Background and Objectives

The consensus criteria for traumatic encephalopathy syndrome (TES), the possible in vivo clinical syndrome associated with significant repetitive head impacts, have only been minimally studied to date. This study examined the prevalence of the proposed core clinical features of TES in a sample of healthy adults.

Methods

A cross-sectional survey study was conducted through ResearchMatch, a national health volunteer registry. Participants were assessed for symptoms of TES based on the 2021 consensus criteria, including prior repetitive head impacts and core clinical features. Additional health information (e.g., concussion history, psychological health, sleep, chronic pain) was also evaluated. The consensus proposed research criteria for TES (i.e., reporting at least one progressive core clinical feature of TES, as in progressive difficulties with episodic memory, executive functioning, or neurobehavioral dysregulation) were applied to the sample.

Results

Out of 1100 participants (average age = 53.6 ± 17.7 years, 55% women), 34.6% endorsed one or more progressive core clinical features of TES. Participants with a significant history of contact sports (i.e., ≥ 5 years total, with ≥ 2 years in high school or beyond) had similar rates of endorsing a progressive core clinical feature of TES compared to those without significant histories of repetitive head impacts (36.4% vs 32.8%, respectively, χ² = 0.52, p = 0.47). A significant history of repetitive head impacts in sports was not associated with endorsing a core clinical feature of TES in univariable or multivariable models (p > 0.47), whereas current depression/anxiety (odds ratio [OR] = 6.94), a history of psychiatric disorders (OR = 2.57), current sleep problems (OR = 1.56), and younger age (OR = 0.99) were significant predictors of TES status in a multivariable model. In a subsample of 541 participants who denied a lifetime history of contact sports, other forms of repetitive head impacts, and concussions, approximately 31.0% endorsed one or more progressive core clinical features of TES. Additionally, 73.5% of neurotrauma-naïve participants with current anxiety or depression reported at least one core progressive feature of TES, compared with 20.2% of those without clinically significant depression/anxiety symptoms.

Conclusions

A considerable proportion of adults without a significant history of repetitive head impacts from sports endorsed core TES features, particularly those experiencing mental health symptoms. Having a significant history of contact sports was not associated with endorsing a core progressive clinical feature of TES, whereas other health factors were. These findings underscore the need for validating and refining TES criteria in samples with and without substantial neurotrauma histories.

中文翻译：

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创伤性脑病综合征的症状在社区居住的成年人中很常见

背景和目标

创伤性脑病综合征（TES）是一种可能与严重重复​​性头部撞击相关的体内临床综合征，迄今为止，其共识标准仅得到了很少的研究。本研究检查了健康成人样本中拟议的 TES 核心临床特征的患病率。

方法

通过国家卫生志愿者登记处 ResearchMatch 进行了一项横断面调查研究。根据 2021 年共识标准对参与者进行了 TES 症状评估，包括既往重复性头部撞击和核心临床特征。还评估了其他健康信息（例如脑震荡史、心理健康、睡眠、慢性疼痛）。共识提出的 TES 研究标准（即报告至少一种 TES 进行性核心临床特征，如情景记忆、执行功能或神经行为失调的进行性困难）适用于样本。

结果

在 1100 名参与者中（平均年龄 = 53.6 ± 17.7 岁，55% 为女性），34.6% 的人认可 TES 的一项或多项进展性核心临床特征。与没有明显重复性头部撞击历史的参与者相比，具有显着接触性运动史（即总计≥5年，高中或以上≥2年）的参与者对TES渐进性核心临床特征的认可率相似（36.4 % vs 32.8%，分别为χ ²  = 0.52，p  = 0.47）。在运动中重复性头部撞击的显着病史与单变量或多变量模型中认可 TES 的核心临床特征无关（p  > 0.47），而当前的抑郁/焦虑（比值比 [OR] = 6.94）、精神病史在多变量模型中，疾病（OR = 2.57）、当前睡眠问题（OR = 1.56）和年轻（OR = 0.99）是 TES 状态的重要预测因素。在 541 名否认终生接触运动、其他形式的重复性头部撞击和脑震荡病史的参与者的子样本中，大约 31.0% 的人认可 TES 的一种或多种进行性核心临床特征。此外，73.5% 的未受过神经外伤且当前患有焦虑或抑郁的参与者报告了至少一种 TES 的核心进展特征，而没有临床显着抑郁/焦虑症状的参与者中这一比例为 20.2%。

结论

相当一部分没有重大运动重复性头部撞击史的成年人认可 TES 的核心特征，特别是那些经历过心理健康症状的成年人。具有显着的接触运动史与认可 TES 的核心进展性临床特征无关，而其他健康因素则与此相关。这些发现强调需要在有或没有大量神经外伤史的样本中验证和完善 TES 标准。