ArticleAnnals of neurology2018
Age of first exposure to tackle football and chronic traumatic encephalopathy.
Article in Annals of neurology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 85 papers, 3 of them syntheses that pooled it.
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Who cites it
85 citing papers in PubMed, 3 syntheses or guidelines pooled it, 149 citations in OpenAlex.
- Mortality Risk from Neurodegenerative Disease in Sports Associated with Repetitive Head Impacts: Preliminary Findings from a Systematic Review and Meta-Analysis.Sports medicine (Auckland, N.Z.) · 2022Pooled it
- A global collaboration to study intimate partner violence-related head trauma: The ENIGMA consortium IPV working group.Brain imaging and behavior · 2021Pooled it
- Concussion and long-term cognitive impairment among professional or elite sport-persons: a systematic review.Journal of neurology, neurosurgery, and psychiatry · 2020Pooled it
- Does acute soccer heading cause an increase in plasma S100B? A randomized controlled trial.PloS one · 2020Trial
- Younger Age of First Exposure to American Football Is Associated with Worse Informant-Reported Clinical Outcomes in Older Age Brain Donors.Journal of neurotrauma · 2026Article
- Astrocytic contributions to the pathogenesis of chronic traumatic encephalopathy: a scoping review.Chinese neurosurgical journal · 2026Review
- 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
- From Traumatic Brain Injury to Alzheimer's Disease: Multilevel Biomechanical, Neurovascular, and Molecular Mechanisms with Emerging Therapeutic Directions.International journal of molecular sciences · 2026Review
- Cognitive and Neuropsychiatric Function in Former American Football Players.JAMA network open · 2026Article
- Single- versus two-test criteria for cognitive impairment: associations with CSF and imaging markers in former American football players.The Clinical neuropsychologist · 2025Article
- Comparison of multiple quantitative strategies for neuropathologic image analyses.Journal of neuropathology and experimental neurology · 2025Article
- The Association Between Age of First Exposure to American Football at a Young Age and Later-Life Health Issues in Healthy, Community-Dwelling Adults.Sports medicine (Auckland, N.Z.) · 2025Article
- Unprecedented Combination of Rare Degenerative Pathologies in an Octogenarian Ex-Football Player.Neuropathology : official journal of the Japanese Society of Neuropathology · 2025Article
- Traumatic Brain Injury and Chronic Traumatic Encephalopathy: Not Only Trigger for Neurodegeneration but Also for Cerebral Amyloid Angiopathy?Biomedicines · 2025Review
- Does white matter and vascular injury from repetitive head impacts lead to a novel pattern on T2 FLAIR MRI? A hypothesis proposal and call for research.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Review
- Duration of Ice Hockey Play and Chronic Traumatic Encephalopathy.JAMA network open · 2024Article
- Examination of plasma biomarkers of amyloid, tau, neurodegeneration, and neuroinflammation in former elite American football players.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Brain morphometry in former American football players: findings from the DIAGNOSE CTE research project.Brain : a journal of neurology · 2024Article
- Age of First Exposure Does Not Relate to Post-Career Health in Former Professional American-Style Football Players.Sports medicine (Auckland, N.Z.) · 2024Article
- Lack of Association of Informant-Reported Traumatic Brain Injury and Chronic Traumatic Encephalopathy.Journal of neurotrauma · 2024Article
25 more citing papers are in PubMed but not listed here.
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Authors and funding
20 authors at 6 institutions in 2 countries.
Funding
Abstract
objectiveTo examine the effect of age of first exposure to tackle football on chronic traumatic encephalopathy (CTE) pathological severity and age of neurobehavioral symptom onset in tackle football players with neuropathologically confirmed CTE.
methodsThe sample included 246 tackle football players who donated their brains for neuropathological examination. Two hundred eleven were diagnosed with CTE (126 of 211 were without comorbid neurodegenerative diseases), and 35 were without CTE. Informant interviews ascertained age of first exposure and age of cognitive and behavioral/mood symptom onset.
resultsAnalyses accounted for decade and duration of play. Age of exposure was not associated with CTE pathological severity, or Alzheimer's disease or Lewy body pathology. In the 211 participants with CTE, every 1 year younger participants began to play tackle football predicted earlier reported cognitive symptom onset by 2.44 years (p < 0.0001) and behavioral/mood symptoms by 2.50 years (p < 0.0001). Age of exposure before 12 predicted earlier cognitive (p < 0.0001) and behavioral/mood (p < 0.0001) symptom onset by 13.39 and 13.28 years, respectively. In participants with dementia, younger age of exposure corresponded to earlier functional impairment onset. Similar effects were observed in the 126 CTE-only participants. Effect sizes were comparable in participants without CTE.
interpretationIn this sample of deceased tackle football players, younger age of exposure to tackle football was not associated with CTE pathological severity, but predicted earlier neurobehavioral symptom onset. Youth exposure to tackle football may reduce resiliency to late-life neuropathology. These findings may not generalize to the broader tackle football population, and informant-report may have affected the accuracy of the estimated effects. Ann Neurol 2018;83:886-901.
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