184 Interrelationships Among Neuroimaging Biomarkers, Neuropsychological Test Data, and Symptom Reporting in a Cohort of Retired National Football League Players. (August 2016)

• Record Type: Journal Article
• Authors: Kuhn, Andrew W.; Zuckerman, Scott L.; Solomon, Gary; Casson, Ira
• Is Part Of: Clinical neurosurgery. Volume 63(2016)Supplement 1
• Publication Date: 2016-08
• Subjects: Nervous system -- Surgery -- Congresses; Neurosurgery; Nervous system -- Surgery; Neurologie; Congresses; Conference papers and proceedings; 617.48
• DOI: 10.1227/01.neu.0000489753.67038.ae
• Languages: English
• ISSNs: 0069-4827

Abstract

Abstract : INTRODUCTION: Repetitive brain trauma (RBT) in American football has become a topic of recent interest. The objective of this study was to assess the interrelationships among neuroimaging findings with neurocognitive test performance and symptom endorsement in a cohort of retired professional (National Football League [NFL]) football players. METHODS: Magnetic resonance imaging (MRI) scans were performed in 45 retired NFL players. Three neuroimaging parameters were recorded by blinded, board-certified neuroradiologists: (1) the absence or presence of small or large cavum septum pellucidum; (2) a global mean score of fractional anisotropy (FA); and (3) the presence or absence of microhemorrhages (microbleeds). The subjects underwent a battery of 9 paper-and-pencil neuropsychological tests (yielding 12 separate scores), a computerized neurocognitive test, and multiple (4) symptom and depression scales. The associations among the 3 independent neuroimaging results with these outcome measures were assessed using Pearson, Spearman Rank, and Point-Biserial Correlations. RESULTS: Data from 45 retired NFL players (average age: 46.7 years) were analyzed. The retirees reported an average of 6.9 (±6.2) concussions and 13.0 (±7.9) sport-related "dings" in the NFL. Assessment of cavum septum pellucidum yielded a negative finding in 10 subjects (22%), while 32 (71%) had a small, and 3 (7%) had a large one. Four (9%) of the subjects had microhemorrhages present and average FA mean was 0.459 (±0.035). Number of sport-related "dings" was correlated with an increased risk of microhemorrhages ( r = 0.305, P = .042). The majority (50.8%) of the correlations obtained among the 3 neuroimaging parameters and the neurocognitive/symptom scores were below the threshold of a "small" effect size ( r < 0.10). The remaining (49.2%) correlations fell somewhere between "small" and "medium" effect sizes (0.1 < r < 0.3). However, all correlations were statistically nonsignificant. CONCLUSION: The current results demonstrate minimal and statistically nonsignificant correlations among neuroimaging, neurocognitive, and symptom scores in a cohort of NFL retirees. The results indicate that, in this cohort, neuroimaging findings do not relate directly to neurocognitive test performance and clinical symptom burden. Although an often-accepted paradigm, associating the severity of structural brain changes with neurocognitive performance and symptom presentation after chronic RBT is complex, may involve other moderating variables, and requires further study.