Comprehensive Neuropsychiatric and Cognitive Characterization of Former Professional Football Players: Implications for Neurorehabilitation
Objectives: To identify novel targets for neurorehabilitation of people with a remote history of multiple concussions by: (1) comprehensively characterizing neuropsychiatric and cognitive functioning in former professional football players, with a focus on executive functions; (2) distinguishing con...
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Frontiers Media S.A.
2019-08-01
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Series: | Frontiers in Neurology |
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Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2019.00712/full |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Alex R. Terpstra Alex R. Terpstra Brandon P. Vasquez Brandon P. Vasquez Brenda Colella Brenda Colella Maria Carmela Tartaglia Maria Carmela Tartaglia Maria Carmela Tartaglia Charles H. Tator Charles H. Tator David Mikulis David Mikulis Karen D. Davis Karen D. Davis Karen D. Davis Karen D. Davis Karen D. Davis Richard Wennberg Richard Wennberg Robin E. A. Green Robin E. A. Green Robin E. A. Green |
spellingShingle |
Alex R. Terpstra Alex R. Terpstra Brandon P. Vasquez Brandon P. Vasquez Brenda Colella Brenda Colella Maria Carmela Tartaglia Maria Carmela Tartaglia Maria Carmela Tartaglia Charles H. Tator Charles H. Tator David Mikulis David Mikulis Karen D. Davis Karen D. Davis Karen D. Davis Karen D. Davis Karen D. Davis Richard Wennberg Richard Wennberg Robin E. A. Green Robin E. A. Green Robin E. A. Green Comprehensive Neuropsychiatric and Cognitive Characterization of Former Professional Football Players: Implications for Neurorehabilitation Frontiers in Neurology sports concussion neuropsychiatric functioning cognitive dysfunction executive function neurorehabilitation |
author_facet |
Alex R. Terpstra Alex R. Terpstra Brandon P. Vasquez Brandon P. Vasquez Brenda Colella Brenda Colella Maria Carmela Tartaglia Maria Carmela Tartaglia Maria Carmela Tartaglia Charles H. Tator Charles H. Tator David Mikulis David Mikulis Karen D. Davis Karen D. Davis Karen D. Davis Karen D. Davis Karen D. Davis Richard Wennberg Richard Wennberg Robin E. A. Green Robin E. A. Green Robin E. A. Green |
author_sort |
Alex R. Terpstra |
title |
Comprehensive Neuropsychiatric and Cognitive Characterization of Former Professional Football Players: Implications for Neurorehabilitation |
title_short |
Comprehensive Neuropsychiatric and Cognitive Characterization of Former Professional Football Players: Implications for Neurorehabilitation |
title_full |
Comprehensive Neuropsychiatric and Cognitive Characterization of Former Professional Football Players: Implications for Neurorehabilitation |
title_fullStr |
Comprehensive Neuropsychiatric and Cognitive Characterization of Former Professional Football Players: Implications for Neurorehabilitation |
title_full_unstemmed |
Comprehensive Neuropsychiatric and Cognitive Characterization of Former Professional Football Players: Implications for Neurorehabilitation |
title_sort |
comprehensive neuropsychiatric and cognitive characterization of former professional football players: implications for neurorehabilitation |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2019-08-01 |
description |
Objectives: To identify novel targets for neurorehabilitation of people with a remote history of multiple concussions by: (1) comprehensively characterizing neuropsychiatric and cognitive functioning in former professional football players, with a focus on executive functions; (2) distinguishing concussion-related findings from pre-morbid/cohort characteristics of professional football players; and, (3) exploring the relationship between executive functions and neuropsychiatric symptoms.Participants: Sixty-one high-functioning former professional football players and 31 age- and sex-matched control participants without history of concussion or participation in contact sports.Design: Between-groups analyses.Main measures:Neuropsychiatric. Personality Assessment Inventory (PAI) clinical scales plus the Aggression treatment consideration scale; the Mini International Neuropsychiatric Interview (MINI). Cognitive. Comprehensive clinical neuropsychological battery assessing domains of verbal and visuospatial attention; speed of processing and memory; current and estimated pre-morbid IQ; and, executive functioning, including two experimental measures that were novel for this population (i.e., response inhibition and inconsistency of responding on a go/no-go task).Results: (1) Compared to control participants, former professional football players scored significantly higher on the PAI Depression, Mania, and Aggression scales, and significantly lower on response inhibition. (2) Relative to controls, former players with >3 concussions (x̄=6.1), but not former players with ≤ 3 concussions (x̄=2.0), showed (i) significantly higher scores on the PAI Depression scale, (ii) significantly more MINI clinical diagnoses overall, and manic/hypomanic episodes specifically, and (iii) significantly poorer executive function. (3) Mediation analysis revealed that concussion exposure had a significant indirect effect on PAI Depression, Mania, and Aggression via inconsistency of responding on the go/no-go task.Conclusions: Notable impairments to neuropsychiatric functioning and worse performance on a sensitive experimental measure of executive function were observed; these were related to both concussion history and pre-morbid (cohort) factors. Therefore, neuropsychiatric and executive functioning should be carefully assessed in those with a remote history of multiple concussions. Moreover, former players' neuropsychiatric symptoms were associated with inconsistency of responding; this suggests that treatments targeted at response inconsistency could help to mitigate neuropsychiatric dysfunction. |
topic |
sports concussion neuropsychiatric functioning cognitive dysfunction executive function neurorehabilitation |
url |
https://www.frontiersin.org/article/10.3389/fneur.2019.00712/full |
work_keys_str_mv |
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doaj-aa43598b92674e288ff50a86e1926fbb2020-11-24T21:37:58ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-08-011010.3389/fneur.2019.00712461023Comprehensive Neuropsychiatric and Cognitive Characterization of Former Professional Football Players: Implications for NeurorehabilitationAlex R. Terpstra0Alex R. Terpstra1Brandon P. Vasquez2Brandon P. Vasquez3Brenda Colella4Brenda Colella5Maria Carmela Tartaglia6Maria Carmela Tartaglia7Maria Carmela Tartaglia8Charles H. Tator9Charles H. Tator10David Mikulis11David Mikulis12Karen D. Davis13Karen D. Davis14Karen D. Davis15Karen D. Davis16Karen D. Davis17Richard Wennberg18Richard Wennberg19Robin E. A. Green20Robin E. A. Green21Robin E. A. Green22Cognitive Neurorehabilitation Sciences Laboratory, Toronto Rehabilitation Institute, Toronto, ON, CanadaDepartment of Psychology, University of British Columbia, Vancouver, BC, CanadaCognitive Neurorehabilitation Sciences Laboratory, Toronto Rehabilitation Institute, Toronto, ON, CanadaNeuropsychology & Cognitive Health, Baycrest, Toronto, ON, CanadaCognitive Neurorehabilitation Sciences Laboratory, Toronto Rehabilitation Institute, Toronto, ON, CanadaCanadian Concussion Centre, Toronto Western Hospital, Toronto, ON, CanadaCanadian Concussion Centre, Toronto Western Hospital, Toronto, ON, CanadaDivision of Neurology, Krembil Neuroscience Centre, University Health Network, University of Toronto, Toronto, ON, CanadaTanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, ON, CanadaCanadian Concussion Centre, Toronto Western Hospital, Toronto, ON, CanadaDivision of Neurosurgery, Krembil Neuroscience Centre, Toronto Western Hospital, University of Toronto, Toronto, ON, CanadaCanadian Concussion Centre, Toronto Western Hospital, Toronto, ON, CanadaDivision of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, University of Toronto, Toronto, ON, CanadaCanadian Concussion Centre, Toronto Western Hospital, Toronto, ON, CanadaDivision of Neurosurgery, Krembil Neuroscience Centre, Toronto Western Hospital, University of Toronto, Toronto, ON, CanadaDivision of Brain, Imaging and Behaviour – Systems Neuroscience, Krembil Research Institute, University Health Network, Toronto, ON, Canada0Department of Surgery, University of Toronto, Toronto, ON, Canada1Institute of Medical Science, University of Toronto, Toronto, ON, CanadaCanadian Concussion Centre, Toronto Western Hospital, Toronto, ON, CanadaDivision of Neurology, Krembil Neuroscience Centre, University Health Network, University of Toronto, Toronto, ON, CanadaCognitive Neurorehabilitation Sciences Laboratory, Toronto Rehabilitation Institute, Toronto, ON, CanadaCanadian Concussion Centre, Toronto Western Hospital, Toronto, ON, Canada2Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, CanadaObjectives: To identify novel targets for neurorehabilitation of people with a remote history of multiple concussions by: (1) comprehensively characterizing neuropsychiatric and cognitive functioning in former professional football players, with a focus on executive functions; (2) distinguishing concussion-related findings from pre-morbid/cohort characteristics of professional football players; and, (3) exploring the relationship between executive functions and neuropsychiatric symptoms.Participants: Sixty-one high-functioning former professional football players and 31 age- and sex-matched control participants without history of concussion or participation in contact sports.Design: Between-groups analyses.Main measures:Neuropsychiatric. Personality Assessment Inventory (PAI) clinical scales plus the Aggression treatment consideration scale; the Mini International Neuropsychiatric Interview (MINI). Cognitive. Comprehensive clinical neuropsychological battery assessing domains of verbal and visuospatial attention; speed of processing and memory; current and estimated pre-morbid IQ; and, executive functioning, including two experimental measures that were novel for this population (i.e., response inhibition and inconsistency of responding on a go/no-go task).Results: (1) Compared to control participants, former professional football players scored significantly higher on the PAI Depression, Mania, and Aggression scales, and significantly lower on response inhibition. (2) Relative to controls, former players with >3 concussions (x̄=6.1), but not former players with ≤ 3 concussions (x̄=2.0), showed (i) significantly higher scores on the PAI Depression scale, (ii) significantly more MINI clinical diagnoses overall, and manic/hypomanic episodes specifically, and (iii) significantly poorer executive function. (3) Mediation analysis revealed that concussion exposure had a significant indirect effect on PAI Depression, Mania, and Aggression via inconsistency of responding on the go/no-go task.Conclusions: Notable impairments to neuropsychiatric functioning and worse performance on a sensitive experimental measure of executive function were observed; these were related to both concussion history and pre-morbid (cohort) factors. Therefore, neuropsychiatric and executive functioning should be carefully assessed in those with a remote history of multiple concussions. Moreover, former players' neuropsychiatric symptoms were associated with inconsistency of responding; this suggests that treatments targeted at response inconsistency could help to mitigate neuropsychiatric dysfunction.https://www.frontiersin.org/article/10.3389/fneur.2019.00712/fullsports concussionneuropsychiatric functioningcognitive dysfunctionexecutive functionneurorehabilitation |