A Systematic Review on the Risk of Neurodegenerative Diseases and Neurocognitive Disorders in Professional and Varsity Athletes

Overview

Journal Neurol Sci

Specialty Neurology

Date 2022 Aug 17

PMID 35976476

Authors

G Bellomo

P Piscopo

M Corbo

E Pupillo

G Stipa

E Beghi

N Vanacore

E Lacorte

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this systematic review (SR) was to gather all available epidemiological evidence on former participation in any type of sport, at a professional and varsity level, as a potential risk factor for neurodegenerative diseases (NDs) and neurocognitive disorders (NCDs).

Design: Systematic searches were performed on PubMed, the Cochrane databases, and the ISI Web of Knowledge databases. Included studies were assessed using the NOS checklist.

Eligibility Criteria For Selecting Studies: All epidemiological studies reporting data on the possible association between a clinical diagnosis of amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND), dementia or mild cognitive impairment (MCI), Parkinson's disease (PD), chronic traumatic encephalopathy (CTE) at any stage and with any clinical pattern and the former participation in any types of sport at a varsity and professional level were included.

Results: Data from the 17 included studies showed a higher frequency of NDs and NCDs in former soccer and American football players. Updating the previous SR confirmed a higher frequency of ALS/MND in former soccer players. Data reported a significantly higher risk of dementia/AD in former soccer players, and of MCI in former American football players. Results also showed a significantly higher risk of PD in former soccer and American football players, and a significantly higher risk of CTE in former boxers and American football players. This SR confirmed a higher risk of NDs and NCDs in former professional/varsity athletes. However, the pathological mechanisms underlying this association remain unclear, and further high-quality studies should be performed to clarify whether the association could be sport specific.

Citing Articles

Clinical implications of head trauma in frontotemporal dementia and primary progressive aphasia.

Asken B, Bove J, Bauer R, Tanner J, Casaletto K, Staffaroni A Alzheimers Res Ther. 2024; 16(1):193.

PMID: 39210451 PMC: 11363650. DOI: 10.1186/s13195-024-01553-1.

The Effect of Intranasal Plus Transcranial Photobiomodulation on Neuromuscular Control in Individuals with Repetitive Head Acceleration Events.

Johnson P, Fino P, Wilde E, Hovenden E, Russell H, Velez C Photobiomodul Photomed Laser Surg. 2024; 42(6):404-413.

PMID: 38848287 PMC: 11587703. DOI: 10.1089/pho.2023.0178.

The altered TBI fecal microbiome is stable and functionally distinct.

Pyles R, Miller A, Urban R, Sheffield-Moore M, Wright T, Maxwell C Front Mol Neurosci. 2024; 17:1341808.

PMID: 38544523 PMC: 10965628. DOI: 10.3389/fnmol.2024.1341808.

Kumanu Tāngata: the aftermatch study - protocol to examine the health outcomes of high-level male rugby union players using linked administrative data.

DSouza S, Milne B, Li C, Anns F, Gardner A, Lumley T BMJ Open Sport Exerc Med. 2024; 10(1):e001795.

PMID: 38362564 PMC: 10868174. DOI: 10.1136/bmjsem-2023-001795.

The amyotrophic lateral sclerosis exposome: recent advances and future directions.

Goutman S, Savelieff M, Jang D, Hur J, Feldman E Nat Rev Neurol. 2023; 19(10):617-634.

PMID: 37709948 PMC: 11027963. DOI: 10.1038/s41582-023-00867-2.

References

Lolekha P, Phanthumchinda K, Bhidayasiri R . Prevalence and risk factors of Parkinson's disease in retired Thai traditional boxers. Mov Disord. 2010; 25(12):1895-901. DOI: 10.1002/mds.23210. View

Trojsi F, Sagnelli A, Vanacore N, Piccirillo G, Daniele L, Izzo F . Clinical features and lifestyle of patients with amyotrophic lateral sclerosis in Campania: brief overview of an Italian database. Ann Ist Super Sanita. 2012; 48(3):287-91. DOI: 10.4415/ANN_12_03_09. View

Bieniek K, Blessing M, Heckman M, Diehl N, Serie A, Paolini 2nd M . Association between contact sports participation and chronic traumatic encephalopathy: a retrospective cohort study. Brain Pathol. 2019; 30(1):63-74. PMC: 6916416. DOI: 10.1111/bpa.12757. View

Belli S, Vanacore N . Proportionate mortality of Italian soccer players: is amyotrophic lateral sclerosis an occupational disease?. Eur J Epidemiol. 2005; 20(3):237-42. DOI: 10.1007/s10654-004-6879-7. View

Stewart W, McNamara P, Lawlor B, Hutchinson S, Farrell M . Chronic traumatic encephalopathy: a potential late and under recognized consequence of rugby union?. QJM. 2015; 109(1):11-5. DOI: 10.1093/qjmed/hcv070. View

Harwood C, McDermott C, Shaw P . Physical activity as an exogenous risk factor in motor neuron disease (MND): a review of the evidence. Amyotroph Lateral Scler. 2009; 10(4):191-204. DOI: 10.1080/17482960802549739. View

Jellinger K . Recent advances in our understanding of neurodegeneration. J Neural Transm (Vienna). 2009; 116(9):1111-62. DOI: 10.1007/s00702-009-0240-y. View

McKee A, Stern R, Nowinski C, Stein T, Alvarez V, Daneshvar D . The spectrum of disease in chronic traumatic encephalopathy. Brain. 2012; 136(Pt 1):43-64. PMC: 3624697. DOI: 10.1093/brain/aws307. View

Beeldman E, Raaphorst J, Klein Twennaar M, de Visser M, Schmand B, de Haan R . The cognitive profile of ALS: a systematic review and meta-analysis update. J Neurol Neurosurg Psychiatry. 2015; 87(6):611-9. DOI: 10.1136/jnnp-2015-310734. View

10.

Gitler A, Dhillon P, Shorter J . Neurodegenerative disease: models, mechanisms, and a new hope. Dis Model Mech. 2017; 10(5):499-502. PMC: 5451177. DOI: 10.1242/dmm.030205. View

11.

Russell E, Mackay D, Stewart K, MacLean J, Pell J, Stewart W . Association of Field Position and Career Length With Risk of Neurodegenerative Disease in Male Former Professional Soccer Players. JAMA Neurol. 2021; 78(9):1057-1063. PMC: 8329793. DOI: 10.1001/jamaneurol.2021.2403. View

12.

Bradley W, Andrew A, Traynor B, Chio A, Butt T, Stommel E . Gene-Environment-Time Interactions in Neurodegenerative Diseases: Hypotheses and Research Approaches. Ann Neurosci. 2019; 25(4):261-267. PMC: 6470336. DOI: 10.1159/000495321. View

13.

Abel E . Football increases the risk for Lou Gehrig's disease, amyotrophic lateral sclerosis. Percept Mot Skills. 2007; 104(3 Pt 2):1251-4. DOI: 10.2466/pms.104.4.1251-1254. View

14.

Pearce N, Gallo V, McElvenny D . Head trauma in sport and neurodegenerative disease: an issue whose time has come?. Neurobiol Aging. 2015; 36(3):1383-9. DOI: 10.1016/j.neurobiolaging.2014.12.024. View

15.

Gamez J, Carmona F . Confirmation of early non-bulbar onset of amyotrophic lateral sclerosis in Spanish league soccer players. J Neurol Sci. 2021; 428:117586. DOI: 10.1016/j.jns.2021.117586. View

16.

Al-Chalabi A, Hardiman O . The epidemiology of ALS: a conspiracy of genes, environment and time. Nat Rev Neurol. 2013; 9(11):617-28. DOI: 10.1038/nrneurol.2013.203. View

17.

Schaffert J, Didehbani N, LoBue C, Hart J, Rossetti H, Lacritz L . Frequency and Predictors of Traumatic Encephalopathy Syndrome in a Prospective Cohort of Retired Professional Athletes. Front Neurol. 2021; 12:617526. PMC: 7940833. DOI: 10.3389/fneur.2021.617526. View

18.

Schulte P, Burnett C, Boeniger M, Johnson J . Neurodegenerative diseases: occupational occurrence and potential risk factors, 1982 through 1991. Am J Public Health. 1996; 86(9):1281-8. PMC: 1380592. DOI: 10.2105/ajph.86.9.1281. View

19.

Lee E, Kinch K, Johnson V, Trojanowski J, Smith D, Stewart W . Chronic traumatic encephalopathy is a common co-morbidity, but less frequent primary dementia in former soccer and rugby players. Acta Neuropathol. 2019; 138(3):389-399. PMC: 6689293. DOI: 10.1007/s00401-019-02030-y. View

20.

Adani G, Filippini T, Garuti C, Malavolti M, Vinceti G, Zamboni G . Environmental Risk Factors for Early-Onset Alzheimer's Dementia and Frontotemporal Dementia: A Case-Control Study in Northern Italy. Int J Environ Res Public Health. 2020; 17(21). PMC: 7663191. DOI: 10.3390/ijerph17217941. View