ArticleThe Journal of neuropsychiatry and clinical neurosciences2025
Characterizing Neurobehavioral Dysregulation Among Former American Football Players: Findings From the DIAGNOSE CTE Research Project.
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Article in The Journal of neuropsychiatry and clinical neurosciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6citing papers in PubMed
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What it found
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Who cites it
6 citing papers in PubMed.
- Cognitive and Behavioral Functioning in Female Former Soccer Players: Results from the Head Impact and Trauma Surveillance Study (HITSS).Brain sciences · 2026Article
- 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
- Inflammation, Limbic White Matter Microstructure, and Clinical Symptoms in Retired American Football Players With Repetitive Head Impacts.Neurology · 2026Article
- Factors associated with subjective cognitive complaints in former American football players.Journal of the International Neuropsychological Society : JINS · 2026Article
- Catecholamine Dysregulation in Former American Football Players: Findings From the DIAGNOSE CTE Research Project.Neurology · 2025Observational
- Inflammatory biomarkers for neurobehavioral dysregulation in former American football players: findings from the DIAGNOSE CTE Research Project.Journal of neuroinflammation · 2024Article
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Authors and funding
19 authors.
Surya V PulukuriChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Tessa R FagleChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Diana Trujillo-RodriguezChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Suzan van AmerongenChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Charles BernickChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Yonas E GedaChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Jennifer V WetheChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Elaine R PeskindChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Douglas I KatzChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Michael L AloscoChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Joseph N PalmisanoChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Yorghos TripodisChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Charles H AdlerChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Laura J BalcerChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Eric M ReimanChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Martha E ShentonChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Jeffrey L CummingsChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Robert A SternChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
DIAGNOSE CTE Research ProjectChronic Traumatic Encephalopathy Center (Pulukuri, Fagle, Trujillo-Rodriguez, van Amerongen, Katz, Alosco, Tripodis, Stern), Graduate Program in Neuroscience (Trujillo-Rodriguez), Department of Neurology (Katz, Alosco, Stern), Alzheimer's Disease Research Center (Alosco, Tripodis, Stern), Department of Neurosurgery and Department of Anatomy and Neurobiology (Stern), Boston University Chobanian and Avedisian School of Medicine, Boston; Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit (VU) Amsterdam, VU University Medical Center, and Department of Neurodegeneration, Amsterdam Neuroscience, Amsterdam (van Amerongen); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas (Bernick); Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix (Geda); Department of Psychiatry and Psychology (Wethe) and Department of Neurology (Adler), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Veterans Affairs Northwest Mental Illness Research, Education, and Clinical Center and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Peskind); Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Mass. (Katz); Biostatistics and Epidemiology Data Analytics Center (Palmisano) and Department of Biostatistics (Tripodis), Boston University School of Public Health; Departments of Neurology, Population Health, and Ophthalmology, New York University Grossman School of Medicine, New York (Balcer); Banner Alzheimer's Institute, University of Arizona, Translational Genomics Research Institute, Arizona State University, and Arizona Alzheimer's Consortium, Phoenix (Reiman); Departments of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston (Shenton); Department of Brain Health, Chambers-Grundy Center for Transformative Neuroscience, School of Integrated Health Sciences, University of Nevada Las Vegas (Cummings).
Funding
Trial-Ready Cohort for Preclinical/Prodromal Alzheimer's DiseaseR01AG053798 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI AISEN, PAUL S., CUMMINGS, JEFFREY L. · 2017 to 2022
$39.4MTranslational and Therapeutics CoreP30AG072959 · NIA · CLEVELAND CLINIC LERNER COM-CWRU · PI JAGAN AYYAPPAN PILLAI · 2021 to 2026
$23.9MRenewal of Centers of Biomedical Research Excellence (COBRE) (Phase 2) CNTN - ResubmissionP20GM109025 · NIGMS · CLEVELAND CLINIC FOUNDATION · PI JESSICA KIRKLAND CALDWELL · 2015 to 2026
$22.8MChronic Traumatic Encephalopathy: Detection, Diagnosis, Course, and Risk FactorsU01NS093334 · NINDS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI CUMMINGS, JEFFREY L., REIMAN, ERIC MICHAEL · 2016 to 2022
$17.0MAlzheimer's Clinical Trial InnOvatioN (ACTION) InitiativeR35AG071476 · NIA · UNIVERSITY OF NEVADA LAS VEGAS · PI CUMMINGS, JEFFREY L. · 2021 to 2025
$2.9MPathways linking neuropsychiatric symptoms with Alzheimer's disease neuroimaging biomarkers and the outcome of incident Mild Cognitive Impairment/ DementiaR01AG057708 · NIA · ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER · PI GEDA, YONAS E · 2018 to 2022
$1.7MAlzheimer's Disease and Related Dementias Innovation Incubator (InnovaTor)R25AG083721 · NIA · UNIVERSITY OF NEVADA LAS VEGAS · PI JEFFREY L. CUMMINGS, Xue K Zhong · 2023 to 2026
$1.0MNIA NIH HHS P30 AG072959NIA NIH HHS R01 AG053798NIA NIH HHS R01 AG057708NIA NIH HHS R25 AG083721NIA NIH HHS R35 AG071476NIGMS NIH HHS P20 GM109025NINDS NIH HHS U01 NS093334
Abstract
objectiveNeurobehavioral dysregulation (NBD), a core clinical feature of traumatic encephalopathy syndrome, encompasses neuropsychiatric symptoms reported among individuals with a history of repetitive head impact exposure, including contact sport athletes. The objective of this study was to examine the construct and subconstructs of NBD through a series of factor and cluster analyses.
methodsSix clinician-scientists selected self-report questionnaire items relevant to NBD from seven available neuropsychiatric scales through a blinded voting process. These items were subjected to confirmatory factor analyses in a sample of 178 former college and professional American football players and 60 asymptomatic individuals without a history of repetitive head impact exposure. All participants were enrolled in the Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy Research Project. Factor scores were generated on the basis of the optimal expert-informed model for NBD. Construct validity was assessed with neuropsychiatric scales not included in generation of the factor scores. Cluster analyses with NBD factor scores were used to examine symptom profiles.
resultsFactor analyses confirmed that NBD was composed of four subconstructs: explosivity, emotional dyscontrol, impulsivity, and affective lability. Cluster analyses indicated four distinct symptom profiles of NBD in this group of former football players: asymptomatic (N=80, 45%), short fuse (N=33, 19%), high affective lability (N=34, 19%), and high NBD (N=31, 17%).
conclusionsThese findings characterize NBD as a multifaceted clinical construct with a heterogeneous presentation, providing a foundation for empirical work on the diagnostic criteria for traumatic encephalopathy syndrome and research on the neurobiological underpinnings of NBD.
Indexed as
Athletic InjuriesChronic Traumatic EncephalopathyFootballAdultAthletesCluster AnalysisFactor Analysis, StatisticalHumansMaleMiddle AgedNeuropsychological TestsYoung AdultChronic Traumatic EncephalopathyDIAGNOSE CTE Research ProjectFormer Football PlayersNeurobehavioral DysregulationRepetitive Head ImpactsTraumatic Encephalopathy Syndrome
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