Lewy Body Pathology and Chronic Traumatic Encephalopathy Associated With Contact Sports
Open Access
- 25 July 2018
- journal article
- research article
- Published by Oxford University Press (OUP) in Journal of Neuropathology and Experimental Neurology
- Vol. 77 (9), 757-768
- https://doi.org/10.1093/jnen/nly065
Abstract
Traumatic brain injury has been associated with increased risk of Parkinson disease and parkinsonism, and parkinsonism and Lewy body disease (LBD) can occur with chronic traumatic encephalopathy (CTE). To test whether contact sports and CTE are associated with LBD, we compared deceased contact sports athletes (n = 269) to cohorts from the community (n = 164) and the Boston University Alzheimer disease (AD) Center (n = 261). Participants with CTE and LBD were more likely to have β-amyloid deposition, dementia, and parkinsonism than CTE alone (p < 0.05). Traditional and hierarchical clustering showed a similar pattern of LBD distribution in CTE compared to LBD alone that was most frequently neocortical, limbic, or brainstem. In the community-based cohort, years of contact sports play were associated with neocortical LBD (OR = 1.30 per year, p = 0.012), and in a pooled analysis a threshold of >8 years of play best predicted neocortical LBD (ROC analysis, OR = 6.24, 95% CI = 1.5–25, p = 0.011), adjusting for age, sex, and APOE ɛ4 allele status. Clinically, dementia was significantly associated with neocortical LBD, CTE stage, and AD; parkinsonism was associated with LBD pathology but not CTE stage. Contact sports participation may increase risk of developing neocortical LBD, and increased LBD frequency may partially explain extrapyramidal motor symptoms sometimes observed in CTE.Keywords
Funding Information
- Department of Veterans Affairs
- Veterans Health Administration
- Clinical Sciences Research and Development (I01-CX001038)
- Veterans Affairs Biorepository (BX002466)
- Alzheimer’s Association (NIRG-305779, NIRG-362697)
- National Institute of Aging (RF1AG054156, R56AG057768, K23AG046377, R01AG016495, R01AG008122, R01AG033040)
- National Institute of Neurological Disorders and Stroke (U01NS086659, F32NS096803, R01NS017950)
- National Institute of Aging Boston University AD Center (P30AG13846)
- Department of Defense Peer Reviewed Alzheimer’s Research Program (PRARP #13267017)
- National Heart, Lung, and Blood Institute (N01-HC-25195, HHSN268201500001I)
- Fonds de Recherche du Quebec—Santé
- Andlinger Foundation and WWE
This publication has 46 references indexed in Scilit:
- Head injury and risk of Parkinson disease: A systematic review and meta‐analysisMovement Disorders, 2013
- National Institute on Aging–Alzheimer’s Association guidelines for the neuropathologic assessment of Alzheimer’s disease: a practical approachActa Neuropathologica, 2011
- α-Synuclein and tau concentrations in cerebrospinal fluid of patients presenting with parkinsonism: a cohort studyThe Lancet Neurology, 2011
- α-Synuclein Promotes SNARE-Complex Assembly in Vivo and in VitroScience, 2010
- Nomenclature and nosology for neuropathologic subtypes of frontotemporal lobar degeneration: an updateActa Neuropathologica, 2009
- Twenty-first century brain banking. Processing brains for research: the Columbia University methodsActa Neuropathologica, 2007
- Staging of brain pathology related to sporadic Parkinson’s diseaseNeurobiology of Aging, 2003
- Accumulation of Insoluble α-Synuclein in Dementia with Lewy BodiesNeurobiology of Disease, 2000
- NEUROLOGICAL DISEASE IN BOXERSThe Lancet, 1963
- THE ANALYSIS OF VARIANCE IN CASES OF NON-NORMAL VARIATIONBiometrika, 1931