Interactive Effects of Racial Identity and Repetitive Head Impacts on Cognitive Function, Structural MRI-Derived Volumetric Measures, and Cerebrospinal Fluid Tau and Aβ

Frontiers in Human Neuroscience

Nikos Makris²  Robert C. Cantu⁵  Alexander P. Lin⁶  Martha E. Shenton⁷  Robert A. Stern⁸  Joseph Palmisano⁹  Brett M. Martin⁹  Éimear M. Foley^1,10  Jonathan D. Jackson^1,11  Yorghos Tripodis^1,12  Alicia S. Chua^1,12  Bhupinder Singh^1,12  Jesse Mez^1,13  Megan Mariani^1,13  Olivia Haller^1,13  Michael L. Alosco^1,13  Ofer Pasternak^1,14  Michael Coleman^1,14  Sylvain Bouix^1,14  Marc Muehlmann^1,15  Christian Lepage^1,16  Katie Green^1,16  Inga K. Koerte^1,17 

[1] 0Center for Morphometric Analysis, Massachusetts General Hospital, Boston, MA, United States;1Center for Neural Systems Investigations, Massachusetts General Hospital, Boston, MA, United States;2Concussion Legacy Foundation, Boston, MA, United States;3Department of Neurosurgery, Boston University School of Medicine, Boston, MA, United States;4Department of Neurosurgery, Emerson Hospital, Concord, MA, United States;5Department of Radiology, Center for Clinical Spectroscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States;6VA Boston Healthcare System, U.S. Department of Veteran Affairs, Brockton, MA, United States;7Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, United States;Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, United States;Boston University Alzheimer’s Disease Center and Boston University CTE Center, Boston University School of Medicine, Boston, MA, United States;CARE Research Center, Massachusetts General Hospital, Boston, MA, United States;Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States;Department of Neurology, Boston University School of Medicine, Boston, MA, United States;Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States;Department of Radiology, University Hospital, LMU Munich, Munich, Germany;Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States;cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany;

关键词: American football;    biomarkers;    chronic traumatic encephalopathy;    cognitive function;    concussion;    magnetic resonance imaging;   

DOI  :  10.3389/fnhum.2019.00440

来源: DOAJ

【 摘 要 】

BackgroundFactors of increased prevalence among individuals with Black racial identity (e.g., cardiovascular disease, CVD) may influence the association between exposure to repetitive head impacts (RHI) from American football and later-life neurological outcomes. Here, we tested the interaction between racial identity and RHI on neurobehavioral outcomes, brain volumetric measures, and cerebrospinal fluid (CSF) total tau (t-tau), phosphorylated tau (p-tau181), and Aβ1–42 in symptomatic former National Football League (NFL) players.Methods68 symptomatic male former NFL players (ages 40–69; n = 27 Black, n = 41 White) underwent neuropsychological testing, structural MRI, and lumbar puncture. FreeSurfer derived estimated intracranial volume (eICV), gray matter volume (GMV), white matter volume (WMV), subcortical GMV, hippocampal volume, and white matter (WM) hypointensities. Multivariate generalized linear models examined the main effects of racial identity and its interaction with a cumulative head impact index (CHII) on all outcomes. Age, years of education, Wide Range Achievement Test, Fourth Edition (WRAT-4) scores, CVD risk factors, and APOEε4 were included as covariates; eICV was included for MRI models. P-values were false discovery rate adjusted.ResultsCompared to White former NFL players, Black participants were 4 years younger (p = 0.04), had lower WRAT-4 scores (mean difference = 8.03, p = 0.002), and a higher BMI (mean difference = 3.09, p = 0.01) and systolic blood pressure (mean difference = 8.15, p = 0.03). With regards to group differences on the basis of racial identity, compared to White former NFL players, Black participants had lower GMV (mean adjusted difference = 45649.00, p = 0.001), lower right hippocampal volume (mean adjusted difference = 271.96, p = 0.02), and higher p-tau181/t-tau ratio (mean adjusted difference = −0.25, p = 0.01). There was not a statistically significant association between the CHII with GMV, right hippocampal volume, or p-tau181/t-tau ratio. However, there was a statistically significant Race x CHII interaction for GMV (b = 2206.29, p = 0.001), right hippocampal volume (b = 12.07, p = 0.04), and p-tau181/t-tau ratio concentrations (b = −0.01, p = 0.004).ConclusionContinued research on racial neurological disparities could provide insight into risk factors for long-term neurological disorders associated with American football play.

【 授权许可】

Unknown