{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T08:10:45Z","timestamp":1787991045803,"version":"build-2784847793"},"reference-count":61,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,9,7]],"date-time":"2024-09-07T00:00:00Z","timestamp":1725667200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2024,9,24]]},"abstract":"\n Background:<\/jats:title>\n Chronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy more frequently found in deceased former football players. CTE has heterogeneous clinical presentations with multifactorial causes. Previous literature has shown substance use (alcohol\/drug) can contribute to Alzheimer\u2019s disease and related tauopathies pathologically and clinically.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n To examine the association between substance use and clinical and neuropathological endpoints of CTE.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Our sample included 429 deceased male football players. CTE was neuropathologically diagnosed. Informant interviews assessed features of substance use and history of treatment for substance use to define indicators: history of substance use treatment (yes vs no, primary variable), alcohol severity, and drug severity. Outcomes included scales that were completed by informants to assess cognition (Cognitive Difficulties Scale, BRIEF-A Metacognition Index), mood (Geriatric Depression Scale-15), behavioral regulation (BRIEF-A Behavioral Regulation Index, Barratt Impulsiveness Scale-11), functional ability (Functional Activities Questionnaire), as well as CTE status and cumulative p-tau burden. Regression models tested associations between substance use indicators and outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Of the 429 football players (mean age\u200a=\u200a62.07), 313 (73%) had autopsy confirmed CTE and 100 (23%) had substance use treatment history. Substance use treatment and alcohol\/drug severity were associated with measures of behavioral regulation (FDR-\n p<\/jats:italic>\n -values<0.05,\n \u0394<\/jats:italic>\n R\n 2<\/jats:sup>\n \u200a=\u200a0.04\u20130.18) and depression (FDR-\n p<\/jats:italic>\n -values<0.05,\n \u0394<\/jats:italic>\n R\n 2<\/jats:sup>\n \u200a=\u200a0.02\u20130.05). Substance use indicators had minimal associations with cognitive scales, whereas p-tau burden was associated with all cognitive scales (\n p<\/jats:italic>\n -values <0.05). Substance use treatment had no associations with neuropathological endpoints (FDR-\n p<\/jats:italic>\n -values>0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Among deceased football players, substance use was common and associated with clinical symptoms.<\/jats:p>\n <\/jats:sec>","DOI":"10.3233\/jad-240300","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T10:42:16Z","timestamp":1725964936000},"page":"971-986","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical and Neuropathological Correlates of Substance Use in American Football Players"],"prefix":"10.1177","volume":"101","author":[{"given":"Michael","family":"Walsh","sequence":"first","affiliation":[{"name":"Department of Neurology, Boston University Alzheimer\u2019s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, 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