a potent approach to improve sensorimotor function following neural injury. After spinal cord injury, electrical stimulation targets sensorimotor circuitry to enhance volitional movement; however, motor neurons are located in the ventral gray matter. Previously, we developed a versatile wireless stimulation system and surgical approach to selectively activate motor neurons caudal to a cervical spinal cord injury. Here, we empirically tested if ventral epidural stimulation is sufficient to promote lasting recovery of skilled motor function. Ventrally stimulated animals exhibited significantly improved forelimb function associated with electrically stimulated motor pathways. Further, stimulation produced increases in neuronal Nr4a1 expression, a subacute reduction in microglia Nr4a1 expression, and a shift from activated toward ramified microglial morphologies in the stimulated ventral gray matter. This study reports the first successful application of ventral spinal stimulation to improve function in an animal model and the first sustained improvement in skilled forelimb reaching when behavioral testing was decoupled from the stimulation.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261474845"},"PeriodicalIF":3.8,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter:</i> Observation of Beaded Astrocyte Dysmorphology at Tissue Interfaces in Brains of Blast-Exposed Military Service Members.","authors":"David S Priemer, Daniel P Perl","doi":"10.1177/08977151261474836","DOIUrl":"https://doi.org/10.1177/08977151261474836","url":null,"abstract":"","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261474836"},"PeriodicalIF":3.8,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Pelargonium Graveolens</i> Essential Oil Improves Recovery after Experimental Traumatic Brain Injury.","authors":"Liora Omesi, Shlomit Lempert, Chen Shemesh, Kinneret Rosenblatt, Itzik Cooper, Orly Ravid, Esther Shohami, Alona Shachter, Nativ Dudai, Anat Elmann, Sigal Liraz Zaltsman","doi":"10.1177/08977151261467215","DOIUrl":"https://doi.org/10.1177/08977151261467215","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) is a significant global health issue, causing cognitive, motor, and psychological impairments while increasing neurodegenerative disease risk. Essential oil extracted from <i>Pelargonium graveolens</i> (<i>Pg</i>), also known as geranium oil, is Food and Drug Administration (FDA)-approved and classified as generally recognized as safe for use in the food industry. <i>Pg</i> oil contains low molecular weight lipophilic compounds, which potentially traverse the blood-brain barrier and modulate brain functions. We have previously demonstrated that <i>Pg</i> oil exhibits anti-inflammatory and neuroprotective effects. Given the significant role of these processes in TBI pathophysiology and the absence of FDA-approved treatments, our goal in this study was to investigate the therapeutic potential of <i>Pg</i> oil in the closed-head injury (CHI) model for TBI. For this purpose, male C57BL/6JOlaHsd mice (8-9 weeks old, 20-25 g) underwent CHI using a modified weight-drop device and were treated orally with <i>Pg</i> oil for 2 weeks; 56 mice served as controls. Treatment group assignment was randomized based on neurological severity score (NSS) evaluation at 1-hour postinjury. Mice were monitored for 1 month following injury using a comprehensive behavioral battery administered in a blinded manner, then sacrificed for histopathological assessment. <i>Pg</i> was obtained from the Newe Ya'ar Research Center MAP Germplasm collection and prepared via steam distillation. The essential oil composition was characterized using gas chromatography-mass spectrometry (GC-MS). The therapeutic efficacy of <i>Pg</i> oil was demonstrated through multiple behavioral assessments, including the Barnes Maze, Y-maze, and novel object recognition test. <i>Pg</i> oil significantly enhanced cognitive performance in the injured mice, with effects persisting for at least 1-month post-injury. Histopathological evaluation revealed that <i>Pg</i> oil reduced axonal damage and increased neuronal survival in cortical and hippocampal regions. Additionally, <i>Pg</i> oil treatment significantly improved brain tissue preservation, as evidenced by reduced cortical and corpus callosum atrophy and decreased ventricle enlargement. The therapeutic benefits stemmed from anti-inflammatory and antioxidant activities, evidenced by reduced tumor necrosis factor-α, interleukin-1β, and lipid peroxidation levels, along with M2 phenotype immunomodulation, and elevated phosphorylated cyclic-AMP response element binding protein levels. The exclusive use of male mice in this study necessitates future investigation of <i>Pg</i> effects in female subjects. Our findings support the potential applications of <i>Pg</i> oil as a novel nutraceutical and a therapeutic candidate for TBI treatment and improvement of cognitive outcomes, warranting further translational research in TBI patients.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261467215"},"PeriodicalIF":3.8,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participation in Professional American-Style Football and Suicide Mortality: 1979-2019.","authors":"Rachel Grashow, Niki Konstantinides, Benjamin C Anderson, Michael Leung, Eric N Fung, Aaron L Baggish, Daniel H Daneshvar, Wayne Grove, Ross Zafonte, Marc G Weisskopf","doi":"10.1177/08977151251408496","DOIUrl":"https://doi.org/10.1177/08977151251408496","url":null,"abstract":"<p><p>Despite strong associations established between head injury and mental health, studies of professional athletes exposed to head injury show reduced risk of suicide compared with general populations. We compared the risk of suicide among National Football League (NFL) players to Major League Baseball (MLB) and National Basketball Association (NBA) players. Death data from 1979 to 2019 were obtained from the National Death Index for 20,765 NFL, 9,684 MLB, and 3,564 NBA players whose careers began after 1919. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for suicide for NFL players compared with a combined MLB + NBA reference group, adjusted for age at career end, race, and career body mass index. We additionally stratified follow-up time at 2011, when attention on the long-term effects of head injury and chronic traumatic encephalopathy increased. Between 1979 and 2019, 101 suicides occurred among 34,013 participants with mean ± standard deviation (SD) age at career end of 28.3 ± 4.2, and among whom 13,677 (40.2%) were Black. Overall, the NFL suicide rate was similar to the MLB + NBA (HR = 1.20, 95% CI = 0.71-2.01, <i>p</i> = 0.50). When stratified at 2011, no difference was found through 2010 (HR = 0.91, 95% CI = 0.49-1.71, <i>p</i> = 0.78), while the suicide rate post-2010 was higher among NFL players (HR = 2.64, 95% CI = 1.04-6.84, <i>p</i> = 0.04). We have identified a twofold higher incidence of recent suicide within the at-risk group of former NFL players. These findings underscore the need for more intensive post-career guidance pathways and enhanced, proactive screening measures.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":"43 15-16","pages":"1250-1258"},"PeriodicalIF":3.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148436917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}