Collía Alejandra, Iranzo Alex, Serradell Mónica, Muñoz-Lopetegi Amaia, Mayà Gerard, Santamaría Joan, Sánchez-Valle Raquel, Gaig Carles
Neurology Service, Hospital Clínic Barcelona, Universitat de Barcelona, IDIBAPS, CIBERNED: CB06/05/0018-ISCIII, Villarroel 170, 08036, Barcelona, Spain.
J Neurol. 2023 Jun;270(6):3234-3242. doi: 10.1007/s00415-023-11591-8. Epub 2023 Mar 20.
Contact sports such as football are associated with late development of neurodegenerative diseases, in part due to the deleterious effect of repetitive head impacts during participation. Isolated REM sleep behavior disorder (IRBD) represents an early manifestation of neurodegenerative diseases including Parkinson disease (RBD) and dementia with Lewy bodies (DLB). We hypothesized that former professional football participation would be overrepresented in IRBD.
To assess former participation in professional football as an occupation in IRBD.
In a case-control retrospective study, having played football as a professional occupation in the Spanish Football Professional Leagues was examined interviewing polysomnographically confirmed IRBD patients and matched controls without IRBD.
Among 228 Caucasian Spanish IRBD patients with 68.5 ± 7.2 years, six (2.63%) were retired professional footballers. Length professional football career ranged between 11 and 16 years. Interval between football retirement and IRBD diagnosis was 39.5 ± 6.4 years. At IRBD diagnosis, the six footballers had synucleinopathy biomarkers including pathologic synuclein in the CSF and tissues, nigrostriatal dopaminergic deficit and hyposmia. Follow-up showed that three footballers developed PD and two DLB. None of the controls was a professional footballer. The percentage of professional footballers was higher in IRBD patients than in controls (2.63% versus 0.00%; p = 0.030) and among the general Spanish population (2.63% versus 0.62%; p < 0.0001).
We found an overrepresentation of former professional footballers in IRBD patients who later developed PD and DLB after four decades from professional retirement. In professional footballers the development of a neurodegenerative disease may be first manifested by IRBD. Screening for IRBD in former footballers might identify individuals with underlying synucleinopathies. Further studies with larger samples are needed to confirm our observations.
诸如足球之类的接触性运动与神经退行性疾病的晚期发生有关，部分原因是参与运动期间反复头部撞击的有害影响。孤立性快速眼动睡眠行为障碍（IRBD）是包括帕金森病（RBD）和路易体痴呆（DLB）在内的神经退行性疾病的早期表现。我们推测前职业足球运动员在IRBD患者中所占比例过高。
评估前职业足球运动员作为IRBD的一种职业经历情况。
在一项病例对照回顾性研究中，通过对经多导睡眠图证实的IRBD患者和无IRBD的匹配对照进行访谈，调查其是否曾在西班牙足球职业联赛中从事过足球职业。
在228名年龄为68.5±7.2岁的西班牙白种人IRBD患者中，有6名（2.63%）是退役职业足球运动员。职业足球生涯时长在11至16年之间。从足球退役到IRBD诊断的间隔时间为39.5±6.4年。在IRBD诊断时，这6名足球运动员具有α-突触核蛋白病生物标志物，包括脑脊液和组织中的病理性α-突触核蛋白、黑质纹状体多巴胺能缺陷和嗅觉减退。随访显示，3名足球运动员发展为帕金森病，2名发展为路易体痴呆。对照组中没有一名是职业足球运动员。IRBD患者中职业足球运动员的比例高于对照组（2.63%对0.00%；p = 0.030），也高于西班牙普通人群（2.63%对0.62%；p < 0.0001）。
我们发现，在IRBD患者中，前职业足球运动员的比例过高，这些患者在从职业退役四十年后后来发展为帕金森病和路易体痴呆。在职业足球运动员中，神经退行性疾病的发展可能首先表现为IRBD。对前足球运动员进行IRBD筛查可能会识别出患有潜在α-突触核蛋白病的个体。需要更大样本的进一步研究来证实我们的观察结果。
