ArticleJournal of neurotrauma2017
Cumulative Head Impact Exposure Predicts Later-Life Depression, Apathy, Executive Dysfunction, and Cognitive Impairment in Former High School and College Football Players.
Article in Journal of neurotrauma, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 263 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
263 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- A Systematic Review of Head Impacts and Acceleration Associated with Soccer.International journal of environmental research and public health · 2022Pooled it
- Head Impact Research Using Inertial Sensors in Sport: A Systematic Review of Methods, Demographics, and Factors Contributing to Exposure.Sports medicine (Auckland, N.Z.) · 2022Pooled it
- The Comparative Mental Health Responses Between Post-Musculoskeletal Injury and Post-Concussive Injury Among Collegiate Athletes: A Systematic Review.International journal of sports physical therapy · 2021Pooled it
- History of Sport-Related Concussion and Long-Term Clinical Cognitive Health Outcomes in Retired Athletes: A Systematic Review.Journal of athletic training · 2020Pooled it
- Trial
- Partner-inflicted brain injury may cognitively age survivors by over a decade.medRxiv : the preprint server for health sciences · 2026Article
- Cognitive and Behavioral Functioning in Female Former Soccer Players: Results from the Head Impact and Trauma Surveillance Study (HITSS).Brain sciences · 2026Article
- Regional ventricular enlargement as an in vivo biomarker of cumulative biomechanical neurodegeneration in former American football players.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Instrumented Mouthguards in Women's Rugby League: Quantifying the Incidence and Probability of Head Acceleration Events at Group and Individual Levels.Sports medicine (Auckland, N.Z.) · 2026Article
- Biological Markers of Cognitive Impairments in Combat and Contact-Sport Athletes: A Systematic Review.Sports (Basel, Switzerland) · 2026Review
- Review
- Imaging the later-life white matter pathologies of repetitive head impacts: A novel pattern revealed through T2 FLAIR MRI.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- The Effect of Changing Weekly Contact Training Duration Beyond Current Guidelines on Head Acceleration Events in Rugby Union.Sports medicine (Auckland, N.Z.) · 2026Article
- Proteomic Analysis of Human Chronic Traumatic Encephalopathy Brain Implicates Proteasome and Ribosome Dysfunction in Disease Progression.bioRxiv : the preprint server for biology · 2026Article
- Cognitive and Neuropsychiatric Function in Former American Football Players.JAMA network open · 2026Article
- Factors associated with subjective cognitive complaints in former American football players.Journal of the International Neuropsychological Society : JINS · 2026Article
- Head Acceleration Event Exposure During Elite Men's and Women's Rugby Union Training.Sports medicine (Auckland, N.Z.) · 2026Article
- Dose-dependent white matter changes associated with repetitive head impacts in former American football players.Brain communications · 2026Article
- Sex, but not exposure-related variables, predicts baseline serum glial fibrillar acidic protein and neurofilament light levels in contact sport athletes.BMJ open sport & exercise medicine · 2026Article
- Article
203 more citing papers are in PubMed but not listed here.
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Authors and funding
13 authors.
Funding
Abstract
The term "repetitive head impacts" (RHI) refers to the cumulative exposure to concussive and subconcussive events. Although RHI are believed to increase risk for later-life neurological consequences (including chronic traumatic encephalopathy), quantitative analysis of this relationship has not yet been examined because of the lack of validated tools to quantify lifetime RHI exposure. The objectives of this study were: 1) to develop a metric to quantify cumulative RHI exposure from football, which we term the "cumulative head impact index" (CHII); 2) to use the CHII to examine the association between RHI exposure and long-term clinical outcomes; and 3) to evaluate its predictive properties relative to other exposure metrics (i.e., duration of play, age of first exposure, concussion history). Participants included 93 former high school and collegiate football players who completed objective cognitive and self-reported behavioral/mood tests as part of a larger ongoing longitudinal study. Using established cutoff scores, we transformed continuous outcomes into dichotomous variables (normal vs. impaired). The CHII was computed for each participant and derived from a combination of self-reported athletic history (i.e., number of seasons, position[s], levels played), and impact frequencies reported in helmet accelerometer studies. A bivariate probit, instrumental variable model revealed a threshold dose-response relationship between the CHII and risk for later-life cognitive impairment (p < 0.0001), self-reported executive dysfunction (p < 0.0001), depression (p < 0.0001), apathy (p = 0.0161), and behavioral dysregulation (p < 0.0001). Ultimately, the CHII demonstrated greater predictive validity than other individual exposure metrics.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.