Characterizing a symptom profile in former athletes

Abstract

The long-term effects of repetitive head impacts are a growing concern. Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that is associated with repetitive head impacts and is characterized by distinct neuropathological changes. Other risk factors of developing CTE are still unknown but may include age, genetics, age of first exposure to sports and type of sport. The only way to diagnose CTE is with a post-mortem analysis. Current research is focused on diagnosing CTE during life; efforts are turning towards developing a clinically diagnosable syndrome that is related to CTE prognosis. Common symptoms reported from retrospective analyses of CTE confirmed cases include cognitive difficulties as well as mood and behavior symptoms like depression and impulsivity. The goal of the present study was to define the clinical presentation of a diverse group of former athletes in an effort to categorize a clinical presentation of individuals with various head impact exposure. The individuals in the sample included contact and non-contact sport athletes, both male and female, ranging from 19 to 86 years of age. The data was based on a larger study, the Longitudinal Examination to Gather Evidence of Neurodegenerative Disease (LEGEND). In a sample of 592 participants from this study, cluster analyses identified five discrete groups of individuals based on their symptom profile. These included Asymptomatic, Mildly symptomatic, Mood symptoms, Behavior symptoms and Highly symptomatic groups. Between the groups, there was no difference in age of participants. There was no prevalence of a certain sport in any of the clusters. Additionally, there was no significant finding regarding estimated number of head impacts and symptomatology in football players. Results showed an effect of cognitive reserve, measured by years of education. Participants in the Asymptomatic group had significantly more education. This implies that years of education may be a risk factor for decreasing one’s ability to cope with neuropathology. Further research needs to be done on the connection between symptomatology and neuropathological diagnosis.