Association between contact sports participation and chronic traumatic encephalopathy: a retrospective cohort study

Kevin F. Bieniek, Melissa M. Blessing, Michael G. Heckman, Nancy N. Diehl, Amanda M. Serie, Michael A. Paolini, Bradley F. Boeve, Rodolfo Savica, R. Ross Reichard, Dennis W. Dickson

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Chronic traumatic encephalopathy is a debilitating neurodegenerative disorder associated with repetitive traumatic brain injuries often sustained through prior contact sport participation. The frequency of this disorder in a diverse population, including amateur athletes, is unknown. Primary historical obituary and yearbook records were queried for 2566 autopsy cases in the Mayo Clinic Tissue Registry resulting in identification of 300 former athletes and 450 non-athletes. In these cases, neocortical tissue was screened for tau pathology with immunohistochemistry, including pathology consistent with chronic traumatic encephalopathy, blinded to exposure or demographic information. Using research infrastructure of the Rochester Epidemiology Project, a comprehensive and established medical records-linkage system of care providers in southern Minnesota and western Wisconsin, medical diagnostic billing codes pertaining to head trauma, dementia, movement disorders, substance abuse disorders and psychiatric disorders were recorded for cases and controls in a blinded manner. A total of 42 individuals had pathology consistent with, or features of, chronic traumatic encephalopathy. It was more frequent in athletes compared to non-athletes (27 cases versus 15 cases) and was largely observed in men (except for one woman). For contact sports, American football had the highest frequency of chronic traumatic encephalopathy pathology (15% of cases) and an odds ratio of 2.62 (P-value = 0.005). Cases with chronic traumatic encephalopathy pathology had higher frequencies of antemortem clinical features of dementia, psychosis, movement disorders and alcohol abuse compared to cases without chronic traumatic encephalopathy pathology. Understanding the frequency of chronic traumatic encephalopathy pathology in a large autopsy cohort with diverse exposure backgrounds provides a baseline for future prospective studies assessing the epidemiology and public health impact of chronic traumatic encephalopathy and sports-related repetitive head trauma.

Original languageEnglish (US)
Pages (from-to)63-74
Number of pages12
JournalBrain Pathology
Volume30
Issue number1
DOIs
StatePublished - Jan 1 2020

Fingerprint

Sports
Cohort Studies
Retrospective Studies
Pathology
Athletes
Movement Disorders
Craniocerebral Trauma
Dementia
Autopsy
Medical Record Linkage
Epidemiology
Football
Chronic Traumatic Encephalopathy
Neurodegenerative Diseases
Psychotic Disorders
Alcoholism
Substance-Related Disorders
Psychiatry
Registries
Public Health

Keywords

  • chronic traumatic encephalopathy
  • contact sports
  • football
  • tau
  • traumatic brain injuries

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Neuroscience(all)
  • Clinical Neurology

Cite this

Association between contact sports participation and chronic traumatic encephalopathy : a retrospective cohort study. / Bieniek, Kevin F.; Blessing, Melissa M.; Heckman, Michael G.; Diehl, Nancy N.; Serie, Amanda M.; Paolini, Michael A.; Boeve, Bradley F.; Savica, Rodolfo; Reichard, R. Ross; Dickson, Dennis W.

In: Brain Pathology, Vol. 30, No. 1, 01.01.2020, p. 63-74.

Research output: Contribution to journalArticle

Bieniek, KF, Blessing, MM, Heckman, MG, Diehl, NN, Serie, AM, Paolini, MA, Boeve, BF, Savica, R, Reichard, RR & Dickson, DW 2020, 'Association between contact sports participation and chronic traumatic encephalopathy: a retrospective cohort study', Brain Pathology, vol. 30, no. 1, pp. 63-74. https://doi.org/10.1111/bpa.12757
Bieniek, Kevin F. ; Blessing, Melissa M. ; Heckman, Michael G. ; Diehl, Nancy N. ; Serie, Amanda M. ; Paolini, Michael A. ; Boeve, Bradley F. ; Savica, Rodolfo ; Reichard, R. Ross ; Dickson, Dennis W. / Association between contact sports participation and chronic traumatic encephalopathy : a retrospective cohort study. In: Brain Pathology. 2020 ; Vol. 30, No. 1. pp. 63-74.
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