Guskiewicz Kevin M, Marshall Stephen W, Bailes Julian, McCrea Michael, Cantu Robert C, Randolph Christopher, Jordan Barry D
Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina 27599-8700, USA.
Neurosurgery. 2005 Oct;57(4):719-26; discussion 719-26. doi: 10.1093/neurosurgery/57.4.719.
Cerebral concussion is common in collision sports such as football, yet the chronic neurological effects of recurrent concussion are not well understood. The purpose of our study was to investigate the association between previous head injury and the likelihood of developing mild cognitive impairment (MCI) and Alzheimer's disease in a unique group of retired professional football players with previous head injury exposure.
A general health questionnaire was completed by 2552 retired professional football players with an average age of 53.8 (+/-13.4) years and an average professional football playing career of 6.6 (+/- 3.6) years. A second questionnaire focusing on memory and issues related to MCI was then completed by a subset of 758 retired professional football players (> or = 50 yr of age). Results on MCI were then cross-tabulated with results from the original health questionnaire for this subset of older retirees.
Of the former players, 61% sustained at least one concussion during their professional football career, and 24% sustained three or more concussions. Statistical analysis of the data identified an association between recurrent concussion and clinically diagnosed MCI (chi = 7.82, df = 2, P = 0.02) and self-reported significant memory impairments (chi = 19.75, df = 2, P = 0.001). Retired players with three or more reported concussions had a fivefold prevalence of MCI diagnosis and a threefold prevalence of reported significant memory problems compared with retirees without a history of concussion. Although there was not an association between recurrent concussion and Alzheimer's disease, we observed an earlier onset of Alzheimer's disease in the retirees than in the general American male population.
Our findings suggest that the onset of dementia-related syndromes may be initiated by repetitive cerebral concussions in professional football players.
脑震荡在足球等碰撞性运动中很常见，但反复脑震荡的慢性神经学影响尚未得到充分理解。我们研究的目的是在一组有头部受伤史的退休职业足球运动员中，调查既往头部损伤与发生轻度认知障碍（MCI）及阿尔茨海默病可能性之间的关联。
2552名退休职业足球运动员完成了一份一般健康问卷，他们的平均年龄为53.8（±13.4）岁，平均职业足球生涯为6.6（±3.6）年。然后，758名退休职业足球运动员（年龄≥50岁）的一个子集完成了一份侧重于记忆及与MCI相关问题的第二份问卷。接着，将该老年退休人员子集中MCI的结果与原始健康问卷的结果进行交叉制表。
在这些前运动员中，61%在其职业足球生涯中至少遭受过一次脑震荡，24%遭受过三次或更多次脑震荡。对数据的统计分析确定了反复脑震荡与临床诊断的MCI（χ=7.82，自由度=2，P=0.02）以及自我报告的显著记忆障碍（χ=19.75，自由度=2，P=0.001）之间存在关联。与没有脑震荡病史的退休人员相比，报告有三次或更多次脑震荡的退休球员被诊断为MCI的患病率高出五倍，报告有显著记忆问题的患病率高出三倍。虽然反复脑震荡与阿尔茨海默病之间没有关联，但我们观察到这些退休人员中阿尔茨海默病的发病时间比美国普通男性人群更早。
我们的研究结果表明，职业足球运动员中与痴呆相关综合征的发病可能由反复的脑震荡引发。
