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March 17, 2015; 84 (11) Article

Age of first exposure to football and later-life cognitive impairment in former NFL players

Julie M. Stamm, Alexandra P. Bourlas, Christine M. Baugh, Nathan G. Fritts, Daniel H. Daneshvar, Brett M. Martin, Michael D. McClean, Yorghos Tripodis, Robert A. Stern
First published January 28, 2015, DOI: https://doi.org/10.1212/WNL.0000000000001358
Julie M. Stamm
From the CTE Center (J.M.S., A.P.B., C.M.B., N.G.F., D.H.D., Y.T., R.A.S.), Department of Anatomy and Neurobiology (J.M.S., R.A.S.), BU Alzheimer's Disease Center (A.P.B., Y.T., R.A.S.), Department of Neurology (C.M.B., R.A.S.), and Department of Neurosurgery (R.A.S.), Boston University School of Medicine; and Data Coordinating Center (B.M.M.), Department of Environmental Health (M.D.M.), and Department of Biostatistics (Y.T.), Boston University School of Public Health, Boston, MA.
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Alexandra P. Bourlas
From the CTE Center (J.M.S., A.P.B., C.M.B., N.G.F., D.H.D., Y.T., R.A.S.), Department of Anatomy and Neurobiology (J.M.S., R.A.S.), BU Alzheimer's Disease Center (A.P.B., Y.T., R.A.S.), Department of Neurology (C.M.B., R.A.S.), and Department of Neurosurgery (R.A.S.), Boston University School of Medicine; and Data Coordinating Center (B.M.M.), Department of Environmental Health (M.D.M.), and Department of Biostatistics (Y.T.), Boston University School of Public Health, Boston, MA.
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Christine M. Baugh
From the CTE Center (J.M.S., A.P.B., C.M.B., N.G.F., D.H.D., Y.T., R.A.S.), Department of Anatomy and Neurobiology (J.M.S., R.A.S.), BU Alzheimer's Disease Center (A.P.B., Y.T., R.A.S.), Department of Neurology (C.M.B., R.A.S.), and Department of Neurosurgery (R.A.S.), Boston University School of Medicine; and Data Coordinating Center (B.M.M.), Department of Environmental Health (M.D.M.), and Department of Biostatistics (Y.T.), Boston University School of Public Health, Boston, MA.
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Nathan G. Fritts
From the CTE Center (J.M.S., A.P.B., C.M.B., N.G.F., D.H.D., Y.T., R.A.S.), Department of Anatomy and Neurobiology (J.M.S., R.A.S.), BU Alzheimer's Disease Center (A.P.B., Y.T., R.A.S.), Department of Neurology (C.M.B., R.A.S.), and Department of Neurosurgery (R.A.S.), Boston University School of Medicine; and Data Coordinating Center (B.M.M.), Department of Environmental Health (M.D.M.), and Department of Biostatistics (Y.T.), Boston University School of Public Health, Boston, MA.
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Daniel H. Daneshvar
From the CTE Center (J.M.S., A.P.B., C.M.B., N.G.F., D.H.D., Y.T., R.A.S.), Department of Anatomy and Neurobiology (J.M.S., R.A.S.), BU Alzheimer's Disease Center (A.P.B., Y.T., R.A.S.), Department of Neurology (C.M.B., R.A.S.), and Department of Neurosurgery (R.A.S.), Boston University School of Medicine; and Data Coordinating Center (B.M.M.), Department of Environmental Health (M.D.M.), and Department of Biostatistics (Y.T.), Boston University School of Public Health, Boston, MA.
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Brett M. Martin
From the CTE Center (J.M.S., A.P.B., C.M.B., N.G.F., D.H.D., Y.T., R.A.S.), Department of Anatomy and Neurobiology (J.M.S., R.A.S.), BU Alzheimer's Disease Center (A.P.B., Y.T., R.A.S.), Department of Neurology (C.M.B., R.A.S.), and Department of Neurosurgery (R.A.S.), Boston University School of Medicine; and Data Coordinating Center (B.M.M.), Department of Environmental Health (M.D.M.), and Department of Biostatistics (Y.T.), Boston University School of Public Health, Boston, MA.
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Michael D. McClean
From the CTE Center (J.M.S., A.P.B., C.M.B., N.G.F., D.H.D., Y.T., R.A.S.), Department of Anatomy and Neurobiology (J.M.S., R.A.S.), BU Alzheimer's Disease Center (A.P.B., Y.T., R.A.S.), Department of Neurology (C.M.B., R.A.S.), and Department of Neurosurgery (R.A.S.), Boston University School of Medicine; and Data Coordinating Center (B.M.M.), Department of Environmental Health (M.D.M.), and Department of Biostatistics (Y.T.), Boston University School of Public Health, Boston, MA.
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Yorghos Tripodis
From the CTE Center (J.M.S., A.P.B., C.M.B., N.G.F., D.H.D., Y.T., R.A.S.), Department of Anatomy and Neurobiology (J.M.S., R.A.S.), BU Alzheimer's Disease Center (A.P.B., Y.T., R.A.S.), Department of Neurology (C.M.B., R.A.S.), and Department of Neurosurgery (R.A.S.), Boston University School of Medicine; and Data Coordinating Center (B.M.M.), Department of Environmental Health (M.D.M.), and Department of Biostatistics (Y.T.), Boston University School of Public Health, Boston, MA.
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Robert A. Stern
From the CTE Center (J.M.S., A.P.B., C.M.B., N.G.F., D.H.D., Y.T., R.A.S.), Department of Anatomy and Neurobiology (J.M.S., R.A.S.), BU Alzheimer's Disease Center (A.P.B., Y.T., R.A.S.), Department of Neurology (C.M.B., R.A.S.), and Department of Neurosurgery (R.A.S.), Boston University School of Medicine; and Data Coordinating Center (B.M.M.), Department of Environmental Health (M.D.M.), and Department of Biostatistics (Y.T.), Boston University School of Public Health, Boston, MA.
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  • Search for this author on this site
Full PDF
Citation
Age of first exposure to football and later-life cognitive impairment in former NFL players
Julie M. Stamm, Alexandra P. Bourlas, Christine M. Baugh, Nathan G. Fritts, Daniel H. Daneshvar, Brett M. Martin, Michael D. McClean, Yorghos Tripodis, Robert A. Stern
Neurology Mar 2015, 84 (11) 1114-1120; DOI: 10.1212/WNL.0000000000001358

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Article Information

vol. 84 no. 11 1114-1120
DOI: 
https://doi.org/10.1212/WNL.0000000000001358
PubMed: 
25632088

Published By: 
Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology
Print ISSN: 
0028-3878
Online ISSN: 
1526-632X
History: 
  • Received September 5, 2014
  • Accepted in final form November 12, 2014
  • First Published January 28, 2015.

Article Versions

  • Previous version (January 28, 2015 - 13:01).
  • You are viewing the most recent version of this article.
Copyright & Usage: 
© 2015 American Academy of Neurology

Author Disclosures

    1. Julie M. Stamm, BS,
    2. Alexandra P. Bourlas, MA,
    3. Christine M. Baugh, MPH,
    4. Nathan G. Fritts, BA,
    5. Daniel H. Daneshvar, MA,
    6. Brett M. Martin, MS,
    7. Michael D. McClean, ScD,
    8. Yorghos Tripodis, PhD and
    9. Robert A. Stern, PhD
  1. Julie M. Stamm, BS,
  2. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NIH, F31NS081957, PI, 2013-2016

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  3. Alexandra P. Bourlas, MA,
  4. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  5. Christine M. Baugh, MPH,
  6. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NIMH, T32MH019733 (PI: Tom McGuire), trainee, 9/2014-present

    Research Support, Academic Entities:
    1. Edmond J. Safra Center for Ethics, Harvard University.

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  7. Nathan G. Fritts, BA,
  8. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  9. Daniel H. Daneshvar, MA,
  10. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  11. Brett M. Martin, MS,
  12. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  13. Michael D. McClean, ScD,
  14. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. 1 - Gavin Law Firm, case focused on head and neck cancer, 2012-13 2 - Gavin Law Firm, case focused on exposure to battery acid, 2013

  15. Yorghos Tripodis, PhD and
  16. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. 1) NIA, P30-AG13846, Biostatistician, 2011-2016 2) NIH, R01 ND078337, Biostatistician, 2011, 2015

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  17. Robert A. Stern, PhD
  18. Scientific Advisory Boards:
    1. (1) Mackey-White Traumatic Brain Injury Committee, National Football League Players Association (2) Eli Lilly Expert Advisor (3) Medical Advisory Board, Sports Legacy Institute (4) Medical/Scientific Advisory Board, MA/NH Alzheimer's Association (5) Medical Advisory Board, National Graves Disease Foundation

    Gifts:
    1. NONE

    Funding for travel or speaker honoraria:
    1. (1) Congressional Brain Injury Task Force, honorarium, (2) Institute of Medicine Committee on Nutrition, Trauma and the Brain, honorarium, (3) 2010 Head Trauma and the Athlete CME Conference, honorarium, (4) Braintree Neurorehabilitation Conference, honorarium, (5) MassALFA, honorarium, (6) Massachusetts Neurologic Association and the Massachusetts Medical Society, honorarium, (7) American Neuropsychiatric Association, honorarium, (8) American Neuropsychiatric Association, honorarium, (9) The Neuroscience Institute at the University of Tennessee Health Science Center, honorarium, (10) Alzheimer?s Association, honorarium, (11) American Psychological Association, honorarium, (12) Baptist Hospital Annual Brain Injury Symposium, honorarium, (13) National Public Radio, honorarium, (14) Boston Society of Neurology and Psychiatry, honorarium, (15) Boston Surgical Society, honorarium, (16) Vista Health System, honorarium, (17) Alzheimer?s Partnership, honorarium, (18) Shiley-Marcos Alzheimer?s Disease Research Center University of California San Diego, honorarium, (18) Sunnybrook Hospital, honorarium, (19) Brain Injury Association, honorarium, (20) American Psychological Association, honorarium, (21) Chronic Traumatic Encephalopathy (CTE) Conference, honorarium, (22) Society for Neuroscience, honorarium, (23) Boston University School of Medicine, honorarium, (24) New Hampshire Alzheimer?s Association, honorarium, (25) Massachusetts Chapter of the American College of Surgeons, honorarium, (26) National Institutes of Health, honorarium, (27) Traumatic Brain Injury Conference, honorarium, (28) American Health Care Journalists, honorarium, (29) Rose? Webinar Series, honorarium, (30) International Sports Concussion Symposium, honorarium, (31) World Brain Mapping Conference, honorarium, (32) Harvard Medical School, honorarium, (33) The German Center for Research and Innovation and Ludwig-Maximilians-Universit?t M?nchen, honorarium, (34) New York Academy of Sciences, honorarium, (35) Academy of Clinical Neuropsychology, honorarium.

    Editorial Boards:
    1. (1) Journal of Neuropsychiatry and Clinical Neurosciences, Associate Editor, 1998-Present, (2) Archives of Clinical Neuropsychology, Member of Editorial Board, 2008-Present, (3) Frontiers in Neurotrauma, Review Editor, 2010-Present, (4) Frontiers in Sports Neurology, Review Editor, 2011- Present, (5) Alzheimer's Research and Therapy, Series Editor, 2012-Present

    Patents:
    1. NONE

    Publishing Royalties:
    1. (1) Visual Analog Mood Scales, Psychological Assessment Resources, Inc., 1997-Present, (2) Boston Qualitative Scoring System for the Rey-Osterreith Complex Figure, Psychological Assessment Resources, Inc., 1999-Present, (3) Neuropsychological Assessment Resources, Inc., 2003-Present

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. (1) Neuronix, (2) Eli Lilly, (3)Janssen Alzheimer's Immunotherapy; Athena Diagnostics

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. (1) Janssen Alzheimer's Immunotherapy (previously Elan), (2) Medivation, (3) Pfizer Pharmaceuticals, (4) Eisai Pharmaceuticals, (5)Ely Lilly, (6) Avid Radiopharmaceuticals

    Research Support, Government Entities:
    1. (1) NIH, R01NS078337, PI, 2011-2014, (2) NIH, P30-AG13846, Clinical Core Director, 2004-2016, (3) NIH, D01-HP08796, Neuropsychology Director, 2010-2015 (4) NIH, R01-CA129769, PI, 2009-2014, (5)NIH, R01-MH080295, PI, 2008-2014, (6)NIH, U01-AG10483, Site PI, 2007-2012, (7)NIH, R56NS078337, PI, 2014-2015

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. (1) Alzheimer's Association

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  1. From the CTE Center (J.M.S., A.P.B., C.M.B., N.G.F., D.H.D., Y.T., R.A.S.), Department of Anatomy and Neurobiology (J.M.S., R.A.S.), BU Alzheimer's Disease Center (A.P.B., Y.T., R.A.S.), Department of Neurology (C.M.B., R.A.S.), and Department of Neurosurgery (R.A.S.), Boston University School of Medicine; and Data Coordinating Center (B.M.M.), Department of Environmental Health (M.D.M.), and Department of Biostatistics (Y.T.), Boston University School of Public Health, Boston, MA.
  1. Correspondence to Dr. Stern: bobstern{at}bu.edu
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Cited By...

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Letters: Rapid online correspondence

  • Author Response
    • Robert A. Stern, Boston University School of Medicinebobstern@bu.edu
    • Julie M. Stamm, Yorghos Tripodis, Boston
    Submitted April 29, 2015
  • Cognitive deficits may predate early entry into football
    • Glenn J. Larrabee, Neuropsychologist, Independent Practiceglarrabee@aol.com
    • Martin L. Rohling, Mobile, Alabama; Laurence M. Binder, Beaverton, Oregon
    Submitted March 10, 2015
  • Youth football and late-life cognitive impairment
    • Jim Andrikopoulos, Neuropsychologist, Independent Practiceneuroclinic@msn.com
    • Des Moines, Iowa
    Submitted February 26, 2015
  • Rebuttal to "Age of first exposure to football and later-life cognitive impairment in former NFL players"
    • Joseph C. Maroon, Neurosurgeon, University of Pittsburgh Medical Centermaroonjc@upmc.edu
    • Julian Bailes, Pittsburgh, PA; Michael Collins, Pittsburgh, PA; Mark Lovell, Pittsburgh, PA; Christina Mathyssek, Pittsburgh, PA
    Submitted February 23, 2015
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