Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.
Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA, USA.
Nat Commun. 2023 Jun 20;14(1):3470. doi: 10.1038/s41467-023-39183-0.
Chronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy associated with repetitive head impacts (RHI), but the components of RHI exposure underlying this relationship are unclear. We create a position exposure matrix (PEM), composed of American football helmet sensor data, summarized from literature review by player position and level of play. Using this PEM, we estimate measures of lifetime RHI exposure for a separate cohort of 631 football playing brain donors. Separate models examine the relationship between CTE pathology and players' concussion count, athletic positions, years of football, and PEM-derived measures, including estimated cumulative head impacts, linear accelerations, and rotational accelerations. Only duration of play and PEM-derived measures are significantly associated with CTE pathology. Models incorporating cumulative linear or rotational acceleration have better model fit and are better predictors of CTE pathology than duration of play or cumulative head impacts alone. These findings implicate cumulative head impact intensity in CTE pathogenesis.
慢性创伤性脑病（CTE）是一种与反复头部撞击（RHI）相关的神经退行性tau 病，但导致这种关系的 RHI 暴露因素尚不清楚。我们创建了一个位置暴露矩阵（PEM），该矩阵由美式橄榄球头盔传感器数据组成，根据球员位置和比赛水平从文献综述中进行总结。使用这个 PEM，我们为另一个由 631 名橄榄球运动员大脑捐献者组成的队列估计了一生中 RHI 暴露的程度。单独的模型研究了 CTE 病理与运动员脑震荡次数、运动位置、橄榄球年限以及源自 PEM 的测量值（包括估计的累积头部冲击、线性加速度和旋转加速度）之间的关系。只有运动时间和源自 PEM 的测量值与 CTE 病理显著相关。纳入累积线性或旋转加速度的模型具有更好的模型拟合度，并且比运动时间或累积头部冲击更能预测 CTE 病理。这些发现提示累积头部冲击强度与 CTE 发病机制有关。
