{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T07:44:24Z","timestamp":1793432664855,"version":"4.5.0"},"reference-count":49,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec id=\"ab-noi240059-4\"><jats:title>Importance<\/jats:title><jats:p>Participation in American-style football (ASF) has been linked to chronic traumatic encephalopathy neuropathological change (CTE-NC), a specific neuropathologic finding that can only be established at autopsy. Despite being a postmortem diagnosis, living former ASF players may perceive themselves to have CTE-NC. At present, the proportion and clinical correlates of living former professional ASF athletes with perceived CTE who report suicidality are unknown.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi240059-5\"><jats:title>Objective<\/jats:title><jats:p>To determine the proportion, clinical correlates, and suicidality of living former professional ASF players with perceived CTE.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi240059-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>A cross-sectional study within the Football Players Health Study at Harvard University was conducted from 2017 to 2020. Using electronic and paper surveys, this population-based study included former ASF players who contracted with a professional league from 1960 to 2020 and volunteered to fill out a baseline survey. Data for this study were analyzed from June 2023 through March 2024.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi240059-7\"><jats:title>Exposures<\/jats:title><jats:p>Data included demographics, football-related exposures (eg, position, career duration), and current health problems (anxiety, attention-deficit\/hyperactivity disorder, depression, diabetes, emotional and behavioral dyscontrol symptoms, headache, hyperlipidemia, hypertension, low testosterone level, pain, sleep apnea, and subjective cognitive function).<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi240059-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The proportion of participants reporting perceived CTE. Univariable and multivariable models were used to determine clinical and suicidality correlates of perceived CTE.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi240059-9\"><jats:title>Results<\/jats:title><jats:p>Among 4180 former professional ASF players who volunteered to fill out a baseline survey, 1980 (47.4%) provided follow-up data (mean [SD] age, 57.7 [13.9] years). A total of 681 participants (34.4%) reported perceived CTE. Subjective cognitive difficulties, low testosterone level, headache, concussion signs and symptoms accrued during playing years, depressive\/emotional and behavioral dyscontrol symptoms, pain, and younger age were significantly associated with perceived CTE. Suicidality was reported by 171 of 681 participants with perceived CTE (25.4%) and 64 of 1299 without perceived CTE (5.0%). After adjusting for established suicidality predictors (eg, depression), men with perceived CTE remained twice as likely to report suicidality (odds ratio, 2.06; 95% CI, 1.36-3.12; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi240059-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>This study found that approximately one-third of living former professional ASF players reported perceived CTE. Men with perceived CTE had an increased prevalence of suicidality and were more likely to have health problems associated with cognitive impairment compared with men without perceived CTE. Perceived CTE represents a novel risk factor for suicidality and, if present, should motivate the diagnostic assessment and treatment of medical and behavioral conditions that may be misattributed to CTE-NC.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaneurol.2024.3083","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T15:32:10Z","timestamp":1727105530000},"page":"1130","source":"Crossref","is-referenced-by-count":31,"title":["Perceived Chronic Traumatic Encephalopathy and Suicidality in Former Professional Football Players"],"prefix":"10.1001","volume":"81","author":[{"given":"Rachel","family":"Grashow","sequence":"first","affiliation":[{"name":"Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas P.","family":"Terry","sequence":"additional","affiliation":[{"name":"Vanderbilt Sports Concussion Center, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant L.","family":"Iverson","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts"},{"name":"Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, Massachusetts"},{"name":"Department of Physical Medicine and Rehabilitation, Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, Massachusetts"},{"name":"Sports Concussion Program, Mass General for Children, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"DiGregorio","sequence":"additional","affiliation":[{"name":"Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inana","family":"Dairi","sequence":"additional","affiliation":[{"name":"Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheyenne","family":"Brown","sequence":"additional","affiliation":[{"name":"Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula S.","family":"Atkeson","sequence":"additional","affiliation":[{"name":"Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia J.","family":"Whittington","sequence":"additional","affiliation":[{"name":"Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LeRoy","family":"Reese","sequence":"additional","affiliation":[{"name":"Prevention Research Center, Morehouse School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan H.","family":"Kim","sequence":"additional","affiliation":[{"name":"Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niki","family":"Konstantinides","sequence":"additional","affiliation":[{"name":"Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herman A.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts"},{"name":"Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank E.","family":"Speizer","sequence":"additional","affiliation":[{"name":"Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"},{"name":"Channing Division of Network Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel H.","family":"Daneshvar","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross D.","family":"Zafonte","sequence":"additional","affiliation":[{"name":"Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts"},{"name":"Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc G.","family":"Weisskopf","sequence":"additional","affiliation":[{"name":"Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron L.","family":"Baggish","sequence":"additional","affiliation":[{"name":"Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts"},{"name":"Cardiovascular Performance Program, Massachusetts General Hospital, Boston"},{"name":"Department of Cardiology, Lausanne University Hospital (CHUV) and Institute for Sport Science, University of Lausanne (ISSUL), Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"3","key":"noi240059r1","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1093\/jnen\/nlab001","article-title":"The second NINDS\/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy.","volume":"80","author":"Bieniek","year":"2021","journal-title":"J Neuropathol Exp Neurol"},{"issue":"4","key":"noi240059r2","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1001\/jama.2017.8334","article-title":"Clinicopathological evaluation of chronic traumatic encephalopathy in players of American football.","volume":"318","author":"Mez","year":"2017","journal-title":"JAMA"},{"issue":"1","key":"noi240059r3","doi-asserted-by":"publisher","first-page":"3470","DOI":"10.1038\/s41467-023-39183-0","article-title":"Leveraging football accelerometer data to quantify associations between repetitive head impacts and chronic traumatic encephalopathy in males.","volume":"14","author":"Daneshvar","year":"2023","journal-title":"Nat Commun"},{"issue":"10","key":"noi240059r4","doi-asserted-by":"publisher","first-page":"1709","DOI":"10.1002\/alz.12338","article-title":"Validity of the 2014 traumatic encephalopathy syndrome criteria for CTE pathology.","volume":"17","author":"Mez","year":"2021","journal-title":"Alzheimers Dement"},{"issue":"18","key":"noi240059r5","doi-asserted-by":"publisher","first-page":"848","DOI":"10.1212\/WNL.0000000000011850","article-title":"National Institute of Neurological Disorders and Stroke consensus diagnostic criteria for traumatic encephalopathy syndrome.","volume":"96","author":"Katz","year":"2021","journal-title":"Neurology"},{"key":"noi240059r6","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1214814","article-title":"A narrative review of psychiatric features of traumatic encephalopathy syndrome as conceptualized in the 20th century.","volume":"14","author":"Iverson","year":"2023","journal-title":"Front Neurol"},{"issue":"10","key":"noi240059r14","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.2174\/1567205013666160720112608","article-title":"Suicide risk in Alzheimer\u2019s disease: a systematic review.","volume":"13","author":"Serafini","year":"2016","journal-title":"Curr Alzheimer Res"},{"key":"noi240059r15","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/j.parkreldis.2016.09.006","article-title":"Increased suicide risk and clinical correlates of suicide among patients with Parkinson\u2019s disease.","volume":"32","author":"Lee","year":"2016","journal-title":"Parkinsonism Relat Disord"},{"issue":"6","key":"noi240059r16","doi-asserted-by":"publisher","first-page":"466","DOI":"10.2174\/1871527318666190703093345","article-title":"Suicide in Parkinson\u2019s disease: a systematic review.","volume":"18","author":"Berardelli","year":"2019","journal-title":"CNS Neurol Disord Drug Targets"},{"issue":"5","key":"noi240059r17","doi-asserted-by":"publisher","first-page":"1876","DOI":"10.1007\/s00415-020-10333-4","article-title":"Suicidal ideation in early-onset Parkinson\u2019s disease.","volume":"268","author":"Ou","year":"2021","journal-title":"J Neurol"},{"issue":"11","key":"noi240059r18","doi-asserted-by":"publisher","first-page":"1573","DOI":"10.1002\/mds.22130","article-title":"Suicidal and death ideation in Parkinson\u2019s disease.","volume":"23","author":"Nazem","year":"2008","journal-title":"Mov Disord"},{"issue":"11","key":"noi240059r19","doi-asserted-by":"publisher","first-page":"2548","DOI":"10.1007\/s00415-018-9013-6","article-title":"Risk factors of suicidal ideation in Huntington\u2019s disease: literature review and data from Enroll-HD.","volume":"265","author":"Honrath","year":"2018","journal-title":"J Neurol"},{"key":"noi240059r20","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1016\/j.jad.2019.03.043","article-title":"Suicidal ideation and behavior in Huntington\u2019s disease: systematic review and recommendations.","volume":"250","author":"Kachian","year":"2019","journal-title":"J Affect Disord"},{"issue":"3","key":"noi240059r21","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/j.pec.2006.08.009","article-title":"To know or not to know: a review of behaviour and suicidal ideation in preclinical Huntington\u2019s disease.","volume":"65","author":"Robins Wahlin","year":"2007","journal-title":"Patient Educ Couns"},{"key":"noi240059r22","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1016\/j.jad.2020.08.066","article-title":"Suicidal behavior in individuals with amyotrophic lateral sclerosis: a systematic review.","volume":"277","author":"Silva-Moraes","year":"2020","journal-title":"J Affect Disord"},{"issue":"6","key":"noi240059r23","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1002\/mus.27181","article-title":"Suicide among veterans with amyotrophic lateral sclerosis.","volume":"63","author":"Lund","year":"2021","journal-title":"Muscle Nerve"},{"issue":"1","key":"noi240059r24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2190\/G5TA-9KV0-MT3G-RWM0","article-title":"Attitudes toward and desire for assisted suicide among persons with amyotrophic lateral sclerosis.","volume":"48","author":"Achille","year":"2003","journal-title":"Omega (Westport)"},{"issue":"16","key":"noi240059r25","doi-asserted-by":"publisher","first-page":"7537","DOI":"10.1017\/S0033291723001265","article-title":"Alterations in pituitary adenylate cyclase-activating polypeptide in major depressive disorder, bipolar disorder, and comorbid depression in Alzheimer\u2019s disease in the human hypothalamus and prefrontal cortex.","volume":"53","author":"Slabe","year":"2023","journal-title":"Psychol Med"},{"issue":"8","key":"noi240059r26","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1002\/ajim.22991","article-title":"The Football Players\u2019 Health Study at Harvard University: design and objectives.","volume":"62","author":"Zafonte","year":"2019","journal-title":"Am J Ind Med"},{"issue":"5","key":"noi240059r27","doi-asserted-by":"publisher","first-page":"822","DOI":"10.2105\/AJPH.2013.301840","article-title":"The first concussion crisis: head injury and evidence in early American football.","volume":"104","author":"Harrison","year":"2014","journal-title":"Am J Public Health"},{"issue":"12","key":"noi240059r28","doi-asserted-by":"publisher","first-page":"1428","DOI":"10.1001\/jamaneurol.2019.2664","article-title":"Association of concussion symptoms with testosterone levels and erectile dysfunction in former professional US-style football players.","volume":"76","author":"Grashow","year":"2019","journal-title":"JAMA Neurol"},{"issue":"12","key":"noi240059r29","doi-asserted-by":"publisher","first-page":"2871","DOI":"10.1177\/0363546519868989","article-title":"Exposure to American football and neuropsychiatric health in former National Football League players: findings from the Football Players Health Study.","volume":"47","author":"Roberts","year":"2019","journal-title":"Am J Sports Med"},{"issue":"2","key":"noi240059r30","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1089\/neu.2020.7070","article-title":"Modifiable risk factors for poor cognitive function in former American-style football players: findings from the Harvard Football Players Health Study.","volume":"38","author":"Roberts","year":"2021","journal-title":"J Neurotrauma"},{"issue":"14","key":"noi240059r31","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1161\/CIRCULATIONAHA.122.063767","article-title":"Association between concussion burden during professional American-style football and postcareer hypertension.","volume":"147","author":"Grashow","year":"2023","journal-title":"Circulation"},{"issue":"1","key":"noi240059r32","doi-asserted-by":"publisher","first-page":"43","DOI":"10.18043\/ncm.69.1.43","article-title":"Detecting traumatic brain injury among veterans of Operations Enduring and Iraqi Freedom.","volume":"69","author":"Jackson","year":"2008","journal-title":"N C Med J"},{"issue":"1","key":"noi240059r33","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1176\/appi.neuropsych.23.1.98","article-title":"Impact of playing American professional football on long-term brain function.","volume":"23","author":"Amen","year":"2011","journal-title":"J Neuropsychiatry Clin Neurosci"},{"issue":"3","key":"noi240059r34","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1016\/j.emc.2010.03.003","article-title":"Traumatic alterations in consciousness: traumatic brain injury.","volume":"28","author":"Blyth","year":"2010","journal-title":"Emerg Med Clin North Am"},{"issue":"6","key":"noi240059r35","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1097\/01.HTR.0000300227.67748.77","article-title":"Initial reliability and validity of the Ohio State University TBI identification method.","volume":"22","author":"Corrigan","year":"2007","journal-title":"J Head Trauma Rehabil"},{"issue":"5","key":"noi240059r36","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1080\/09602011.2018.1526692","article-title":"The development of the Brain Injury Screening Index (BISI): a self-report measure.","volume":"30","author":"Ramos","year":"2020","journal-title":"Neuropsychol Rehabil"},{"issue":"1","key":"noi240059r37","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1002\/ana.25747","article-title":"Premortem chronic traumatic encephalopathy diagnoses in professional football.","volume":"88","author":"Grashow","year":"2020","journal-title":"Ann Neurol"},{"issue":"3","key":"noi240059r38","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1007\/s11606-012-2194-2","article-title":"Characteristics, management, and depression outcomes of primary care patients who endorse thoughts of death or suicide on the PHQ-9.","volume":"28","author":"Bauer","year":"2013","journal-title":"J Gen Intern Med"},{"issue":"1-3","key":"noi240059r39","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.jad.2008.06.026","article-title":"The PHQ-8 as a measure of current depression in the general population.","volume":"114","author":"Kroenke","year":"2009","journal-title":"J Affect Disord"},{"issue":"10","key":"noi240059r40","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7.","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch Intern Med"},{"issue":"23","key":"noi240059r41","doi-asserted-by":"publisher","first-page":"1860","DOI":"10.1212\/WNL.0b013e318258f744","article-title":"Neuro-QOL: brief measures of health-related quality of life for clinical research in neurology.","volume":"78","author":"Cella","year":"2012","journal-title":"Neurology"},{"issue":"2","key":"noi240059r43","first-page":"129","article-title":"Pain assessment: global use of the Brief Pain Inventory.","volume":"23","author":"Cleeland","year":"1994","journal-title":"Ann Acad Med Singap"},{"issue":"11","key":"noi240059r44","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.118.005263","article-title":"Physical activity guidelines for americans from the US Department of Health and Human Services.","volume":"11","author":"Piercy","year":"2018","journal-title":"Circ Cardiovasc Qual Outcomes"},{"issue":"6","key":"noi240059r45","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1093\/aje\/kwn164","article-title":"Constructing inverse probability weights for marginal structural models.","volume":"168","author":"Cole","year":"2008","journal-title":"Am J Epidemiol"},{"key":"noi240059r46","doi-asserted-by":"publisher","DOI":"10.1159\/000510987","article-title":"Head injury and amyotrophic lateral sclerosis: a meta-analysis.","author":"Liu","year":"2021","journal-title":"Neuroepidemiology"},{"issue":"9","key":"noi240059r47","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1002\/mds.25458","article-title":"Head injury and risk of Parkinson disease: a systematic review and meta-analysis.","volume":"28","author":"Jafari","year":"2013","journal-title":"Mov Disord"},{"issue":"5","key":"noi240059r48","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1007\/s40279-021-01589-5","article-title":"Subjective concerns regarding the effects of sport-related concussion on long-term brain health among former NFL players: an NFL-LONG study.","volume":"52","author":"Walton","year":"2022","journal-title":"Sports Med"},{"issue":"3","key":"noi240059r49","doi-asserted-by":"publisher","first-page":"319","DOI":"10.2105\/AJPH.2023.307511","article-title":"Suicide methods and trends across race\/ethnicity, age, and sex groups in Chicago, Illinois, 2015-2021.","volume":"114","author":"Goodwill","year":"2024","journal-title":"Am J Public Health"},{"key":"noi240059r7","author":"Shpigel","year":"2022"},{"key":"noi240059r8","author":"Convery","year":"2023"},{"key":"noi240059r9","author":"Pfeiffer","year":"2021"},{"key":"noi240059r10","author":"Morris","year":"2023"},{"key":"noi240059r11","author":"Schwarz","year":"2007"},{"key":"noi240059r12","author":"Ward","year":"2023"},{"key":"noi240059r13","author":"Sifferlin","year":"2017"},{"key":"noi240059r42","volume-title":"Physical Activity Guidelines for Americans","author":"US Dept of Health and Human Services","year":"2018","edition":"2nd ed"}],"container-title":["JAMA Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaneurology\/articlepdf\/2824064\/jamaneurology_grashow_2024_oi_240059_1731111348.27512.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T16:01:04Z","timestamp":1731340864000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaneurology\/fullarticle\/2824064"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,1]]},"references-count":49,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaneurol.2024.3083","relation":{},"ISSN":["2168-6149"],"issn-type":[{"value":"2168-6149","type":"print"}],"subject":[],"published":{"date-parts":[[2024,11,1]]}}}