Association between recurrent concussion and late-life cognitive impairment in retired professional football players
Abstract
OBJECTIVE: Cerebral concussion is common in collision sports such as football, yet the chronic neurological effects of recurrent concussion are not well understood. The purpose of our study was to investigate the association between previous head injury and the likelihood of developing mild cognitive impairment (MCI) and Alzheimer's disease in a unique group of retired professional football players with previous head injury exposure. METHODS: A general health questionnaire was completed by 2552 retired professional football players with an average age of 53.8 (±13.4) years and an average professional football playing career of 6.6 (± 3.6) years. A second questionnaire focusing on memory and issues related to MCI was then completed by a subset of 758 retired professional football players (≥50 yr of age). Results on MCI were then cross-tabulated with results from the original health questionnaire for this subset of older retirees. RESULTS: Of the former players, 61% sustained at least one concussion during their professional football career, and 24% sustained three or more concussions. Statistical analysis of the data identified an association between recurrent concussion and clinically diagnosed MCI (χ2 = 7.82, df = 2, P = 0.02) and self-reported significant memory impairments (χ2 = 19.75, df = 2, P = 0.001). Retired players with three or more reported concussions had a fivefold prevalence of MCI diagnosis and a threefold prevalence of reported significant memory problems compared with retirees without a history of concussion. Although there was not an association between recurrent concussion and Alzheimer's disease, we observed an earlier onset of Alzheimer's disease in the retirees than in the general American male population CONCLUSION: Our findings suggest that the onset of dementia-related syndromes may be initiated by repetitive cerebral concussions in professional football players.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The third finding, on the effects of recurrent injuries, is broadly consistent with the emerging literature on the adverse consequences of sports and combat-related neurotrauma.
“Our third finding, on the effects of recurrent injuries, is broadly consistent with the emerging literature on the adverse consequences of sports and combat-related neurotrauma [7,9,11–14,46–49].”
Epidemiological studies have consistently found higher rates of adverse outcomes in adults who have sustained a TBI compared to the general population.
“Epidemiological studies have consistently found higher rates of adverse outcomes in adults who have sustained a TBI when compared to the general population [7–16].”
Surveys of retired professional football players found that players who reported sustaining three or more concussions were significantly more likely to report cognitive symptoms, including a threefold increase in self-reported significant memory impairment and a fivefold increase in diagnosed mild cognitive impairment.
“surveys of retired professional football players found that players who reported sustaining three or more concussions were significantly more likely to report cognitive symptoms, including a threefold increase in self-reported significant memory impairment and a fivefold increase in diagnosed mild cognitive impairment [77].”
From The neuropathology of sport (2014) · cites this paper as [77]
Cites
Current concepts in mild cognitive impairment
Petersen, R. C., Doody, R., Kurz, A., Mohs, R. C., Morris, J. C., Rabins, P. V., Ritchie, K., Rossor, M., Thal, L., & Winblad, B. (2001) · Archives of Neurology · doi:10.1001/archneur.58.12.1985 · Cited by 4,781 · see citing works
Petersen, R. C., Stevens, J. C., Ganguli, M., Tangalos, E. G., Cummings, J. L., & DeKosky, S. T. (2001) · Neurology · doi:10.1212/wnl.56.9.1133 · Cited by 2,065 · see citing works
Mild Cognitive Impairment Represents Early-Stage Alzheimer Disease
Morris, J. C., Storandt, M., Miller, J. P., McKeel, D. W., Price, J. L., Rubin, E. H., & Berg, L. (2001) · Archives of Neurology · doi:10.1001/archneur.58.3.397 · Cited by 1,833 · see citing works
Brookmeyer, R., Gray, S. G., & Kawas, C. H. (1998) · American Journal of Public Health · doi:10.2105/ajph.88.9.1337 · Cited by 1,774 · see citing works
Guskiewicz, K. M., McCrea, M., Marshall, S. W., Cantu, R. C., Randolph, C., Barr, W., Onate, J. A., & Kelly, J. P. (2003) · JAMA · doi:10.1001/jama.290.19.2549 · Cited by 1,712 · see citing works
Self-citationPrediction of AD with MRI-based hippocampal volume in mild cognitive impairment
Jack, C. R., Petersen, R. C., Xu, Y. C., O’Brien, P. C., Smith, G. E., Ivnik, R. J., Boeve, B. F., Waring, S. C., Tangalos, E. G., & Kokmen, E. (1999) · Neurology · doi:10.1212/wnl.52.7.1397 · Cited by 1,404 · see citing works
Epidemiology of Concussion in Collegiate and High School Football Players
Guskiewicz, K. M., Weaver, N. L., Padua, D. A., & Garrett, W. E. J. (2000) · The American Journal of Sports Medicine · doi:10.1177/03635465000280050401 · Cited by 851 · see citing works
Self-citationRates and risk factors for dementia and Alzheimer’s disease: Results from EURODEM pooled analyses
Launer, L. J., Andersen, K., Dewey, M. E., Letenneur, L., Ott, A., Amaducci, L. A., Brayne, C., Copeland, J. R. M., Dartigues, J.-F., Kragh-Sorensen, P., et al. (1999) · Neurology · doi:10.1212/wnl.52.1.78 · Cited by 758 · see citing works
Apolipoprotein E epsilon4 associated with chronic traumatic brain injury in boxing
Jordan, B. D. (1997) · JAMA · doi:10.1001/jama.278.2.136 · Cited by 659 · see citing works
Self-citationMayeux, R., Ottman, R., Maestre, G., Ngai, C., Tang, M., Ginsberg, H., Chun, M., Tycko, B., & Shelanski, M. (1995) · Neurology · doi:10.1212/wnl.45.3.555 · Cited by 597 · see citing works
Prediction of probable Alzheimer's disease in memory-impaired patients
Tierney, M. C., Szalai, J. P., Snow, W. G., Fisher, R. H., Nores, A., Nadon, G., Dunn, E. M., & George‐Hyslop, P. S. (1996) · Neurology · doi:10.1212/wnl.46.3.661 · Cited by 575 · see citing works
Ware, J. E., Gandek, B., Kosinski, M. R., Aaronson, N. K., Apolone, G., Brazier, J. E., Bullinger, M., Kaasa, S., Leplège, A., Prieto, L. M., et al. (1998) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(98)00108-5 · Cited by 561 · see citing works
The occult aftermath of boxing.
Roberts, G. W., Allsop, D., & Bruton, C. (1990) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.53.5.373 · Cited by 518 · see citing works
Head injury and the risk of AD in the MIRAGE study
Guo, Z., Cupples, L. A., Kurz, A., Auerbach, S. H., Volicer, L., Chui, H., Green, R. C., Sadovnick, A. D., Duara, R., DeCarli, C., et al. (2000) · Neurology · doi:10.1212/wnl.54.6.1316 · Cited by 506 · see citing works
Cumulative Effects of Concussion in High School Athletes
Collins, M. W., Lovell, M. R., Iverson, G. L., Cantu, R. C., Maroon, J. C., & Field, M. (2002) · Neurosurgery · doi:10.1097/00006123-200211000-00011 · Cited by 471 · see citing works
Self-citationDevelopment of dementing illnesses in an 80‐year‐old volunteer cohort
Katzman, R., Aronson, M., Fuld, P. A., Kawas, C. H., Brown, T., Morgenstern, H., Frishman, W. H., Gidez, L. I., Eder, H., & Ooi, W. L. (1989) · Annals of Neurology · doi:10.1002/ana.410250402 · Cited by 453 · see citing works
A case‐control study of Alzheimer's disease in Australia
Broe, G. A., Henderson, A. S., Creasey, H. M., McCusker, E. A., Korten, A. E., Jorm, A. F., Longley, W. A., & Anthony, J. C. (1990) · Neurology · doi:10.1212/wnl.40.11.1698 · Cited by 446 · see citing works
Cumulative effects of concussion in amateur athletes
Iverson, G. L., Gaetz, M., Lovell, M. R., & Collins, M. W. (2004) · Brain Injury · doi:10.1080/02699050310001617352 · Cited by 429 · see citing works
Predicting Conversion to Alzheimer Disease Using Standardized Clinical Information
Daly, E. J., Zaitchik, D., Copeland, M., Schmahmann, J. D., Gunther, J. M., & Albert, M. (2000) · Archives of Neurology · doi:10.1001/archneur.57.5.675 · Cited by 358 · see citing works
Thurman, D. J., Branche, C. M., & Sniezek, J. E. (1998) · Journal of Head Trauma Rehabilitation · doi:10.1097/00001199-199804000-00003 · Cited by 340 · see citing works
Head injury as a risk factor for Alzheimer's disease
Mortimer, J. A., French, L., Hutton, J. T., & Schuman, L. M. (1985) · Neurology · doi:10.1212/wnl.35.2.264 · Cited by 308 · see citing works
Risk factors for late‐ onset Alzheimer's disease: A population‐ based, case‐control study
Fratiglioni, L., Ahlbom, A., Viitanen, M., & Winblad, B. (1993) · Annals of Neurology · doi:10.1002/ana.410330306 · Cited by 298 · see citing works
The Canadian Study of Health and Aging *
Aging, T. C. S. O. H. A. (1994) · Neurology · doi:10.1212/wnl.44.11.2073 · Cited by 298 · see citing works
Head Injury in Early Adulthood and the Lifetime Risk of Depression
Holsinger, T., Steffens, D. C., Phillips, C., Helms, M. J., Havlik, R. J., Breitner, J. C. S., Guralnik, J. M., & Plassman, B. L. (2002) · Archives of General Psychiatry · doi:10.1001/archpsyc.59.1.17 · Cited by 267 · see citing works
Alzheimer’s disease after remote head injury: an incidence study
Schofield, P. W., Tang, M., Marder, K., Bell, K., Dooneief, G., Chun, M., Sano, M., Stern, Y., & Mayeux, R. (1997) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.62.2.119 · Cited by 260 · see citing works
THE ASSOCIATION BETWEEN HEAD TRAUMA AND ALZHEIMER'S DISEASE
Graves, A. B., White, E., Koepsell, T. D., Reifler, B. V., van Belle, G., Larson, E. B., & Raskind, M. A. (1990) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a115523 · Cited by 257 · see citing works
Mayeux, R. P., Ottman, R., Tang, M., Noboa‐Bauza, L., Marder, K. S., Gurland, B. J., & Stern, Y. (1993) · Annals of Neurology · doi:10.1002/ana.410330513 · Cited by 220 · see citing works
Is Mild Cognitive Impairment Prodromal for Vascular Dementia Like Alzheimer’s Disease?
Meyer, J. S., Xu, G., Thornby, J. A., Chowdhury, M. H., & Quach, M. (2002) · Stroke · doi:10.1161/01.str.0000024432.34557.10 · Cited by 195 · see citing works
Risk factors for Alzheimer's disease
Shalat, S. L., Seltzer, B., Pidcock, C., & Baker, E. L. (1987) · Neurology · doi:10.1212/wnl.37.10.1630 · Cited by 184 · see citing works
Lower Cognitive Performance of Older Football Players Possessing Apolipoprotein E ε4
Kutner, K. C., Erlanger, D. M., Tsai, J., Jordan, B. D., & Relkin, N. R. (2000) · Neurosurgery · doi:10.1097/00006123-200009000-00026 · Cited by 170 · see citing works
Self-citationHead Injury and Risk of Alzheimer's Disease by Apolipoprotein E Genotype
O’Meara, E. S., Kukull, W. A., Sheppard, L. A., Bowen, J., McCormick, W. C., Teri, L. L., Pfanschmidt, M. L., Thompson, J. D., Schellenberg, G. D., & Larson, E. B. (1997) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009290 · Cited by 165 · see citing works
Brain injury and neurologic sequelae
Williams, D. B., Annegers, J. F., Kokmen, E., O’Brien, P. C., & Kurland, L. T. (1991) · Neurology · doi:10.1212/wnl.41.10.1554 · Cited by 149 · see citing works
Head Trauma and the Risk of Alzheimer's Disease
van Duijn, C. M., Tanja, T. A., Haaxma, R., Schulte, W., Saan, R. J., Lameris, A. J., AntonkJes-Hendriks, G., & Albert Hofman, D. (1992) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116364 · Cited by 111 · see citing works
Genetic vulnerability following traumatic brain injury: the role of apolipoprotein E
Nathoo, N. (2003) · Molecular Pathology · doi:10.1136/mp.56.3.132 · Cited by 96 · see citing works
Longitudinal analysis of abnormal domains comprising mild cognitive impairment (MCI) during aging
Meyer, J. S., Xu, G., Thornby, J. A., Chowdhury, M. H., & Quach, M. (2002) · Journal of the Neurological Sciences · doi:10.1016/s0022-510x(02)00159-4 · Cited by 87 · see citing works
Head injury as a risk factor in Alzheimer's disease.
Rasmusson, D., Brandt, J., Martin, D. B., & Folstein, M. (1995) · Brain Injury · doi:10.3109/02699059509008194 · Cited by 83 · see citing works
Head trauma with loss of consciousness as a risk factor for Alzheimer's disease
Chandra, V., Kokmen, E., Schoenberg, B. S., & Beard, C. M. (1989) · Neurology · doi:10.1212/wnl.39.12.1576 · Cited by 81 · see citing works
Ferini‐Strambi, L., Smirne, S., Garancini, P., Pinto, P., & Franceschi, M. (1990) · Neuroepidemiology · doi:10.1159/000110750 · Cited by 71 · see citing works
Hamberger, A., Huang, Y.-L., Zhu, H., Bao, F., Ding, M., Blennow, K., Olsson, A., Hansson, H.-A., Viano, D., & Haglid, K. G. (2003) · Journal of Neurotrauma · doi:10.1089/08977150360547080 · Cited by 64 · see citing works
Sadek, J. R., Johnson, S. A., White, D. A., Salmon, D. P., Taylor, K. I., DeLaPena, J., Paulsen, J. S., Heaton, R. K., & Grant, I. (2004) · Neuropsychology · doi:10.1037/0894-4105.18.4.692 · Cited by 60 · see citing works
Austrom, M. G., Hartwell, C., MOORE, P. S., Perkins, A. J., Damush, T. M., Unverzagt, F. W., Boustani, M. A., Hendrie, H. C., & Callahan, C. M. (2006) · Dementia · doi:10.1177/1471301206067108 · Cited by 25 · see citing works
Ryan, D. (1994) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000106744 · Cited by 12 · see citing works
Flagged first, then by citations
1 of the 43 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
2016 Alzheimer's disease facts and figures
Alzheimer's Association (2016) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2016.03.001 · Cited by 5,069 · see citing works
2013 Alzheimer's disease facts and figures
Thies, W. H., & Bleiler, L. (2013) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2013.02.003 · Cited by 3,331 · see citing works
Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research
Maas, A. I. R., Menon, D. K., Adelson, P. D., Andelic, N., Bell, M. J., Belli, A., Bragge, P., Brazinova, A., Büki, A., Chesnut, R. M., et al. (2017) · The Lancet Neurology · doi:10.1016/s1474-4422(17)30371-x · Cited by 2,609 · see citing works
McCrory, P. R., Meeuwisse, W. H., Aubry, M., Cantu, B., Dvořák, J., Echemendía, R. J., Engebretsen, L., Johnston, K., Kutcher, J. S., Raftery, M., et al. (2013) · British Journal of Sports Medicine · doi:10.1136/bjsports-2013-092313 · Cited by 2,580 · see citing works
Self-citationMcCrory, P. R., Meeuwisse, W. H., Aubry, M., Cantu, B., Dvořák, J., Echemendía, R. J., Engebretsen, L., Johnston, K., Kutcher, J., Raftery, M., et al. (2013) · Physical Therapy in Sport · doi:10.1016/j.ptsp.2013.03.002 · Cited by 2,133 · see citing works
Self-citation2018 Alzheimer's disease facts and figures
Alzheimer's Association (2018) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2018.02.001 · Cited by 1,912 · see citing works
Baumgart, M., Snyder, H. M., Carrillo, M. C., Fazio, S., Kim, H., & Johns, H. (2015) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2015.05.016 · Cited by 1,660 · see citing works
2015 Alzheimer's disease facts and figures
Alzheimer's Association (2015) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2015.02.003 · Cited by 1,641 · see citing works
American Medical Society for Sports Medicine position statement: concussion in sport
Harmon, K. G., Drezner, J. A., Gammons, M. R., Guskiewicz, K. M., Halstead, M., Herring, S. A., Kutcher, J. S., Pana, A., Putukian, M., & Roberts, W. O. (2012) · British Journal of Sports Medicine · doi:10.1136/bjsports-2012-091941 · Cited by 1,433 · see citing works
Self-citation2017 Alzheimer's disease facts and figures
(, T. D. B. T. A.-R. C. C. A. S. O. A. C. B. S., different, ). J. A. I. A., destroyed, S. A. T. A. S. T. M. E. T. M. C. I. S. I. A. G. W. A. T. R. N. I. T. O. B. T. F. N. T. B. D. A. D. A. U. I. B. R. I. I. F. N. M. A. N. I. O. P. O. T. B. A. D. A., difficulties, I. E. O., agitation, I. N. S. S. A., & delusions., S. A. (2017) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2017.02.001 · Cited by 1,322 · see citing works
Mental health in elite athletes: International Olympic Committee consensus statement (2019)
Reardon, C. L., Hainline, B., Aron, C. M., Baron, D., Baum, A. L., Bindra, A., Budgett, R., Campriani, N., Castaldelli-Maia, J. M., Currie, A., et al. (2019) · British Journal of Sports Medicine · doi:10.1136/bjsports-2019-100715 · Cited by 1,277 · see citing works
Axonal pathology in traumatic brain injury
Johnson, V. E., Stewart, W., & Smith, D. H. (2013) · Experimental Neurology · doi:10.1016/j.expneurol.2012.01.013 · Cited by 1,273 · see citing works
National Athletic Trainers' Association Position Statement: Management of Sport Concussion
Broglio, S. P., Cantu, R. C., Gioia, G. A., Guskiewicz, K. M., Kutcher, J. S., Palm, M., & McLeod, T. C. V. (2014) · Journal of Athletic Training · doi:10.4085/1062-6050-49.1.07 · Cited by 1,112 · see citing works
Self-citation2014 Alzheimer's disease facts and figures
Alzheimer's Association (2014) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2014.02.001 · Cited by 1,032 · see citing works
2012 Alzheimer's disease facts and figures Alzheimer's Association ∗
Thies, W. H., & Bleiler, L. (2012) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2012.02.001 · Cited by 984 · see citing works
Recurrent Concussion and Risk of Depression in Retired Professional Football Players
GUSKIEWICZ, K. M., MARSHALL, S. W., BAILES, J., MCCREA, M., HARDING, H. P., MATTHEWS, A., MIHALIK, J. R., & CANTU, R. C. (2007) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3180383da5 · Cited by 928 · see citing works
Self-citation2011 Alzheimer's disease facts and figures
Alzheimer's Association (2011) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2011.02.004 · Cited by 914 · see citing works
McCrory, P. R., Meeuwisse, W. H., Aubry, M., Cantu, R. C., Dvořák, J., Echemendía, R. J., Engebretsen, L., Johnston, K. M., Kutcher, J. S., Raftery, M., et al. (2013) · PM&R · doi:10.1016/j.pmrj.2013.02.012 · Cited by 896 · see citing works
Self-citationThe neuropathology of traumatic brain injury
McKee, A. C., & Daneshvar, D. H. (2015) · Handbook of clinical neurology · doi:10.1016/b978-0-444-52892-6.00004-0 · Cited by 829 · see citing works
Chronic neuropathologies of single and repetitive TBI: substrates of dementia?
Smith, D. H., Johnson, V. E., & Stewart, W. (2013) · Nature Reviews Neurology · doi:10.1038/nrneurol.2013.29 · Cited by 699 · see citing works
McCrory, P. R., Meeuwisse, W. H., Johnston, K., Dvořák, J., Aubry, M., Molloy, M., & Cantu, R. C. (2009) · Journal of Athletic Training · doi:10.4085/1062-6050-44.4.434 · Cited by 696 · see citing works
Self-citationCHRONIC TRAUMATIC ENCEPHALOPATHY IN A NATIONAL FOOTBALL LEAGUE PLAYER: PART II
Omalu, B. I., DeKosky, S. T., Hamilton, R. L., Minster, R. L., Kamboh, M. I., Shakir, A. M., & Wecht, C. H. (2006) · Neurosurgery · doi:10.1227/01.neu.0000245601.69451.27 · Cited by 694 · see citing works
The Neuropathology and Neurobiology of Traumatic Brain Injury
Blennow, K., Hardy, J., & Zetterberg, H. (2012) · Neuron · doi:10.1016/j.neuron.2012.11.021 · Cited by 669 · see citing works
A systematic review of potential long-term effects of sport-related concussion.
Manley, G., Gardner, A. J., Schneider, K. J., Guskiewicz, K. M., Bailes, J., Cantu, R. C., Castellani, R. J., Turner, M., Jordan, B. D., Randolph, C., et al. (2017) · British Journal of Sports Medicine · doi:10.1136/bjsports-2017-097791 · Cited by 663 · see citing works
Self-citationNeurodegenerative causes of death among retired National Football League players
Lehman, E. J., Hein, M. J., Baron, S. L., & Gersic, C. M. (2012) · Neurology · doi:10.1212/wnl.0b013e31826daf50 · Cited by 638 · see citing works
The chronic and evolving neurological consequences of traumatic brain injury
Wilson, L., Stewart, W., Dams-O'Connor, K., Diaz-Arrastia, R., Horton, L., Menon, D. K., & Polinder, S. (2017) · The Lancet Neurology · doi:10.1016/s1474-4422(17)30279-x · Cited by 607 · see citing works
Gouttebarge, V., Castaldelli-Maia, J. M., Gorczynski, P., Hainline, B., Hitchcock, M. E., Kerkhoffs, G. M., Rice, S. M., & Reardon, C. L. (2019) · British Journal of Sports Medicine · doi:10.1136/bjsports-2019-100671 · Cited by 604 · see citing works
Traumatic brain injury and amyloid-β pathology: a link to Alzheimer's disease?
Johnson, V. E., Stewart, W., & Smith, D. H. (2010) · Nature Reviews Neuroscience · doi:10.1038/nrn2808 · Cited by 587 · see citing works
Montenigro, P., Alosco, M., Martin, B. M., Daneshvar, D., Mez, J., Chaisson, C. E., Nowinski, C., Au, R., Mckee, A., Cantu, R., et al. (2017) · Journal of Neurotrauma · doi:10.1089/neu.2016.4413 · Cited by 535 · see citing works
Self-citationM. Tucker, A., & Stern, Y. (2011) · Current Alzheimer Research · doi:10.2174/156720511795745320 · Cited by 561 · see citing works
Role of subconcussion in repetitive mild traumatic brain injury
Bailes, J. E., Petraglia, A. L., Omalu, B. I., Nauman, E. A., & Talavage, T. M. (2013) · Journal of neurosurgery · doi:10.3171/2013.7.jns121822 · Cited by 549 · see citing works
Self-citationThe molecular pathophysiology of concussive brain injury
Barkhoudarian, G., Hovda, D. A., & Giza, C. C. (2011) · Clinics in Sports Medicine · doi:10.1016/j.csm.2010.09.001 · Cited by 492 · see citing works
McCrory, P. R., Meeuwisse, W. H., Johnston, K., Dvorak, J., Aubry, M., Molloy, M. J., & Cantu, R. C. (2009) · British Journal of Sports Medicine · doi:10.1136/bjsm.2009.058248 · Cited by 473 · see citing works
Self-citationCognitive Outcome Following Traumatic Brain Injury
DIKMEN, S. S., Corrigan, J. D., Levin, H. S., Machamer, J., Stiers, W. M., & Weisskopf, M. G. (2009) · Journal of Head Trauma Rehabilitation · doi:10.1097/htr.0b013e3181c133e9 · Cited by 466 · see citing works
Perry, D. C., Sturm, V. E., Peterson, M. J., Pieper, C. F., Bullock, T., Boeve, B. F., Miller, B. L., Guskiewicz, K. M., Berger, M. S., Kramer, J. H., et al. (2016) · Journal of Neurosurgery · doi:10.3171/2015.2.jns14503 · Cited by 440 · see citing works
Self-citationMcCrory, P. R., Meeuwisse, W. H., Aubry, M., Cantu, R. C., Dvořák, J., Echemendía, R. J., Engebretsen, L., Johnston, K., Kutcher, J. S., Raftery, M., et al. (2013) · Journal of Athletic Training · doi:10.4085/1062-6050-48.4.05 · Cited by 439 · see citing works
Self-citationTraumatic Brain Injury and Risk of Neurodegenerative Disorder
Brett, B. L., Gardner, R. C., Godbout, J. P., Dams-O’Connor, K., & Keene, C. D. (2021) · Biological Psychiatry · doi:10.1016/j.biopsych.2021.05.025 · Cited by 439 · see citing works
Meaney, D. F., & Smith, D. H. (2010) · Clinics in Sports Medicine · doi:10.1016/j.csm.2010.08.009 · Cited by 428 · see citing works
McKee, A. C., Daneshvar, D. H., Alvarez, V. E., & Stein, T. D. (2014) · Acta Neuropathologica · doi:10.1007/s00401-013-1230-6 · Cited by 422 · see citing works
De Beaumont, L., Theoret, H., Mongeon, D., Messier, J., Leclerc, S., Tremblay, S., Ellemberg, D., & Lassonde, M. (2009) · Brain · doi:10.1093/brain/awn347 · Cited by 416 · see citing works
Barnes, D. E., Byers, A. L., Gardner, R. C., Seal, K. H., Boscardin, W. J., & Yaffe, K. (2018) · JAMA Neurology · doi:10.1001/jamaneurol.2018.0815 · Cited by 398 · see citing works
Karr, J. E., Areshenkoff, C. N., & García-Barrera, M. A. (2013) · Neuropsychology · doi:10.1037/neu0000037 · Cited by 392 · see citing works
Tagge, C. A., Fisher, A. M., Minaeva, O. V., Gaudreau, A., Moncaster, J. A., Zhang, X.-L., Wojnarowicz, M. W., Casey, N. F., Lu, H., Kokiko‐Cochran, O. N., et al. (2017) · Brain · doi:10.1093/brain/awx350 · Cited by 383 · see citing works
Self-citationThe clinical spectrum of sport-related traumatic brain injury
Jordan, B. D. (2013) · Nature Reviews Neurology · doi:10.1038/nrneurol.2013.33 · Cited by 347 · see citing works
Self-citationBroglio, S. P., McCrea, M., McAllister, T. W., Harezlak, J., Katz, B. P., Hack, D. C., & Hainline, B. W. (2017) · Sports Medicine · doi:10.1007/s40279-017-0707-1 · Cited by 340 · see citing works
Self-citationMouzon, B., Bachmeier, C. J., Ferro, A., Ojo, J., Crynen, G. C., Acker, C. M., Davies, P., MULLAN, M. J., Stewart, W. B., Jr., & Crawford, F. (2013) · Annals of Neurology · doi:10.1002/ana.24064 · Cited by 331 · see citing works
Fann, J. R., Ribe, A. R., Pedersen, H. S., Fenger-Grøn, M., Christensen, J., Benros, M. E., & Vestergaard, M. (2018) · The Lancet Psychiatry · doi:10.1016/s2215-0366(18)30065-8 · Cited by 322 · see citing works
A mouse model of human repetitive mild traumatic brain injury
Kane, M. J., Angoa‐Pérez, M., Briggs, D. I., Viano, D. C., Kreipke, C. W., & Kuhn, D. M. (2011) · Journal of Neuroscience Methods · doi:10.1016/j.jneumeth.2011.09.003 · Cited by 322 · see citing works
Traumatic brain injury and risk of dementia in older veterans
Barnes, D. E., Kaup, A. R., Kirby, K. A., Byers, A. L., Diaz-Arrastia, R. R., & Yaffe, K. S. (2014) · Neurology · doi:10.1212/wnl.0000000000000616 · Cited by 319 · see citing works
American Medical Society for Sports Medicine Position Statement
Harmon, K. G., Drezner, J. A., Gammons, M. R., Guskiewicz, K. M., Halstead, M., Herring, S., Kutcher, J., Pana, A., Putukian, M., & Roberts, W. O. (2012) · Clinical Journal of Sport Medicine · doi:10.1097/jsm.0b013e31827f5f93 · Cited by 318 · see citing works
Self-citationHart, J., Kraut, M. A., Womack, K. B., Strain, J., Didehbani, N., Bartz, E., Conover, H., Mansinghani, S., Lu, H., & Cullum, C. M. (2013) · JAMA Neurology · doi:10.1001/2013.jamaneurol.340 · Cited by 315 · see citing works
Galetta, K. M., Brandes, L. E., Maki, K., Dziemianowicz, M. S., Laudano, E., Allen, M. S., Lawler, K. A., Sennett, B. J., Wiebe, D. J., Devick, S., et al. (2011) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2011.07.039 · Cited by 303 · see citing works
The King-Devick test as a determinant of head trauma and concussion in boxers and MMA fighters
Galetta, K. M., Barrett, J., Allen, M., Madda, F., Delicata, D., Tennant, A. T., Branas, C. C., Maguire, M. G., Messner, L. V., Devick, S., et al. (2011) · Neurology · doi:10.1212/wnl.0b013e31821184c9 · Cited by 302 · see citing works
Response of the cerebral vasculature following traumatic brain injury
Salehi, A., Zhang, J. H., & Obenaus, A. (2017) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1177/0271678x17701460 · Cited by 299 · see citing works
Cubon, V. A., Putukian, M., Boyer, C., & Dettwiler, A. (2011) · Journal of Neurotrauma · doi:10.1089/neu.2010.1430 · Cited by 297 · see citing works
TEMPORAL WINDOW OF METABOLIC BRAIN VULNERABILITY TO CONCUSSIONS
Tavazzi, B., Vagnozzi, R., Signoretti, S., Amorini, A. M., Finocchiaro, A., Cimatti, M., Delfini, R., Pietro, V. D., Belli, A., & Lazzarino, G. (2007) · Neurosurgery · doi:10.1227/01.neu.0000255525.34956.3f · Cited by 294 · see citing works
Mouzon, B., Chaytow, H., Crynen, G. C., Bachmeier, C. J., Stewart, J., MULLAN, M. J., Stewart, W. B., Jr., & Crawford, F. (2012) · Journal of Neurotrauma · doi:10.1089/neu.2012.2498 · Cited by 294 · see citing works
Revett, T. J., Baker, G. B., Jhamandas, J. H., & Kar, S. (2012) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.110190 · Cited by 294 · see citing works
Breedlove, E. L., Robinson, M., Talavage, T. M., Morigaki, K. E., Yoruk, U., O'Keefe, K., King, J., Leverenz, L. J., Gilger, J. W., & Nauman, E. A. (2012) · Journal of Biomechanics · doi:10.1016/j.jbiomech.2012.01.034 · Cited by 293 · see citing works
Rowson, S., & Duma, S. M. (2011) · Annals of Biomedical Engineering · doi:10.1007/s10439-011-0322-5 · Cited by 293 · see citing works
Progressive inflammation‐mediated neurodegeneration after traumatic brain or spinal cord injury
Faden, A. I., Wu, J., Stoica, B. A., & Loane, D. J. (2015) · British Journal of Pharmacology · doi:10.1111/bph.13179 · Cited by 287 · see citing works
Age of first exposure to football and later-life cognitive impairment in former NFL players
Stamm, J. M., Bourlas, A. P., Baugh, C. M., Fritts, N. G., Daneshvar, D. H., Martin, B. M., McClean, M. D., Tripodis, Y., & Stern, R. A. (2015) · Neurology · doi:10.1212/wnl.0000000000001358 · Cited by 278 · see citing works
The Prevalence of Undiagnosed Concussions in Athletes
Meehan, W. P., III, Mannix, R., O’Brien, M. J., & Collins, M. W. (2013) · Clinical Journal of Sport Medicine · doi:10.1097/jsm.0b013e318291d3b3 · Cited by 270 · see citing works
Acute and chronic traumatic encephalopathies: pathogenesis and biomarkers
DeKosky, S. T., Blennow, K., Ikonomović, M. D., & Gandy, S. (2013) · Nature Reviews Neurology · doi:10.1038/nrneurol.2013.36 · Cited by 270 · see citing works
Vasterling, J. J., Verfaellie, M. H., & Sullivan, K. D. (2009) · Clinical Psychology Review · doi:10.1016/j.cpr.2009.08.004 · Cited by 268 · see citing works
Molecular mechanisms of cognitive dysfunction following traumatic brain injury
Walker, K. R., & Tesco, G. (2013) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2013.00029 · Cited by 265 · see citing works
Risk factors for sports concussion: an evidence-based systematic review
Abrahams, S., Fie, S. M., Patricios, J., Posthumus, M., & September, A. V. (2013) · British Journal of Sports Medicine · doi:10.1136/bjsports-2013-092734 · Cited by 264 · see citing works
Sariaslan, A., Sharp, D. J., D’Onofrio, B. M., Larsson, H., & Fazel, S. (2016) · PLOS Medicine · doi:10.1371/journal.pmed.1002103 · Cited by 262 · see citing works
Kerr, Z., Register-Mihalik, J., Kroshus, E., Baugh, C. M., & Marshall, S. (2015) · American Journal of Sports Medicine · doi:10.1177/0363546515612082 · Cited by 239 · see citing works
Self-citationChronic traumatic encephalopathy (CTE) in a National Football League Player
Omalu, B. I., Hamilton, R. L., Kamboh, M. I., DeKosky, S. T., & Bailes, J. E. (2010) · Journal of Forensic Nursing · doi:10.1111/j.1939-3938.2009.01064.x · Cited by 260 · see citing works
Self-citationKirkwood, M. W., Yeates, K. O., Taylor, H. G., RANDOLPH, C. C., McCrea, M., & Anderson, V. A. (2008) · The Clinical Neuropsychologist · doi:10.1080/13854040701543700 · Cited by 256 · see citing works
Self-citationCumulative Head Impact Burden in High School Football
Broglio, S. P., Eckner, J. T., Martini, D. N., Sosnoff, J. J., Kutcher, J. S., & RANDOLPH, C. C. (2011) · Journal of Neurotrauma · doi:10.1089/neu.2011.1825 · Cited by 251 · see citing works
Self-citationKerr, Z. Y., Register‐Mihalik, J. K., Marshall, S. W., Evenson, K. R., Mihalik, J. P., & Guskiewicz, K. M. (2014) · Brain Injury · doi:10.3109/02699052.2014.904049 · Cited by 248 · see citing works
Self-citationCognitive decline in older adults with a history of traumatic brain injury
Moretti, L., Cristofori, I., Weaver, S. M., Chau, A., Tremont, J. N. P., & Grafman, J. H. (2012) · The Lancet Neurology · doi:10.1016/s1474-4422(12)70226-0 · Cited by 244 · see citing works
O'Connor, K., Baker, M. M., Dalton, S. L., Dompier, T. P., Broglio, S., & Kerr, Z. (2017) · Journal of athletic training · doi:10.4085/1062-6050-52.1.15 · Cited by 219 · see citing works
Kukull, W. A., & Ganguli, M. (2012) · Neurology · doi:10.1212/wnl.0b013e318258f812 · Cited by 239 · see citing works
Prins, M. L., Hales, A., Reger, M. L., Giza, C. C., & Hovda, D. A. (2010) · Developmental Neuroscience · doi:10.1159/000316800 · Cited by 237 · see citing works
LONG-TERM AND CUMULATIVE EFFECTS OF SPORTS CONCUSSION ON MOTOR CORTEX INHIBITION
Beaumont, L. D., Lassonde, M. C., Leclerc, S., & Théoret, H. (2007) · Neurosurgery · doi:10.1227/01.neu.0000280000.03578.b6 · Cited by 237 · see citing works
Neuroinflammation and brain atrophy in former NFL players: An in vivo multimodal imaging pilot study
Coughlin, J. M., Wang, Y., Munro, C. A., Ma, S., Chen, Y., Chen, S., Airan, R. D., Kim, P. K., Adams, A. V., Garcia, C., et al. (2014) · Neurobiology of Disease · doi:10.1016/j.nbd.2014.10.019 · Cited by 236 · see citing works
The epidemiology of new versus recurrent sports concussions among high school athletes, 2005–2010
Castile, L., Collins, C. L., McIlvain, N. M., & Comstock, R. D. (2011) · British Journal of Sports Medicine · doi:10.1136/bjsports-2011-090115 · Cited by 229 · see citing works
Rehabilitation of Concussion and Post-concussion Syndrome
Leddy, J. J., Sandhu, H., Sodhi, V., Baker, J. G., & Willer, B. S. (2012) · Sports Health A Multidisciplinary Approach · doi:10.1177/1941738111433673 · Cited by 229 · see citing works
McCrory, P. R., Meeuwisse, W. H., Johnston, K., Dvořák, J., Aubry, M., Molloy, M., & Cantu, R. C. (2009) · PM&R · doi:10.3810/psm.2009.06.1721 · Cited by 228 · see citing works
Self-citationBrooks, M. A., Peterson, K., Biese, K. M., Sanfilippo, J. L., Heiderscheit, B. C., & Bell, D. R. (2016) · The American Journal of Sports Medicine · doi:10.1177/0363546515622387 · Cited by 226 · see citing works
PET Scanning of Brain Tau in Retired National Football League Players: Preliminary Findings
Small, G. W., Kepe, V., Siddarth, P., Ercoli, L. M., Merrill, D. A., Donoghue, N., Bookheimer, S. Y., Martinez, J., Omalu, B. I., Bailes, J. E., et al. (2013) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2012.11.019 · Cited by 223 · see citing works
Self-citationRepeated Mild Traumatic Brain Injury
Fehily, B., & Fitzgerald, M. (2017) · Cell Transplantation · doi:10.1177/0963689717714092 · Cited by 223 · see citing works
Morganti-Kossmann, M. C., Semple, B. D., Hellewell, S. C., Bye, N., & Ziebell, J. M. (2018) · Acta Neuropathologica · doi:10.1007/s00401-018-1944-6 · Cited by 221 · see citing works
Petraglia, A. L., Plog, B. A., Dayawansa, S., Chen, M. J., Dashnaw, M. L., Czerniecka, K. H., Walker, C. T., Viterise, T., Hyrien, O., Iliff, J. J., et al. (2014) · Journal of Neurotrauma · doi:10.1089/neu.2013.3255 · Cited by 219 · see citing works
McAllister, T. W., & McCrea, M. (2017) · Journal of Athletic Training · doi:10.4085/1062-6050-52.1.14 · Cited by 219 · see citing works
Self-citationNeuropsychological Contributions to the Early Identification of Alzheimer’s Disease
Bondi, M. W., Jak, A. J., Delano-Wood, L., Jacobson, M. W., Delis, D. C., & Salmon, D. P. (2008) · Neuropsychology Review · doi:10.1007/s11065-008-9054-1 · Cited by 216 · see citing works
Lau, B. C., Collins, M. W., & Lovell, M. R. (2011) · The American Journal of Sports Medicine · doi:10.1177/0363546510392016 · Cited by 216 · see citing works
Epidemiology of Head Injuries Focusing on Concussions in Team Contact Sports: A Systematic Review
Prien, A., Grafe, A., Rößler, R., Junge, A., & Verhagen, E. A. L. M. (2018) · Sports Medicine · doi:10.1007/s40279-017-0854-4 · Cited by 215 · see citing works
Collins, M. W., Kontos, A. P., Okonkwo, D. O., Almquist, J. L., Bailes, J. E., Barisa, M. T., Bazarian, J. J., Bloom, O. J., Brody, D. L., Cantu, R. C., et al. (2016) · Neurosurgery · doi:10.1227/neu.0000000000001447 · Cited by 208 · see citing works
Self-citationBeckwith, J. G., Greenwald, R. M., & Chu, J. J. (2011) · Annals of Biomedical Engineering · doi:10.1007/s10439-011-0422-2 · Cited by 205 · see citing works
The Molecular Pathophysiology of Concussive Brain Injury – an Update
Barkhoudarian, G., Hovda, D. A., & Giza, C. C. (2016) · Physical Medicine and Rehabilitation Clinics of North America · doi:10.1016/j.pmr.2016.01.003 · Cited by 203 · see citing works
Age of first exposure to American football and long-term neuropsychiatric and cognitive outcomes
Alosco, M. L., Kasimis, A. B., Stamm, J. M., Chua, A. S., Baugh, C. M., Daneshvar, D. H., Robbins, C. A., Mariani, M. L., Hayden, J., Conneely, S. E., et al. (2017) · Translational Psychiatry · doi:10.1038/tp.2017.197 · Cited by 202 · see citing works
Self-citationNeurological consequences of traumatic brain injuries in sports
Ling, H., Hardy, J., & Zetterberg, H. (2015) · Molecular and Cellular Neuroscience · doi:10.1016/j.mcn.2015.03.012 · Cited by 197 · see citing works
Leddy, J. J., Kozlowski, K. F., Fung, M., Pendergast, D. R., & Willer, B. S. (2007) · Neurorehabilitation · doi:10.3233/nre-2007-22306 · Cited by 194 · see citing works
Concussion Incidence and Trends in 20 High School Sports
Kerr, Z. Y., Chandran, A. S., Nedimyer, A. K., Arakkal, A. T., Pierpoint, L. A., & Zuckerman, S. L. (2019) · PEDIATRICS · doi:10.1542/peds.2019-2180 · Cited by 194 · see citing works
Long-term Neurologic Outcomes After Traumatic Brain Injury
Bazarian, J. J., Černak, I., Noble‐Haeusslein, L. J., Potolicchio, S. J., & Temkin, N. R. (2009) · Journal of Head Trauma Rehabilitation · doi:10.1097/htr.0b013e3181c15600 · Cited by 190 · see citing works
Gysland, S. M., Mihalik, J. P., Register-Mihalik, J. K., Trulock, S. C., Shields, E. W., & Guskiewicz, K. M. (2012) · Annals of Biomedical Engineering · doi:10.1007/s10439-011-0421-3 · Cited by 189 · see citing works
Self-citation
- Authors
- Guskiewicz, K. M., Marshall, S. W., Bailes, J., McCrea, M., Cantu, R. C., Randolph, C., & Jordan, B. D.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- ORCID
- Venue
- Neurosurgery
- Published
- 2005-10
- Volume
- 57
- Issue
- 4
- Pages
- 719-726
- ISSN
- 0148-396X (ISSN-L)
- OpenAlex
- W2105910930
- Cited by
- 1,197
- References
- 43
- Citations by year
- 2026: 21 · 2025: 29 · 2024: 29 · 2023: 38 · 2022: 48 · 2021: 71 · 2020: 66 · 2019: 84 · 2018: 75 · 2017: 95 · 2016: 88 · 2015: 100 · 2014: 92 · 2013: 93 · 2012: 70
- FWCI
- 10.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurosurgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Keywords
- recurrent concussion, mild cognitive impairment, Alzheimer's disease, traumatic brain injury, memory impairment, dementia onset, chronic traumatic encephalopathy, sports-related brain injury
- MeSH terms
- Adult, Age Factors, Aged, Alzheimer Disease, Brain Concussion, Cognition Disorders, Football, Health Surveys, Humans, Male, Middle Aged, Recurrence, Retirement
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
