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Neuroimaging of Cognitive Dysfunction and Depression in Aging Retired National Football League Players: A Cross-sectional Study
Open accessAbstract
OBJECTIVES To assess cognitive impairment and depression in aging former professional football (National Football League [NFL]) players and to identify neuroimaging correlates of these dysfunctions. DESIGN We compared former NFL players with cognitive impairment and depression, cognitively normal retired players who were not depressed, and matched healthy control subjects. SETTING Research center in the North Texas region of the United States. PATIENTS Cross-sectional sample of former NFL players with and without a history of concussion recruited from the North Texas region and age-, education-, and IQ-matched controls. Thirty-four retired NFL players (mean age, 61.8 years) underwent neurological and neuropsychological assessment. A subset of 26 players also underwent detailed neuroimaging; imaging data in this subset were compared with imaging data acquired in 26 healthy matched controls. MAIN OUTCOME MEASURES Neuropsychological measures, clinical diagnoses of depression, neuroimaging mea-sures of white matter pathology, and a measure of cerebral blood flow. RESULTS Of the 34 former NFL players, 20 were cognitively normal. Four were diagnosed as having a fixed cognitive deficit; 8, mild cognitive impairment; 2, dementia; and 8, depression. Of the subgroup in whom neuroimaging data were acquired, cognitively impaired participants showed the greatest deficits on tests of naming, word finding, and visual/verbal episodic memory. We found significant differences in white matter abnormalities in cognitively impaired and depressed retired players compared with their respective controls. Regional blood flow differences in the cognitively impaired group (left temporal pole, inferior parietal lobule, and superior temporal gyrus) corresponded to regions associated with impaired neurocognitive performance (problems with memory, naming, and word finding). CONCLUSIONS Cognitive deficits and depression appear to be more common in aging former NFL players compared with healthy controls. These deficits are correlated with white matter abnormalities and changes in regional cerebral blood flow.
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“Depression in these athletes is also associated with increased fractional anisotropy on DTI, as well as white matter abnormalities on structural imaging [87, 176].”
From The neuropathology of sport (2014) · cites this paper as [87]
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“Multiple studies have also demonstrated cognitive deficits in retired NFL players on neurological and neuropsychological examination [63, 87, 157]”
From The neuropathology of sport (2014) · cites this paper as [87]
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Self-citationHiskens, M. I., Vella, R. K., Schneiders, A. G., & Fenning, A. S. (2021) · Brain Injury · doi:10.1080/02699052.2021.1909139 · Cited by 15
Iverson, G. L., Terry, D. P., Luz, M., ZAFONTE, R. D., McCrory, P. R., Solomon, G. S., & Gardner, A. J. (2019) · Journal of Neuropsychiatry · doi:10.1176/appi.neuropsych.18110280 · Cited by 14
Zedde, M., Piazza, F., & Pascarella, R. (2025) · Biomedicines · doi:10.3390/biomedicines13040881 · Cited by 12
Electrophysiological correlates of semantic memory retrieval in Gulf War Syndrome 2 patients
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Self-citationLee, B. G., Bennett, L. L., Bernick, C. B., Shan, G., & Banks, S. J. (2019) · Journal of Head Trauma Rehabilitation · doi:10.1097/htr.0000000000000495 · Cited by 12
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Clancy, Ú., Cheng, Y., Brara, A., Doubal, F., & Wardlaw, J. M. (2024) · Alzheimer s & Dementia · doi:10.1002/alz.13647 · Cited by 11
Asynchrony in executive networks predicts cognitive slowing in multiple sclerosis.
Hubbard, N. A., Hutchison, J. L., Turner, M. P., Sundaram, S., Oasay, L., Robinson, D. A., Strain, J. F., Weaver, T. P., Davis, S. L., Remington, G. M., et al. (2015) · Neuropsychology · doi:10.1037/neu0000202 · Cited by 11
Self-citationTenforde, A. S., Cortez, B., Coughlan-Gifford, E., Grashow, R. G., Baker, J. S., Baggish, A. L., Pascual‐Leone, Á., Nadler, L. M., Speizer, F. E., Taylor, H. A., et al. (2021) · PM&R · doi:10.1002/pmrj.12581 · Cited by 10
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High-School Football and Midlife Brain Health Problems
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Chronic Traumatic Encephalopathy
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Concussions: A Review of Physiological Changes and Long-Term Sequelae
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Chronic traumatic encephalopathy in athletes, players, boxers and military: systematic review
Barbosa, M. G. D. S., Francisco, G. G. D. O. A., de Souza, R. L. V., de Souza, J. M. A., Carneiro, R. A., Rabelo, N. N., & Chaurasia, B. K. (2024) · Annals of Medicine and Surgery · doi:10.1097/ms9.0000000000002693 · Cited by 14
Hart, M. G., Housden, C. R., John Suckling, A., Tait, R. J., Young, A., Müller, U., Newcombe, V., Jalloh, I., Pearson, B., Cross, J., et al. (2017) · NeuroImage Clinical · doi:10.1016/j.nicl.2017.04.026 · Cited by 10
Participation in Collision Sports and Cognitive Aging Among Swedish Twins
Weiss, J., Rabinowitz, A. R., Deshpande, S. K., Hasegawa, R. B., & Small, D. S. (2021) · American Journal of Epidemiology · doi:10.1093/aje/kwab177 · Cited by 9
Jin, S., Rabinowitz, A. R., Weiss, J., Deshpande, S. K., Gupta, N., May, R. A. B., & Small, D. S. (2021) · PLoS ONE · doi:10.1371/journal.pone.0257487 · Cited by 9
Metadata
- Authors
- Hart, J., Kraut, M. A., Womack, K. B., Strain, J., Didehbani, N., Bartz, E., Conover, H., Mansinghani, S., Lu, H., & Cullum, C. M.
- Affiliations
- The University of Texas at Dallas (US)
- Johns Hopkins University (US)
- The University of Texas Southwestern Medical Center (US)
- ORCID
- Venue
- JAMA Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 2013-03-01
- Volume
- 70
- Issue
- 3
- Pages
- 326
- ISSN
- 2168-6149 (ISSN-L)
- PMC
- PMC4016798
- OpenAlex
- W2114679345
- Cited by
- 315
- References
- 59
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 12 · 2023: 12 · 2022: 13 · 2021: 27 · 2020: 24 · 2019: 40 · 2018: 31 · 2017: 34 · 2016: 33 · 2015: 32 · 2014: 21 · 2013: 15
- FWCI
- 24.52
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- JAMA Neurology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Texas at Dallas
- National Institute on Aging (P30AG012300, K23AG030006)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Oncology › Cancer-related cognitive impairment studies
- Keywords
- former NFL players, professional football players, cognitive impairment, mild cognitive impairment, dementia, depression, aging, white matter abnormalities, regional cerebral blood flow, episodic memory, word retrieval, naming deficits, concussion, neuroimaging correlates
- MeSH terms
- Adult, Aged, Aging, Brain Concussion, Cognition Disorders, Cross-Sectional Studies, Depression, Football, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Retirement, Retrospective Studies, Texas, United States, Athletes, Neuroimaging
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