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February 28, 2017; 88 (9) Article

Symptoms from repeated intentional and unintentional head impact in soccer players

Walter F. Stewart, Namhee Kim, Chloe S. Ifrah, Richard B. Lipton, Tamar A. Bachrach, Molly E. Zimmerman, Mimi Kim, Michael L. Lipton
First published February 1, 2017, DOI: https://doi.org/10.1212/WNL.0000000000003657
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Article Information

vol. 88 no. 9 901-908
DOI: 
https://doi.org/10.1212/WNL.0000000000003657
PubMed: 
28148633
Published By: 
Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology
Print ISSN: 
0028-3878
Online ISSN: 
1526-632X
History: 
  • Received June 15, 2016
  • Accepted in final form November 7, 2016
  • First Published February 1, 2017.

Article Versions

Copyright & Usage: 
© 2017 American Academy of Neurology

Author Disclosures

    1. Walter F. Stewart, PhD, MPH,
    2. Namhee Kim, PhD, PhD,
    3. Chloe S. Ifrah, BA,
    4. Richard B. Lipton, MD,
    5. Tamar A. Bachrach, BA,
    6. Molly E. Zimmerman, PhD,
    7. Mimi Kim, ScD and
    8. Michael L. Lipton, MD, PhD
  1. Walter F. Stewart, PhD, MPH,
    2. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Neuroepidemiology, associate editor, 2011-2014

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. 1) Amgen, outcomes research, $8,950 2) Genentech, translational research, $1500 3) Health Affairs, $750

    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. NHLBI, R01 HL116832, Heart Failure, PI NIH, R01 NS 082432, Head Injury in Soccer, Consultant NIDDK, R01 DK 082551, Bladder Control, Co-I

    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

  2. Namhee Kim, PhD, PhD,
    3. 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

  3. Chloe S. Ifrah, BA,
    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. NIH Grant R01 310567 since July 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

  4. Richard B. Lipton, MD,
    5. Scientific Advisory Boards:

    1. Allergan, e-Neura, Merck

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. Serve as consultant, advisory board member or received honoraria from: Alder, Allergan, American Headache Society, Amgen, Autonomic Technologies, Avanir, Boston Scientific, CoLucid, Dr. Reddys, Electrocore, Eli Lilly, eNeura Therapeutics, Glaxo Inc. (formerly Novartis), Merck, Pfizer, Teva, Vedanta

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. Wolff's Headache, 8th Edition, Oxford University Press; Informa

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. Serve as consultant, advisory board member or received honoraria from: Alder, Allergan, American Headache Society, Amgen, Autonomic Technologies, Avanir, Boston Scientific, CoLucid, Dr. Reddys, Electrocore, Eli Lilly, eNeura Therapeutics, Glaxo Inc. (formerly Novartis), Merck, Pfizer, Teva, Vedanta

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. Bristol Myers Squibb Early Detection of Alzheimer's Disease June 2010 - present Vedanta Research Migraine epidemiology and Progression June 2010 - present Boston Scientific Occipital Nerve Stimulation in Migraine March 2013 - present ElectroCore Vagal Nerve Stimulation for Migraine and Cluster May 2013 Novartis Sleep and Migraine September 2012 - present Allergan Botox in Migraine April 2012 - present Allergan Chronic Migraine Epidemiology and Outcome Study January 2012 - present

    Research Support, Government Entities:

    1. P01 AG03949 4/1/11-3/31/16 Einstein Aging Study Role: Principle Investigator 1KL2RR025749 07/01/09-06/30/13 Clinical and Translational Science Award (CTSA) Research Career Development Award Role: Primary Mentor R01AG022374 8/1/10-7/31/15 Biomarkers in Early Alzheimer?s Disease Role: Investigator R01AG034119 8/1/10-7/31/15 Two Preclinical Latent Scores to Predict Occurrence of DAT Role: PI, Einstein Site R01AG012101 9/15/10-7/31/15 MRI Progression Markers of Cognitive Decline in the Elderly Role: PI, Einstein Site 1R01AG039409-01 Stress, Unconstructive Repetitive Thought & Cognitive Aging 4/1/11-3/31/16 Role: PI, Einstein Site 1R01AG038651-01A1 Role of impaired cognitive states & risk factors in conversion to mixed dementias 9/1/11-8/31/16 Role: PI, Einstein Site 1U10NS077308- 01 9/30/11-8/31/18 Einstein Center for Excellence for Clinical Trials in Neuroscience Role: PI NIH 4/1/12-3/31/17 Behavioral Weight Loss as a Treatment for Migraine in Obese Women Role: Investigator NIH 1R01AG042595 - 01A1 Stress, cognition, repetitive unconstructive thoughts and inflammatory markers Role: Investigator

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. S & L Marx Foundation Alzheimer's Research Czap Foundation Alzheimer's Research

    Stock/Stock Options/Board of Directors Compensation:

    1. eNeura Pharma

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. Oxford University Press; Baxter Publishing

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  5. Tamar A. Bachrach, BA,
    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. 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

  6. Molly E. Zimmerman, PhD,
    7. 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. Funded as co-investigator by NIH grants # P01AG003949 (PI: R. B. Lipton) and R01NS082432 (P.I.: M. L. Lipton)

    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

  7. Mimi Kim, ScD and
    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. NIH UH2AR067689-02 (Buyon, Putterman, Tuschl) 09/24/2014 ? 05/31/2019 0.60 calendar months Biostatistician P30 CA01330-35 (Goldman) 07/01/2013 ? 06/30/2018 1.32 calendar months NIH $3,585,248 Cancer Center Support Grant Type: Center Grant; July, 2007 ? June, 2012 Role: Dr. Kim directs the Biostatistics Shared resource which provides statistical expertise and collaboration to investigators in the Albert Einstein Cancer Center. 1UL1RR025750-01 (Shamoon) 05/01/2013 ? 04/30/2018 1.62 calendar months NIH $2,607,087 Clinical and Translational Science Award The mission of the Institute for Clinical and Translational Research is to enhance clinical and translational research by promoting multidisciplinary collaboration, addressing translational ?blocks? in research, providing infrastructure and collaborative support, and enhancing training, education, and career development. Role: Co-Investigator R01NS082432 (Lipton) 02/01/2013-01/31/2018 0.94 calendar months NIH $466,607 Brain injury due to soccer heading and opportunities for its mitigation The purpose of this project is to determine the influence of heading on brain structure and function. 1 R01 HD079951-01A1 (Buyon) 12/01/2014 ? 11/30/2019 0.48 calendar months NIH/NICHD $10,986 (Year 1 direct costs ? Einstein subaward) Preventive Approach to Congenital Heart Block with Hydroxychloroquine (PATCH) The goal of this project is to determine whether hydroxychloroquine use during pregnancy prevents the recurrence of congenital heart block (CHB). Specific Aim 1 is to complete Stage II of the open label Phase II trial, entitled Preventive Approach To Congenital Heart Block with Hydroxychloroquine (PATCH), in pregnant women who have had a previous CHB child. Specific Aim 2 addresses the ophthalmologic safety of HCQ exposure during pregnancy. Role on project: Biostatistician (Consortium site PI) AHRQ (Marantz) 06/01/2014 ? 05/31/2019 1.20 calendar months $500,000 Education and Training Program in Patient Centered Outcomes Research Role: Instructor 1U01CA199221-02 (Gorlick) 7/1/2015 ? 6/30/2020 0.4 calendar months NCI $242,719 Osteosarcoma: Patient Derived Xenograft Preclinical Testing In this proposal a highly informative and representative panel of osteosarcoma tumor samples obtained from patients and grown in immuno-deficient mice will be used to identify novel drugs and drug combinations that may be effective in clinical trials in osteosarcoma patients Role: Biostatistician Lupus Foundation of America (Kim) 10/01/2015 ? 09/30/2016 1.66 calendar months $60,000 An Integrated Analysis of Data from Placebo Groups Participation Multi-Center Clinical Trials for Lupus The goal of this project is to use statistical modeling approaches to identify predictors of disease outcomes in lupus patients randomized to the placebo arms of multiple clinical trials. Role: PI AD-1402-10857 (McKee) 9/1/2015 ? 11/30/2017 0.93 calendar months $20,408 salary support Acupuncture Approaches to Decrease Disparities in Outcomes of Pain Treatment - A Two Arm Comparative Effectiveness Trial This project will compare the effectiveness of group versus individual acupuncture therapy for reducing chronic pain. Role: Biostatistician

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. Lupus Foundation of America

    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

  8. Michael L. Lipton, MD, PhD
    9. Scientific Advisory Boards:

    1. (1) Guerbet (2) Bracco

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. (1) American Journal of Neuroimaging, Editorial Board, 2015- (2) Brain Imaging and Behavior, Editorial Board, 2016-

    Patents:

    1. (1) EZ-MAP image processing software

    Publishing Royalties:

    1. (1) Totally Accessible MRI, Springer, 2008

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. (1) Bracco

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. (1) Philips Medical Systems

    Research Support, Government Entities:

    1. (1) NIH - NINDS, R01 NS082432, Principle Investigator, 2013- (2) NIH - NIA, P01 AG003949, Core Leader, 2009- (3) NIH - NICHD, P30 HD071593, Core Leader, 2011-2016 (4) NIH - NIA, R01 AG036921, Co-Investigator, 2011-2016 (5) NIH - NICHD, R01 HL105212, Co-Investigator, 2011-2016 (6) NIH - NIA, R01 AG044007, Co-Investigator, 2013- (7) NIH - NICHD, U54 HD090260, Co-Investigator, 2016-

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. (1) The Dana Foundation (2) The Resurrecting Lives Foundation

    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 Sutter Health Research (W.F.S.), Walnut Creek, CA; The Gruss Magnetic Resonance Research Center (N.K., C.S.I., T.A.B., M.L.L.), the Departments of Radiology (N.K., C.S.I., T.A.B., M.L.L.), Neurology (R.B.L., M.E.Z.), Epidemiology and Population Health (R.B.L., M.K.), and Psychiatry and Behavioral Sciences (M.L.L.), and The Dominick P. Purpura Department of Neuroscience (M.L.L.), Albert Einstein College of Medicine and Montefiore Medical Center; and Fordham University (M.E.Z.), Bronx, NY.
  1. Correspondence to Dr. Lipton: Michael.Lipton{at}einstein.yu.edu
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