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Neuroimaging of Cognitive Dysfunction and Depression in Aging Retired National Football League Players: A Cross-sectional Study

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Hart, John, Kraut, Michael A., Womack, Kyle B., Strain, Jeremy, Didehbani, Nyaz, Bartz, Elizabeth, Conover, Heather, Mansinghani, Sethesh, Lu, Hanzhang, Cullum, C. Munro·2013·JAMA Neurology

DOI 10.1001/2013.jamaneurol.340PMC PMC4016798

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Abstract

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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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: Hart, John
Kraut, Michael A.
Womack, Kyle B.
Strain, Jeremy
Didehbani, Nyaz
Mansinghani, Sethesh
Lu, Hanzhang
Cullum, C. Munro
Venue: JAMA Neurology
Publisher: American Medical Association (AMA)
Published: 2013-03-01
Volume: 70
Issue: 3
Pages: 326
ISSN: 2168-6149 (ISSN-L)
DOI: 10.1001/2013.jamaneurol.340
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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Neuroimaging of Cognitive Dysfunction and Depression in Aging Retired National Football League Players: A Cross-sectional Study

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