{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T20:48:05Z","timestamp":1778791685816,"version":"3.51.4"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,5,4]],"date-time":"2020-05-04T00:00:00Z","timestamp":1588550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007299","name":"Harvard Catalyst","doi-asserted-by":"publisher","award":["UL1 RR025758"],"award-info":[{"award-number":["UL1 RR025758"]}],"id":[{"id":"10.13039\/100007299","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>American\u2010style football (ASF) has gained attention because of possible links between repetitive head injury and neurodegenerative diseases. Although postmortem pathologic changes consistent with chronic traumatic encephalopathy (CTE) have been reported in ASF players, there are currently no established premortem diagnostic criteria for CTE. Nevertheless, presented with symptoms of cognitive impairment, clinicians treating former players may be inclined to suggest CTE without a thorough exploration of comorbid factors that demonstrate similar clinical phenotypes to putative CTE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A survey of 3,913 former ASF players aged 24 to 89 was conducted for those who responded by March 2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Despite being a postmortem diagnosis, 108 players (2.8%) self\u2010reported clinician\u2010diagnosed CTE. The percentage of players under age 60\u2009years reporting a CTE diagnosis was 2.3% versus 3.7% in participants age 60 or older. Comorbidities in participants self\u2010reporting CTE were significantly more common, including sleep apnea, hypercholesterolemia, obesity, indicators of past or current depression, hypertension, prescription pain medication use, heart conditions, and low testosterone when compared to non\u2010CTE respondents. Patterns of reporting for obesity, hypertension, heart conditions, or hypercholesterolemia differed between older and younger participants. Cognitive impairment symptoms were significantly higher in participants self\u2010reporting CTE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Some former professional football players have been clinically diagnosed with CTE, a postmortem condition. Comorbidities that can affect cognition were associated with CTE diagnoses in both older and younger players. Although underlying neuropathology cannot be ruled out, treatable conditions should be explored in former athletes demonstrating CTE\u2010linked clinical phenotypes or symptoms as a means of improving cognitive health in these patients. ANN NEUROL 2020 <jats:bold>ANN NEUROL 2020;88:106\u2013112<\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.1002\/ana.25747","type":"journal-article","created":{"date-parts":[[2020,4,13]],"date-time":"2020-04-13T11:58:52Z","timestamp":1586779132000},"page":"106-112","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Premortem Chronic Traumatic Encephalopathy Diagnoses in Professional Football"],"prefix":"10.1002","volume":"88","author":[{"given":"Rachel","family":"Grashow","sequence":"first","affiliation":[{"name":"Football Players Health Study at Harvard University Harvard Medical School  Boston MA"},{"name":"Department of Environmental Health Harvard T.H. 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