R01NS119651

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)

Exposure to repetitive head impacts (RHI) through participation in contact and collision sports (CCS) can result in symptomatic concussions and asymptomatic subconcussions. This exposure may increase the risk for later-life cognitive decline, neuropsychiatric dysfunction, and dementia from neurodegenerative disease, including chronic traumatic encephalopathy. However, there are critical knowledge gaps in this area due to small sample sizes, cross-sectional designs, focus on male professional American football players, recruitment biases, and reliance on retrospective reports from informants.

Many questions remain, such as which aspects of RHI are most pertinent to these risks, whether there are non-RHI factors that enhance or mitigate risk, and whether the risks generalize to women and 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, and dementia in female and male former soccer players and male former American football players.

To achieve this, 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. The 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 approximately 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 aim to enroll 1800 former soccer players (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 traumatic brain injury (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 the risk for cognitive impairment, neurobehavioral dysregulation, and dementia. Additionally, we will investigate how non-RHI factors (e.g., TBI history, sex, race, vascular risk, cognitive reserve) may modify the effect.

The data collected in this study will be shared with researchers worldwide. The findings will advance research on the risk of later-life cognitive decline, neurobehavioral dysregulation, and dementia from CCS involvement. The development of HITSS will also create a self-sustaining mechanism for follow-up of participants in other CCS studies, a longitudinal, sharable dataset of thousands of female and male, active and former CCS athletes, and a readiness registry of CCS athletes for future research.

Trustees Of Boston University

(1) TO SUPPORT EXTRAMURAL RESEARCH FUNDED BY THE NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE (NINDS) INCLUDING: BASIC RESEARCH THAT EXPLORES THE FUNDAMENTAL STRUCTURE AND FUNCTION OF THE BRAIN AND THE NERVOUS SYSTEM, RESEARCH TO UNDERSTAND THE CAUSES AND ORIGINS OF PATHOLOGICAL CONDITIONS OF THE NERVOUS SYSTEM WITH THE GOAL OF PREVENTING THESE DISORDERS, RESEARCH ON THE NATURAL COURSE OF NEUROLOGICAL DISORDERS, IMPROVED METHODS OF DISEASE PREVENTION, NEW METHODS OF DIAGNOSIS AND TREATMENT, DRUG DEVELOPMENT, DEVELOPMENT OF NEURAL DEVICES, CLINICAL TRIALS, AND RESEARCH TRAINING IN BASIC, TRANSLATIONAL AND CLINICAL NEUROSCIENCE. THE INSTITUTE IS THE LARGEST FUNDER OF BASIC NEUROSCIENCE IN THE US AND SUPPORTS RESEARCH ON TOPICS INCLUDING BUT NOT LIMITED TO: DEVELOPMENT OF THE NERVOUS SYSTEM, INCLUDING NEUROGENESIS AND PROGENITOR CELL BIOLOGY, SIGNAL TRANSDUCTION IN DEVELOPMENT AND PLASTICITY, AND PROGRAMMED CELL DEATH, SYNAPSE FORMATION, FUNCTION, AND PLASTICITY, LEARNING AND MEMORY, CHANNELS, TRANSPORTERS, AND PUMPS, CIRCUIT FORMATION AND MODULATION, BEHAVIORAL AND COGNITIVE NEUROSCIENCE, SENSORIMOTOR LEARNING, INTEGRATION AND EXECUTIVE FUNCTION, NEUROENDOCRINE SYSTEMS, SLEEP AND CIRCADIAN RHYTHMS, AND SENSORY AND MOTOR SYSTEMS. IN ADDITION, THE INSTITUTE SUPPORTS BASIC, TRANSLATIONAL AND CLINICAL STUDIES ON A NUMBER OF DISORDERS OF THE NERVOUS SYSTEM INCLUDING (BUT NOT LIMITED TO): STROKE, TRAUMATIC INJURY TO THE BRAIN, SPINAL CORD AND PERIPHERAL NERVOUS SYSTEM, NEURODEGENERATIVE DISORDERS, MOVEMENT DISORDERS, BRAIN TUMORS, CONVULSIVE DISORDERS, INFECTIOUS DISORDERS OF THE BRAIN AND NERVOUS SYSTEM, IMMUNE DISORDERS OF THE BRAIN AND NERVOUS SYSTEM, INCLUDING MULTIPLE SCLEROSIS, DISORDERS RELATED TO SLEEP, AND PAIN. PROGRAMMATIC AREAS, WHICH ARE PRIMARILY SUPPORTED BY THE DIVISION OF NEUROSCIENCE, ARE ALSO SUPPORTED BY THE DIVISION OF EXTRAMURAL ACTIVITIES, THE DIVISION OF TRANSLATIONAL RESEARCH, THE DIVISION OF CLINICAL RESEARCH, THE OFFICE OF TRAINING AND WORKFORCE DEVELOPMENT, THE OFFICE OF PROGRAMS TO ENHANCE NEUROSCIENCE WORKFORCE DEVELOPMENT, AND THE OFFICE OF INTERNATIONAL ACTIVITIES. (2) TO EXPAND AND IMPROVE THE SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. TO UTILIZE THE SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM, TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.866 - Aging Research

National Institute of Neurological Disorders and Stroke (NNDS) [HHS - NIH]

National Institute on Aging (NIA) [HHS - NIH]

Massachusetts United States

State-Wide

Research Project Grant (Parent R01 Clinical Trial Not Allowed) (PA-19-056)

Amendment Since initial award the total obligations have increased 2391% from $157,262 to $3,917,121.