Caroline Altaras, Monica T Ly, Olivia Schultz, William B Barr, Sarah J Banks, Jennifer V Wethe, Yorghos Tripodis, Charles H Adler, Laura J Balcer, Charles Bernick, Henrik Zetterberg, Kaj Blennow, Nicholas Ashton, Elaine Peskind, Robert C Cantu, Michael J Coleman, Alexander P Lin, Inga K Koerte, Sylvain Bouix, Daniel Daneshvar, David W Dodick, Yonas E Geda, Douglas L Katz, Jason L Weller, Jesse Mez, Joseph N Palmisano, Brett Martin, Jeffrey L Cummings, Eric M Reiman, Martha E Shenton, Robert A Stern, Michael L Alosco
{"title":"前美式橄榄球运动员基于分散的认知个体内变异：与创伤性脑病综合征、重复性头部撞击和生物标志物的关联","authors":"Caroline Altaras, Monica T Ly, Olivia Schultz, William B Barr, Sarah J Banks, Jennifer V Wethe, Yorghos Tripodis, Charles H Adler, Laura J Balcer, Charles Bernick, Henrik Zetterberg, Kaj Blennow, Nicholas Ashton, Elaine Peskind, Robert C Cantu, Michael J Coleman, Alexander P Lin, Inga K Koerte, Sylvain Bouix, Daniel Daneshvar, David W Dodick, Yonas E Geda, Douglas L Katz, Jason L Weller, Jesse Mez, Joseph N Palmisano, Brett Martin, Jeffrey L Cummings, Eric M Reiman, Martha E Shenton, Robert A Stern, Michael L Alosco","doi":"10.1080/13854046.2025.2453103","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background:</b> Exposure to repetitive head impacts (RHI), such as those experienced in American football, is linked to cognitive dysfunction later in life. Traumatic encephalopathy syndrome (TES) is a proposed clinical syndrome thought to be linked to neuropath-ology of chronic traumatic encephalopathy (CTE), a condition associated with RHI from football. Cognitive intra-individual variability (d-CIIV) measures test-score dispersion, indicating cognitive dysfunction. This study examined d-CIIV in former football players and its associations with TES diagnosis, RHI exposure, and DTI and CSF biomarkers. <b>Methods:</b> Data included 237 males (45-74 years) from DIAGNOSE CTE Research Project, including former professional and college football players (COL) (<i>n</i> = 173) and asymptomatic men without RHI or TBI (<i>n</i> = 55). Participants completed neuropsychological tests. TES diagnosis was based on 2021 NINDS TES criteria. Years of football play and a cumulative head impact index (CHII) measured RHI exposure. Lumipulse technology was used for CSF assays. DTI fractional anisotropy assessed white matter integrity. Coefficient of variation (CoV) measured d-CIIV. ANCOVA compared d-CIIV among groups (football versus control; TES-status). Pearson correlations and linear regressions tested associations between d-CIIV, RHI exposure, and CSF and DTI biomarkers. <b>Results:</b> Former professional players had higher d-CIIV than controls (F(7, 194) = 2.87, <i>p</i> = .007). d-CIIV was associated with TES diagnosis (F(8, 146) = 9.063, <i>p</i> < .001), with highest d-CIIV in TES Possible/Probable-CTE. Higher d-CIIV correlated with higher CHII scores (<i>r</i> = 0.19), reduced CSF Aβ<sub>1-42</sub> (<i>β</i> = -0.302), increased p-tau<sub>181</sub> (<i>β<u> </u></i>= 0.374), and reduced DTI FA (<i>β</i> = -0.202). <b>Conclusion:</b> d-CIIV is linked to RHI exposure and TES diagnosis in former football players, with associated changes in CSF biomarkers and white matter integrity.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-29"},"PeriodicalIF":3.0000,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Dispersion-based cognitive intra-individual variability in former American football players: Association with traumatic encephalopathy syndrome, repetitive head impacts, and biomarkers.\",\"authors\":\"Caroline Altaras, Monica T Ly, Olivia Schultz, William B Barr, Sarah J Banks, Jennifer V Wethe, Yorghos Tripodis, Charles H Adler, Laura J Balcer, Charles Bernick, Henrik Zetterberg, Kaj Blennow, Nicholas Ashton, Elaine Peskind, Robert C Cantu, Michael J Coleman, Alexander P Lin, Inga K Koerte, Sylvain Bouix, Daniel Daneshvar, David W Dodick, Yonas E Geda, Douglas L Katz, Jason L Weller, Jesse Mez, Joseph N Palmisano, Brett Martin, Jeffrey L Cummings, Eric M Reiman, Martha E Shenton, Robert A Stern, Michael L Alosco\",\"doi\":\"10.1080/13854046.2025.2453103\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background:</b> Exposure to repetitive head impacts (RHI), such as those experienced in American football, is linked to cognitive dysfunction later in life. Traumatic encephalopathy syndrome (TES) is a proposed clinical syndrome thought to be linked to neuropath-ology of chronic traumatic encephalopathy (CTE), a condition associated with RHI from football. Cognitive intra-individual variability (d-CIIV) measures test-score dispersion, indicating cognitive dysfunction. This study examined d-CIIV in former football players and its associations with TES diagnosis, RHI exposure, and DTI and CSF biomarkers. <b>Methods:</b> Data included 237 males (45-74 years) from DIAGNOSE CTE Research Project, including former professional and college football players (COL) (<i>n</i> = 173) and asymptomatic men without RHI or TBI (<i>n</i> = 55). Participants completed neuropsychological tests. TES diagnosis was based on 2021 NINDS TES criteria. Years of football play and a cumulative head impact index (CHII) measured RHI exposure. Lumipulse technology was used for CSF assays. DTI fractional anisotropy assessed white matter integrity. Coefficient of variation (CoV) measured d-CIIV. ANCOVA compared d-CIIV among groups (football versus control; TES-status). Pearson correlations and linear regressions tested associations between d-CIIV, RHI exposure, and CSF and DTI biomarkers. <b>Results:</b> Former professional players had higher d-CIIV than controls (F(7, 194) = 2.87, <i>p</i> = .007). d-CIIV was associated with TES diagnosis (F(8, 146) = 9.063, <i>p</i> < .001), with highest d-CIIV in TES Possible/Probable-CTE. Higher d-CIIV correlated with higher CHII scores (<i>r</i> = 0.19), reduced CSF Aβ<sub>1-42</sub> (<i>β</i> = -0.302), increased p-tau<sub>181</sub> (<i>β<u> </u></i>= 0.374), and reduced DTI FA (<i>β</i> = -0.202). <b>Conclusion:</b> d-CIIV is linked to RHI exposure and TES diagnosis in former football players, with associated changes in CSF biomarkers and white matter integrity.</p>\",\"PeriodicalId\":55250,\"journal\":{\"name\":\"Clinical Neuropsychologist\",\"volume\":\" \",\"pages\":\"1-29\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-01-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Neuropsychologist\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1080/13854046.2025.2453103\",\"RegionNum\":3,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Neuropsychologist","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1080/13854046.2025.2453103","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：暴露于重复性的头部撞击（RHI），比如那些在美式足球中经历过的，与以后生活中的认知功能障碍有关。创伤性脑病综合征（TES）是一种被提出的临床综合征，被认为与慢性创伤性脑病（CTE）的神经病理学有关，CTE是一种与足球RHI相关的疾病。认知个体内变异性（d-CIIV）衡量测试分数的分散程度，表明认知功能障碍。本研究检查了前足球运动员的d-CIIV及其与TES诊断、RHI暴露、DTI和CSF生物标志物的关系。方法：数据包括来自诊断CTE研究项目的237名男性（45-74岁），包括前职业和大学橄榄球运动员（COL） （n = 173）和无RHI或TBI的无症状男性（n = 55）。参与者完成了神经心理学测试。TES诊断基于2021年NINDS TES标准。踢足球的年数和累积头部撞击指数（CHII）测量了RHI暴露。脑脊液检测采用Lumipulse技术。DTI分数各向异性评估白质完整性。变异系数（CoV）测量d-CIIV。ANCOVA比较各组之间的d-CIIV(足球与对照组；TES-status)。Pearson相关性和线性回归检验了d-CIIV、RHI暴露、CSF和DTI生物标志物之间的相关性。结果：退役职业球员的d-CIIV高于对照组（F(7,194) = 2.87, p = .007）。d-CIIV与TES诊断相关（F(8,146) = 9.063, p r = 0.19），脑脊液Aβ1-42减少（β = -0.302）， p-tau181增加（β = 0.374）， DTI FA减少（β = -0.202）。结论：d-CIIV与前足球运动员RHI暴露和TES诊断有关，与脑脊液生物标志物和白质完整性的变化相关。
Dispersion-based cognitive intra-individual variability in former American football players: Association with traumatic encephalopathy syndrome, repetitive head impacts, and biomarkers.
Background: Exposure to repetitive head impacts (RHI), such as those experienced in American football, is linked to cognitive dysfunction later in life. Traumatic encephalopathy syndrome (TES) is a proposed clinical syndrome thought to be linked to neuropath-ology of chronic traumatic encephalopathy (CTE), a condition associated with RHI from football. Cognitive intra-individual variability (d-CIIV) measures test-score dispersion, indicating cognitive dysfunction. This study examined d-CIIV in former football players and its associations with TES diagnosis, RHI exposure, and DTI and CSF biomarkers. Methods: Data included 237 males (45-74 years) from DIAGNOSE CTE Research Project, including former professional and college football players (COL) (n = 173) and asymptomatic men without RHI or TBI (n = 55). Participants completed neuropsychological tests. TES diagnosis was based on 2021 NINDS TES criteria. Years of football play and a cumulative head impact index (CHII) measured RHI exposure. Lumipulse technology was used for CSF assays. DTI fractional anisotropy assessed white matter integrity. Coefficient of variation (CoV) measured d-CIIV. ANCOVA compared d-CIIV among groups (football versus control; TES-status). Pearson correlations and linear regressions tested associations between d-CIIV, RHI exposure, and CSF and DTI biomarkers. Results: Former professional players had higher d-CIIV than controls (F(7, 194) = 2.87, p = .007). d-CIIV was associated with TES diagnosis (F(8, 146) = 9.063, p < .001), with highest d-CIIV in TES Possible/Probable-CTE. Higher d-CIIV correlated with higher CHII scores (r = 0.19), reduced CSF Aβ1-42 (β = -0.302), increased p-tau181 (β= 0.374), and reduced DTI FA (β = -0.202). Conclusion: d-CIIV is linked to RHI exposure and TES diagnosis in former football players, with associated changes in CSF biomarkers and white matter integrity.
期刊介绍：
The Clinical Neuropsychologist (TCN) serves as the premier forum for (1) state-of-the-art clinically-relevant scientific research, (2) in-depth professional discussions of matters germane to evidence-based practice, and (3) clinical case studies in neuropsychology. Of particular interest are papers that can make definitive statements about a given topic (thereby having implications for the standards of clinical practice) and those with the potential to expand today’s clinical frontiers. Research on all age groups, and on both clinical and normal populations, is considered.
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