Motor Findings in former National Football League Players

Objective: To examine later-life motor functioning in former National Football League (NFL) players. Background: Chronic traumatic encephalopathy (CTE) is associated with prior exposure to repetitive head impacts (RHI) and clinically presents with cognitive, behavior, and mood symptoms. Motor disturbances have historically been prominent in former boxers with autopsy-confirmed CTE, but this has not been the case in recent day neuropathological studies among former NFL players with CTE. Design/Methods: 95 former NFL players (ages 40–69) were compared to 25 same-age male controls were examined using the Movement Disorder Society (MDS) Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Balance Error Scoring System (BESS), Grooved Pegboard, and cognitive and behavior/mood evaluations. A cumulative head impact index (CHII) estimated RHI exposure. Principal Component Analysis generated clinical function composites. Analysis of Covariance controlling for age and body mass index (BMI) examined group differences on the MDS-UPDRS, BESS, and Grooved Pegboard. Partial correlations (age and BMI adjusted) tested the relationship between the MDS-UPDRS and the CHII and clinical function composite scores. Results: MDS-UPDRS scores were low for both groups, but significantly higher in the former NFL group (mean[SD]=5.26[4.25]) than in controls (mean[SD]=2.40[3.25]), p=0.020. A majority of NFL subjects received normal ratings on individual MDS-UPDRS items; a subset had slightly abnormal ratings. Former NFL players had worse BESS (p=0.032) and dominant (p=0.007) and non-dominant (p=0.001) Grooved Pegboard scores. The CHII and MDS-UPDRS were not associated (pu003e0.05). Worse MDS-UPDRS scores correlated with worse psychomotor speed/executive function (p=0.006). Conclusions: Former NFL players exhibited statistically significant worse motor function than controls, but their motor test performances were relatively normal and unrelated to RHI exposure. The biomechanics of head trauma in American tackle football may have less impact on motor brain regions compared to boxing. Future macro- and microstructural neuroimaging investigations in former NFL players will test this hypothesis. Study Supported by: This study was supported by grants from the National Institutes of Health (R01 NS 078337; R56 9500304025; 1UL1TR001430). Participant travel was supported, in part, by JetBlue, the National Football League, and the NFL Players Association. Disclosure: Dr. Frank has received research support from the Huntington Study Group, funded by Teva Pharmaceuticals. Dr. Alosco has nothing to disclose. Dr. Jarnagin has nothing to disclose. Dr. Mez has nothing to disclose. Dr. Chaisson has nothing to disclose. Dr. Martin has nothing to disclose. Dr. Cantu has nothing to disclose. Dr. Tripodis has nothing to disclose. Dr. Stern has received personal compensation for activities with Biogen, Avanir Pharmaceuticals, the NCAA, and Eli Lilly. Dr. Stern has received royalty payments from Psychological Assessment Resources, Inc. Dr. Stern has received research support from Avid Radiopharmaceuticals, Amarantus, Eisai, and Eli Lilly.