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Alzheimer's Association International Conference 2026
July 12-15, 2026 | London, United Kingdom, and Online
9837
Duration Of Soccer Play And Chronic Traumatic Encephalopathy
Poster Presenter
Authors
Bobak Abdolmohammadi, Nicholas Parise, Samantha Thevenin, Brett Martin, Joseph Palmisano, Christopher Nowinski, Douglas Katz, Brigid Dwyer, Robert Cantu, Lee Goldstein, Robert Stern, Michael Alosco, Daniel Daneshvar, Yorghos Tripodis, Victor Alvarez, Thor Stein, Ann McKee, Jesse Mez
Affiliations
Harvard Medical School, Boston University Chobanian and Avedisian School of Medicine, Concussion and CTE Foundation
Part of Topic
Background)
oChronic traumatic Encephalopathy (CTE) is a progressive neurodegenerative tauopathy associated with exposure to repetitive head impacts (RHI) frequently experienced through contact sport participation.
oCTE has been predominantly described in American football, ice hockey, and rugby players, boxers, and military veterans. Over the past decade, research has suggested a robust dose-response relationship between years of American football, ice hockey, and rugby play and CTE risk.
oSoccer is the world’s most popular sport, with approximately 240 million registered players across 205 member associations worldwide. CTE has also been described in some soccer players.
oWhile there are various descriptions of CTE in former soccer players, the mechanisms leading to CTE risk from soccer play are ill-defined.
oTo our knowledge, no cohort-level studies have been conducted to assess whether RHI incurred from soccer play leads to increased risk for CTE
Objectives)
oTo test the hypothesis that increasing duration of soccer career play, measured in years, would be associated with a corresponding increase in CTE risk and severity.
oTo test whether adjustment for potential selection bias by utilizing inverse probability weighting changes the estimated associations.
oTo verify if CTE neuropathology is associated with presence of dementia and an informant-reported clinical scale measuring daily function.
Methods)
oOverview: A case series of 69 brain donors to the UNITE Brain Bank whose primary RHI exposure came from soccer play.
oClinical/Neuropathologic Evaluation: A series of retrospective online surveys and telephone interviews were conducted with informants, including collection of primary position and years of soccer play. Standardized neuropathological assessments were conducted on each brain donor blinded to any clinical or demographic information (Figure 1).
Statistical Analysis: We used binary logistic regression to estimate the association of duration played with CTE diagnosis and dementia, Bayesian piecewise regression to estimate the association with cumulative ptau burden, and linear regression to estimate the association with FAQ score. To quantify conditions under which selection bias could invalidate our findings, we conducted simulation analyses for CTE diagnosis.
Conclusions)
oAmong former soccer playing brain donors, most professionals were diagnosed with CTE (10/11, 91%).
oWe observed a dose-response association showing 1.27 higher odds of CTE diagnosis for each additional year of soccer play.
oSimulation analyses demonstrated that this relationship remained robust under conditions where duration of play was associated with brain bank selection across a range of scenarios.
oWe found that each year of soccer play above 13.25 years corresponded with a 0.54-point increase in cumulative p-tau burden.
oCumulative ptau burden was not associated with clinician-adjudicated dementia status but was associated with increased impairment in iADLs as measured by functional activities questionnaire (FAQ) score.
oMore research is needed to better elucidate the impact more granular soccer-specific measures of RHI, such as heading, may have on CTE risk.
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