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Background: A recent study found that an earlier age of first exposure (AFE) to tackle football was associated with long-term neurocognitive impairment in retired National Football League (NFL) players., Purpose: To assess the association between years of exposure to pre-high school football (PreYOE) and neuroradiological, neurological, and neuropsychological outcome measures in a different sample of retired NFL players., Study Design: Cross-sectional study; Level of evidence, 3., Methods: Forty-five former NFL players were included in this study. All participants prospectively completed extensive history taking, a neurological examination, brain magnetic resonance imaging, and a comprehensive battery of neuropsychological tests. To measure the associations between PreYOE and these outcome measures, multiple regression models were utilized while controlling for several covariates., Results: After applying a Bonferroni correction for multiple comparisons, none of the neurological, neuroradiological, or neuropsychological outcome measures yielded a significant relationship with PreYOE. A second Bonferroni-corrected analysis of a subset of these athletes with self-reported learning disability yielded no significant relationships on paper-and-pencil neurocognitive tests but did result in a significant association between learning disability and computerized indices of visual motor speed and reaction time., Conclusion: The current study failed to replicate the results of a prior study, which concluded that an earlier AFE to tackle football might result in long-term neurocognitive deficits. In 45 retired NFL athletes, there were no associations between PreYOE and neuroradiological, neurological, and neuropsychological outcome measures., (© 2016 The Author(s).)

Objective: Acute recovery from concussion (mild traumatic brain injury) is assessed in samples of NFL and high school athletes evaluated within days of injury., Methods: All athletes were evaluated within days of injury using a computer-based neuropsychological test and symptom inventory protocol. Test performance was compared to preinjury baseline levels of a similar but not identical group of athletes who had undergone preseason testing. Statistical analyses were completed using Multivariate Analysis of Variance (MANOVA)., Results: NFL athletes demonstrated a rapid neuropsychological recovery. As a group, NFL athletes returned to baseline performance in a week with the majority of athletes having normal performance two days after injury. High school athletes demonstrated a slower recovery than NFL athletes., Conclusion: Computer-based neuropsychological testing was used within the overall medical evaluation and care of NFL athletes. As found in a prior study using more traditional neuropsychological testing, NFL players did not demonstrate decrements in neuropsychological performance beyond one week of injury. High school players demonstrated more prolonged neuropsychological effects of concussion.

Objective: The National Football League (NFL) neuropsychological testing program is reviewed, and neuropsychological test data are presented on various samples of NFL athletes who sustained concussion (mild traumatic brain injury, MTBI)., Methods: This study evaluated post-MTBI neuropsychological testing of NFL players from 1996 to 2001. All athletes completed a standardized battery of neuropsychological tests and underwent postinjury neuropsychological testing within a few days after concussion. Test scores were compared with baselines using analysis of variance for athletes having on-field memory dysfunction, three or more concussions, or 7+ days out from practice and play., Results: The MTBI group did not display significant neuropsychological dysfunction relative to baseline scores within a few days of injury. However, a subsample of the injured athletes who displayed on-field memory dysfunction performed significantly more poorly on two of the memory tests. The neuropsychological test results of a group of athletes with a history of three or more MTBIs did not differ significantly compared with a group who had fewer than three concussions or compared with league-wide normative data. The neuropsychological performance of athletes who were out from full participation 7+ days was not significantly different from the group who returned to play within 7 days or the norms., Conclusion: Neuropsychological testing is used within the overall medical evaluation and care of NFL athletes. Players who experience MTBI generally demonstrate rapid recovery of neuropsychological performance, although poorer neuropsychological test results were related to on-field memory dysfunction. NFL players did not demonstrate evidence of neurocognitive decline after multiple (three or more) MTBIs or in those players out 7+ days. The data show that MTBI in this population is characterized by a rapid return of neuropsychological function in the days after injury.

Background: Structural brain changes, potentially resulting from repetitive brain trauma (RBT), have been correlated with neurocognitive decline and increased symptom reporting in retired athletes.Hypothesis: In a cohort of retired National Football League (NFL) players, the relationships between 3 neuroimaging parameters, neuropsychological testing, and symptom scores will be significantly correlated.Study Design: Cross-sectional study.Level Of Evidence: Level 3.Methods: Comprehensive magnetic resonance imaging was performed in 45 retired NFL players. Three neuroanatomical parameters were assessed by board-certified radiologists blinded to the purpose of the study: (1) the absence or presence of small or large cavum septum pellucidum, (2) a global mean score of fractional anisotropy (FA), and (3) the presence or absence of microhemorrhages. The subjects underwent a battery of 9 paper-and-pencil neuropsychological tests, a computerized neurocognitive test, and multiple symptom and depression scales. The associations among the neuroimaging results with these outcome measures were assessed utilizing Pearson, Spearman rank, and point-biserial correlations.Results: The 45 subjects (mean age, 46.7 ± 9.1 years) reported a mean 6.9 (±6.2) concussions and 13.0 (±7.9) "dings" in the NFL. Ten (22%) did not have a cavum septum pellucidum, while 32 (71%) had a small and 3 (7%) had a large one. Four (9%) had microhemorrhages. Global FA mean was 0.459 (±0.035). The majority (50.8%) of correlations among the neuroimaging parameters and neurocognitive/symptom scores fell below the threshold of "small" effect size ( r < 0.10). The remaining (49.2%) correlations were between "small" and "medium" effect sizes (0.1 < r < 0.3). However, all correlations were statistically nonsignificant.Conclusion: There were minimal and statistically nonsignificant correlations among the neuroimaging, neurocognitive, and symptom scores examined in this cohort of NFL retirees.Clinical Relevance: Associating the severity of structural brain changes to neurocognitive performance and symptom burden after RBT is complex may involve other moderating variables or biomarkers, and demands further study. [ABSTRACT FROM AUTHOR]

The use of clinical neuropsychological tests in the evaluation of National Football League (NFL) players has been ongoing for more than two decades. Prior research has demonstrated that the NFL population may perform differently than the general population on standard paper and pencil neuropsychological tests. Given the increased interest in the longitudinal and long-term assessment of neurocognitive functioning in this group of athletes, we reviewed the published neuropsychological literature in an attempt to compile an initial compendium of available normative data on paper and pencil as well as computerized neuropsychological tests for this group of football players. Thirteen published studies met the inclusion criteria, and the results are presented by athlete status (active vs. retired) and classified by neuropsychological domain. Suggestions for potential core batteries with this population are discussed, as are directions for future research. [ABSTRACT FROM PUBLISHER]