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.

通过参加接触和碰撞运动 (CCS) 可能会导致重复性头部撞击 (RHI) 有症状的脑震荡和无症状的亚脑震荡，可能会增加晚年认知的风险 衰退和神经精神功能障碍，以及神经退行性疾病引起的痴呆，包括 尽管该领域取得了许多科学进展，但仍存在严重的知识差距。 由于：样本小，横截面设计，专注于男性职业美式橄榄球运动员， 招聘偏见以及对线人回顾性报告的依赖仍然存在许多问题，例如：什么。 RHI 的哪些方面与这些风险最相关？是否存在增强或减轻风险的非 RHI 因素？ 风险是否普遍存在于女性和足球运动员身上？我们的目标是解决这些限制并检查风险 认知障碍、神经行为障碍的影响因素和特征的频率、严重程度和概况 女性和男性前足球运动员的调节失调（例如爆发力、冲动、“易怒”）和痴呆 我们将创建头部撞击和创伤监测。 利用旧金山加州大学脑健康登记处 (BHR) 进行的研究 (HITSS)。 是一个在线注册中心，针对有兴趣参与阿尔茨海默病 (AD) 的人群进行纵向研究 和相关痴呆症 (ADRD) 研究，目前约有 70,000 名 BHR 参与者已完成。 人口和健康问卷、医学和神经病史、抑郁量表、主观 认知投诉测量，以及两项经过验证的在线认知测试 他们还可以有一个学习伙伴。 完成参与者认知和功能状态以及神经精神状态的额外在线测量 将开发 HITSS 模块并将其添加到 BHR 中，以评估 CCS 历史、RHI 暴露（例如， 踢球位置、首次接触年龄、比赛持续时间、比赛时代、足球头球）和标准化 神经精神病学措施将通过广泛的全国性广告招募参与者加入 HITSS。 我们将招募 1800 名前足球运动员（900 名女性，900 名男性）和 1800 名男性前足球运动员。 进入 HITSS 的美式橄榄球运动员，不同级别的比赛（高中、大学或精英/职业），年龄 40- 75. 使用现有的 BHR 数据集，当前 BHR 参与者的两个比较组（每组 n = 1800）没有 CCS 或 TBI 历史将与前足球运动员和前美式橄榄球运动员进行倾向匹配。 将检验以下假设：足球和美式橄榄球累积 RHI 暴露量增加会增加风险 认知障碍、神经行为失调和痴呆，以及非 RHI 因素（例如 TBI） 病史、性别、种族、血管风险、认知储备）将修改效果，数据将与研究人员共享。 研究结果将推动对晚年认知能力下降、神经行为失调、 HITSS 的发展还将创建：（1）自我维持机制。 用于跟踪其他 CCS 研究的参与者；(2) 数千名女性和女性的纵向、可共享数据集； 男性、现役和前 CCS 运动员；(3) CCS 运动员为未来研究做好准备的登记册。