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      Genetic interplay with soccer ball heading

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      Nature Reviews Neurology
      Springer Science and Business Media LLC

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          Abstract

          Mortality from neurodegenerative disease is high among professional soccer players, potentially associated with repeated head impacts during routine gameplay. New data suggest that the apolipoprotein E ε4 allele might exacerbate the effects of soccer ball heading on cognition. However, genotyping of athletes to determine their dementia risk remains a distant prospect.

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          Evidence for Acute Electrophysiological and Cognitive Changes Following Routine Soccer Heading

          Introduction There is growing concern around the effects of concussion and sub-concussive impacts in sport. Routine game-play in soccer involves intentional and repeated head impacts through ball heading. Although heading is frequently cited as a risk to brain health, little data exist regarding the consequences of this activity. This study aims to assess the immediate outcomes of routine football heading using direct and sensitive measures of brain function. Methods Nineteen amateur football players (5 females; age 22 ± 3 y) headed machine-projected soccer balls at standardized speeds, modelling routine soccer practice. The primary outcome measure of corticomotor inhibition measured using transcranial magnetic stimulation, was assessed prior to heading and repeated immediately, 24 h, 48 h and 2 weeks post-heading. Secondary outcome measures were cortical excitability, postural control, and cognitive function. Results Immediately following heading an increase in corticomotor inhibition was detected; further to these electrophysiological alterations, measurable reduction memory function were also found. These acute changes appear transient, with values normalizing 24 h post-heading. Discussion Sub-concussive head impacts routine in soccer heading are associated with immediate, measurable electrophysiological and cognitive impairments. Although these changes in brain function were transient, these effects may signal direct consequences of routine soccer heading on (long-term) brain health which requires further study.
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            Chronic traumatic encephalopathy is a common co-morbidity, but less frequent primary dementia in former soccer and rugby players

            Chronic traumatic encephalopathy (CTE) is reported at high prevalence in selected autopsy case series of former contact sports athletes. Nevertheless, the contribution of CTE pathology to clinical presentation and its interaction with co-morbid neurodegenerative pathologies remain unclear. To address these issues, we performed comprehensive neuropathology assessments on the brains of former athletes with dementia and considered these findings together with detailed clinical histories to derive an integrated clinicopathological diagnosis for each case. Consecutive, autopsy-acquired brains from former soccer and rugby players with dementia were assessed for neurodegenerative pathologies using established and preliminary consensus protocols. Thereafter, next of kin interviews were conducted to obtain detailed accounts of the patient’s clinical presentation and course of disease to inform a final, integrated clinicopathological diagnosis. Neuropathologic change consistent with CTE (CTE-NC) was confirmed in five of seven former soccer and three of four former rugby players’ brains, invariably in combination with mixed, often multiple neurodegenerative pathologies. However, in just three cases was the integrated dementia diagnosis consistent with CTE, the remainder having alternate diagnoses, with the most frequent integrated diagnosis Alzheimer’s disease (AD) (four cases; one as mixed AD and vascular dementia). This consecutive autopsy series identifies neuropathologic change consistent with preliminary diagnostic criteria for CTE (CTE-NC) in a high proportion of former soccer and rugby players dying with dementia. However, in the majority, CTE-NC appears as a co-morbidity rather than the primary, dementia causing pathology. As such, we suggest that while CTE-NC might be common in former athletes with dementia, in many cases its clinical significance remains uncertain.
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              Apolipoprotein E ∈4 Associated With Chronic Traumatic Brain Injury in Boxing

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                Author and article information

                Journal
                Nature Reviews Neurology
                Nat Rev Neurol
                Springer Science and Business Media LLC
                1759-4758
                1759-4766
                March 9 2020
                Article
                10.1038/s41582-020-0334-6
                7799370
                32152459
                d9a36807-5b72-4b45-910b-5543f4f07caf
                © 2020

                http://www.springer.com/tdm

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