학술논문
Imaging Brain Injury in Former National Football League Players.
Document Type
Academic Journal
Author
Rubin LH; Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Department of Epidemiology, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Department of Molecular and Comparative Pathobiology, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Du Y; Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Sweeney SE; Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland.; O'Toole R; Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Thomas CL; Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Zandi AG; Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Shinehouse LK; Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Brosnan MK; Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Nam H; Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Burke ME; Concussion Legacy Foundation, Boston, Massachusetts.; Bureau SC; Concussion Legacy Foundation, Boston, Massachusetts.; Kilgore JJ; Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Yoon M; Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Soule AR; Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Lesniak WG; Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Minn I; Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Rowe SP; Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Holt DP; Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Hall AW; Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Mathews WB; Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Smith GS; Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Nowinski CJ; Concussion Legacy Foundation, Boston, Massachusetts.; Alzheimer's Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts.; Kassiou M; School of Chemistry, University of Sydney, Sydney, New South Wales, Australia.; Dannals RF; Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Pomper MG; Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Department of Molecular and Comparative Pathobiology, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Coughlin JM; Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, Maryland.; Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Source
Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
Subject
Language
English
Abstract
Importance: Pilot studies that involved early imaging of the 18 kDa translocator protein (TSPO) using positron emission tomography (PET) indicated high levels of TSPO in the brains of active or former National Football League (NFL) players. If validated further in larger studies, those findings may have implications for athletes involved in collision sport.
Objective: To test for higher TSPO that marks brain injury and repair in a relatively large, unique cohort of former NFL players compared with former elite, noncollision sport athletes.
Design, Setting, and Participants: This cross-sectional study used carbon 11-labeled N,N-diethyl-2-(4-methoxyphenyl)-5,7-dimethylpyrazolo[1,5-a]pyrimidine-3-acetamide positron emission tomography ([11C]DPA-713 PET) data from former NFL players within 12 years of last participation in the NFL and elite noncollision sport athletes from across the US. Participants were enrolled between April 2018 and February 2023.
Main Outcomes and Measures: Regional [11C]DPA-713 total distribution volume from [11C]DPA-713 PET that is a measure of regional brain TSPO; regional brain volumes on magnetic resonance imaging; neuropsychological performance, including attention, executive function, and memory domains.
Results: This study included 27 former NFL players and 27 former elite, noncollision sport athletes. Regional TSPO levels were higher in former NFL players compared with former elite, noncollision sport athletes (unstandardized β coefficient, 1.08; SE, 0.22; 95% CI, 0.65 to 1.52; P < .001). The magnitude of the group difference depended on region, with largest group differences in TSPO in cingulate and frontal cortices as well as hippocampus. Compared with noncollision sport athletes, former NFL players performed worse in learning (mean difference [MD], -0.70; 95% CI, -1.14 to -0.25; P = .003) and memory (MD, -0.77; 95% CI, -1.24 to -0.30; P = .002), with no correlation between total gray matter TSPO and these cognitive domains.
Conclusions and Relevance: In this cross-sectional study using [11C]DPA-713 PET, higher brain TSPO was found in former NFL players compared with noncollision sport athletes. This finding is consistent with neuroimmune activation even after cessation of NFL play. Future longitudinal [11C]DPA-713 PET and neuropsychological testing promises to inform whether neuroimmune-modulating therapy may be warranted.
Objective: To test for higher TSPO that marks brain injury and repair in a relatively large, unique cohort of former NFL players compared with former elite, noncollision sport athletes.
Design, Setting, and Participants: This cross-sectional study used carbon 11-labeled N,N-diethyl-2-(4-methoxyphenyl)-5,7-dimethylpyrazolo[1,5-a]pyrimidine-3-acetamide positron emission tomography ([11C]DPA-713 PET) data from former NFL players within 12 years of last participation in the NFL and elite noncollision sport athletes from across the US. Participants were enrolled between April 2018 and February 2023.
Main Outcomes and Measures: Regional [11C]DPA-713 total distribution volume from [11C]DPA-713 PET that is a measure of regional brain TSPO; regional brain volumes on magnetic resonance imaging; neuropsychological performance, including attention, executive function, and memory domains.
Results: This study included 27 former NFL players and 27 former elite, noncollision sport athletes. Regional TSPO levels were higher in former NFL players compared with former elite, noncollision sport athletes (unstandardized β coefficient, 1.08; SE, 0.22; 95% CI, 0.65 to 1.52; P < .001). The magnitude of the group difference depended on region, with largest group differences in TSPO in cingulate and frontal cortices as well as hippocampus. Compared with noncollision sport athletes, former NFL players performed worse in learning (mean difference [MD], -0.70; 95% CI, -1.14 to -0.25; P = .003) and memory (MD, -0.77; 95% CI, -1.24 to -0.30; P = .002), with no correlation between total gray matter TSPO and these cognitive domains.
Conclusions and Relevance: In this cross-sectional study using [11C]DPA-713 PET, higher brain TSPO was found in former NFL players compared with noncollision sport athletes. This finding is consistent with neuroimmune activation even after cessation of NFL play. Future longitudinal [11C]DPA-713 PET and neuropsychological testing promises to inform whether neuroimmune-modulating therapy may be warranted.