Gouttebarge Vincent, Aoki Haruhito, Lambert Michael, Stewart William, Kerkhoffs Gino
a Academic Center for Evidence-based Sports medicine (ACES) , Academic Medical Center , Amsterdam , The Netherlands.
b World Players' Union (FIFPro) , Hoofddorp , The Netherlands.
Phys Sportsmed. 2017 Nov;45(4):443-449. doi: 10.1080/00913847.2017.1376572. Epub 2017 Sep 13.
Recent reports suggest that exposure to repetitive concussions in sports is associated with an increased risk of symptoms of distress, anxiety and depression, sleep disturbance or substance abuse/dependence (typically referred as symptoms of common mental disorders[CMD]) and of later development of neurodegenerative disease, in particular chronic traumatic encephalopathy (CTE). The primary aim of this study was to explore the relationship between sports career-related concussions and the subsequent occurrence of symptoms of CMD among former male professional athletes retired from football (soccer), ice hockey and rugby (union).
Cross-sectional analyses were performed on baseline electronic questionnaires from three prospective cohort studies among former male professional athletes retired from football (soccer), ice hockey and rugby (union). The number of confirmed concussions was examined through a single question, while symptoms of distress, anxiety and depression, sleep disturbance and adverse alcohol use were assessed using validated questionnaires.
From 1,957 former professional athletes contacted, a total of 576 (29%) completed the questionnaire. Of these, 23% had not incurred a concussion during their career, 34% had two or three, 18% four or five, and 11% six or more concussions. The number of sports career-related concussions was a predictor for all outcome measures (β = 0.072-0.109; P ≤ 0.040). Specifically, former professional athletes who reported a history of four or five concussions were approximately 1.5 times more likely to report symptoms of CMD, rising to a two- to five-fold increase in those reporting a history of six or more sports career-related concussions.
These data demonstrate an association between exposure to sports concussion and subsequent risk of symptoms of CMD in former professional athletes across a range of contact sports. Further work to explore the association between sports concussion and symptoms of CMD is required; in the meanwhile, strategies for effective risk reduction and improved management appear indicated.
近期报告表明，在体育运动中反复遭受脑震荡与出现困扰、焦虑和抑郁症状、睡眠障碍或药物滥用/依赖（通常称为常见精神障碍[CMD]症状）以及日后患神经退行性疾病尤其是慢性创伤性脑病（CTE）的风险增加有关。本研究的主要目的是探讨与体育生涯相关的脑震荡与从足球（英式足球）、冰球和橄榄球（联盟式橄榄球）项目退役的前男性职业运动员中随后出现的CMD症状之间的关系。
对来自三项前瞻性队列研究的基线电子问卷进行横断面分析，这些研究针对的是从足球（英式足球）、冰球和橄榄球（联盟式橄榄球）项目退役的前男性职业运动员。通过一个单一问题来调查确诊脑震荡的次数，同时使用经过验证的问卷评估困扰、焦虑和抑郁症状、睡眠障碍以及不良饮酒情况。
在联系的1957名前职业运动员中，共有576人（29%）完成了问卷。其中，23%在其职业生涯中未遭受过脑震荡，34%有两到三次脑震荡，18%有四到五次脑震荡，11%有六次或更多脑震荡。与体育生涯相关的脑震荡次数是所有结果指标的一个预测因素（β = 0.072 - 0.109；P≤0.040）。具体而言，报告有四到五次脑震荡病史的前职业运动员报告CMD症状的可能性大约高1.5倍，而报告有六次或更多与体育生涯相关脑震荡病史的运动员这一可能性则增至两到五倍。
这些数据表明，在一系列接触性运动项目的前职业运动员中，遭受体育脑震荡与随后出现CMD症状的风险之间存在关联。需要进一步开展工作来探究体育脑震荡与CMD症状之间的关联；与此同时，似乎需要采取有效降低风险和改善管理的策略。
