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）接触重复的头部影响（RHI） 在有症状的咨询和不对称的亚语中，可能会增加对后期认知的风险 下降和神经精神功能障碍以及神经退行性疾病的痴呆症，包括 慢性创伤性脑病。尽管这一领域有许多科学进步，但存在关键的知识差距 由于：小样本，横断面设计，专注于男性专业的美式足球运动员， 招聘偏见，并依赖线人的回顾性报告。仍然存在许多问题，例如：什么 RHI的各个方面与这些风险最相关吗？是否有非RHI因素可以增强或减轻风险？做 风险推广到女性和足球运动员？我们的目标是解决这些限制并检查风险 认知障碍的频率，严重程度和概况的因素，神经行为 失调（例如，爆炸性，冲动性，“短保险丝”）和痴呆症，女性和男性以前的足球 球员和男性前美国足球运动员。我们将创建头部影响和创伤监视 通过利用加州大学旧金山分校的大脑健康注册中心（BHR）的研究（HITS）。 bhr 是对有兴趣参加阿尔茨海默氏病（AD）的人们的纵向研究的在线注册表 和相关的痴呆症（ADRD）研究，目前约有70,000名参与者参加。 BHR参与者完成 人口统计和健康问卷，医学和神经学历史，抑郁量表，主观 认知投诉措施和两项经过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病学的其他在线措施 症状。将开发HITS模块并将其添加到BHR中，以评估CCS历史记录，RHI暴露（例如，， 职位扮演，首次曝光年龄，比赛时间，踢球时代，足球标题）和标准化 神经精神病学措施。参与者将通过广泛的国家广告将参与者招募到HITS中 和社交媒体宣传。我们将注册1800次足球（900名女性，900名男性）和1800名男性 美国足球运动员跨越比赛（高中，大学或精英/专业），年龄40岁 - 75。使用现有的BHR数据集，两个当前BHR参与者的比较组（n = 1800个） CCS或TBI历史将有望与前足球和前美国足球运动员匹配。我们 将检验以下假设：足球和美式足球的累积累积RHI暴露会增加风险 对于认知障碍，神经行为失调和痴呆，以及非RHI因素（例如，TBI） 历史，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 全世界。调查结果将进一步研究对后期认知下降，神经行为失调的风险的研究， 和CCS参与的痴呆症。命中的开发也将创建：（1）一种自我维持的机制 用于跟进其他CCS研究的参与者； （2）成千上万的女性的纵向，可共享的数据集 男性，活跃和前CCS运动员； （3）CCS运动员的准备就绪登记处，以供未来的研究。