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PMID- 28742910
OWN - NLM
STAT- In-Process
DA  - 20170725
LR  - 20170725
IS  - 1538-3598 (Electronic)
IS  - 0098-7484 (Linking)
VI  - 318
IP  - 4
DP  - 2017 Jul 25
TI  - Clinicopathological Evaluation of Chronic Traumatic Encephalopathy in Players of 
      American Football.
PG  - 360-370
LID - 10.1001/jama.2017.8334 [doi]
AB  - Importance: Players of American football may be at increased risk of long-term
      neurological conditions, particularly chronic traumatic encephalopathy (CTE).
      Objective: To determine the neuropathological and clinical features of deceased
      football players with CTE. Design, Setting, and Participants: Case series of 202 
      football players whose brains were donated for research. Neuropathological
      evaluations and retrospective telephone clinical assessments (including head
      trauma history) with informants were performed blinded. Online questionnaires
      ascertained athletic and military history. Exposures: Participation in American
      football at any level of play. Main Outcomes and Measures: Neuropathological
      diagnoses of neurodegenerative diseases, including CTE, based on defined
      diagnostic criteria; CTE neuropathological severity (stages I to IV or
      dichotomized into mild [stages I and II] and severe [stages III and IV]);
      informant-reported athletic history and, for players who died in 2014 or later,
      clinical presentation, including behavior, mood, and cognitive symptoms and
      dementia. Results: Among 202 deceased former football players (median age at
      death, 66 years [interquartile range, 47-76 years]), CTE was neuropathologically 
      diagnosed in 177 players (87%; median age at death, 67 years [interquartile
      range, 52-77 years]; mean years of football participation, 15.1 [SD, 5.2]),
      including 0 of 2 pre-high school, 3 of 14 high school (21%), 48 of 53 college
      (91%), 9 of 14 semiprofessional (64%), 7 of 8 Canadian Football League (88%), and
      110 of 111 National Football League (99%) players. Neuropathological severity of 
      CTE was distributed across the highest level of play, with all 3 former high
      school players having mild pathology and the majority of former college (27
      [56%]), semiprofessional (5 [56%]), and professional (101 [86%]) players having
      severe pathology. Among 27 participants with mild CTE pathology, 26 (96%) had
      behavioral or mood symptoms or both, 23 (85%) had cognitive symptoms, and 9 (33%)
      had signs of dementia. Among 84 participants with severe CTE pathology, 75 (89%) 
      had behavioral or mood symptoms or both, 80 (95%) had cognitive symptoms, and 71 
      (85%) had signs of dementia. Conclusions and Relevance: In a convenience sample
      of deceased football players who donated their brains for research, a high
      proportion had neuropathological evidence of CTE, suggesting that CTE may be
      related to prior participation in football.
FAU - Mez, Jesse
AU  - Mez J
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts2Department of Neurology, Boston University School
      of Medicine, Boston, Massachusetts.
FAU - Daneshvar, Daniel H
AU  - Daneshvar DH
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts3Department of Orthopaedic Surgery, Stanford
      University, Stanford, California.
FAU - Kiernan, Patrick T
AU  - Kiernan PT
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts2Department of Neurology, Boston University School
      of Medicine, Boston, Massachusetts.
FAU - Abdolmohammadi, Bobak
AU  - Abdolmohammadi B
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts2Department of Neurology, Boston University School
      of Medicine, Boston, Massachusetts.
FAU - Alvarez, Victor E
AU  - Alvarez VE
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts4VA Boston Healthcare System, US Department of
      Veteran Affairs, Boston, Massachusetts5Department of Veterans Affairs Medical
      Center, Bedford, Massachusetts.
FAU - Huber, Bertrand R
AU  - Huber BR
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts2Department of Neurology, Boston University School
      of Medicine, Boston, Massachusetts4VA Boston Healthcare System, US Department of 
      Veteran Affairs, Boston, Massachusetts5Department of Veterans Affairs Medical
      Center, Bedford, Massachusetts.
FAU - Alosco, Michael L
AU  - Alosco ML
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts2Department of Neurology, Boston University School
      of Medicine, Boston, Massachusetts.
FAU - Solomon, Todd M
AU  - Solomon TM
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts.
FAU - Nowinski, Christopher J
AU  - Nowinski CJ
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts6Concussion Legacy Foundation, Waltham,
      Massachusetts.
FAU - McHale, Lisa
AU  - McHale L
AD  - Concussion Legacy Foundation, Waltham, Massachusetts.
FAU - Cormier, Kerry A
AU  - Cormier KA
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts2Department of Neurology, Boston University School
      of Medicine, Boston, Massachusetts.
FAU - Kubilus, Caroline A
AU  - Kubilus CA
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts2Department of Neurology, Boston University School
      of Medicine, Boston, Massachusetts.
FAU - Martin, Brett M
AU  - Martin BM
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts7Data Coordinating Center, Boston University
      School of Public Health, Boston, Massachusetts.
FAU - Murphy, Lauren
AU  - Murphy L
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts2Department of Neurology, Boston University School
      of Medicine, Boston, Massachusetts.
FAU - Baugh, Christine M
AU  - Baugh CM
AD  - Interfaculty Initiative in Health Policy, Harvard University, Boston,
      Massachusetts9Division of Sports Medicine, Boston Children's Hospital, Boston,
      Massachusetts.
FAU - Montenigro, Phillip H
AU  - Montenigro PH
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts2Department of Neurology, Boston University School
      of Medicine, Boston, Massachusetts.
FAU - Chaisson, Christine E
AU  - Chaisson CE
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts7Data Coordinating Center, Boston University
      School of Public Health, Boston, Massachusetts.
FAU - Tripodis, Yorghos
AU  - Tripodis Y
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts10Department of Biostatistics, Boston University, 
      Boston, Massachusetts11School of Public Health, Boston University, Boston,
      Massachusetts.
FAU - Kowall, Neil W
AU  - Kowall NW
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts2Department of Neurology, Boston University School
      of Medicine, Boston, Massachusetts4VA Boston Healthcare System, US Department of 
      Veteran Affairs, Boston, Massachusetts12Department of Pathology, Boston
      University School of Medicine, Boston, Massachusetts.
FAU - Weuve, Jennifer
AU  - Weuve J
AD  - School of Public Health, Boston University, Boston, Massachusetts13Department of 
      Epidemiology, Boston University, Boston, Massachusetts.
FAU - McClean, Michael D
AU  - McClean MD
AD  - School of Public Health, Boston University, Boston, Massachusetts14Department of 
      Environmental Health, Boston University, Boston, Massachusetts.
FAU - Cantu, Robert C
AU  - Cantu RC
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts2Department of Neurology, Boston University School
      of Medicine, Boston, Massachusetts6Concussion Legacy Foundation, Waltham,
      Massachusetts15Department of Neurosurgery, Emerson Hospital, Concord,
      Massachusetts.
FAU - Goldstein, Lee E
AU  - Goldstein LE
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts2Department of Neurology, Boston University School
      of Medicine, Boston, Massachusetts12Department of Pathology, Boston University
      School of Medicine, Boston, Massachusetts16Department of Psychiatry, Boston
      University School of Medicine, Boston, Massachusetts17Department of
      Ophthalmology, Boston University School of Medicine, Boston,
      Massachusetts18Department of Biomedical Engineering, Boston University College of
      Engineering, Boston, Massachusetts19Department of Electrical and Computer
      Engineering, Boston University College of Engineering, Boston, Massachusetts.
FAU - Katz, Douglas I
AU  - Katz DI
AD  - Department of Neurology, Boston University School of Medicine, Boston,
      Massachusetts20Braintree Rehabilitation Hospital, Braintree, Massachusetts.
FAU - Stern, Robert A
AU  - Stern RA
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts2Department of Neurology, Boston University School
      of Medicine, Boston, Massachusetts21Department of Neurosurgery, Boston University
      School of Medicine, Boston, Massachusetts22Department of Anatomy and
      Neurobiology, Boston University School of Medicine, Boston, Massachusetts.
FAU - Stein, Thor D
AU  - Stein TD
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts4VA Boston Healthcare System, US Department of
      Veteran Affairs, Boston, Massachusetts5Department of Veterans Affairs Medical
      Center, Bedford, Massachusetts12Department of Pathology, Boston University School
      of Medicine, Boston, Massachusetts.
FAU - McKee, Ann C
AU  - McKee AC
AD  - Boston University Alzheimer's Disease and CTE Center, Boston University School of
      Medicine, Boston, Massachusetts2Department of Neurology, Boston University School
      of Medicine, Boston, Massachusetts4VA Boston Healthcare System, US Department of 
      Veteran Affairs, Boston, Massachusetts5Department of Veterans Affairs Medical
      Center, Bedford, Massachusetts12Department of Pathology, Boston University School
      of Medicine, Boston, Massachusetts23Boston University School of Medicine, Boston,
      Massachusetts.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - JAMA
JT  - JAMA
JID - 7501160
EDAT- 2017/07/26 06:00
MHDA- 2017/07/26 06:00
CRDT- 2017/07/26 06:00
AID - 2645104 [pii]
AID - 10.1001/jama.2017.8334 [doi]
PST - ppublish
SO  - JAMA. 2017 Jul 25;318(4):360-370. doi: 10.1001/jama.2017.8334.