INS NYC 2024 Program

Poster	Poster Session 11 Program Schedule 02/17/2024 10:45 am - 12:00 pm Room: Majestic Complex (Posters 61-120) Poster Session 11: Cultural Neuropsychology \| Education/Training \| Professional Practice Issues Final Abstract #80 Characterizing Black Male Athlete Brain Donors in the UNITE Brain Bank: Insights into Racial Disparities in Brain Donation Programs Erika Pettway, Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Stephanie Gonzalez Gil, Boston University CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Robert Turner II, The George Washington University School of Medicine & Health Science, Washington, D.C., United States Jacob Labonte, Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Tahlia Bragg, Boston University CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Robert Stern, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Joseph Palmisano, Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Brett Martin, Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Yorghos Tripodis, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Daniel Daneshvar, Harvard Medical School, Boston, United States Christopher Nowinski, Boston University CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Kristen Dams-O’Connor, Icahn School of Medicine at Mount Sinai, Mount Sinai, United States John Crary, See photos Map of Icahn School of Medicine at Mount Sinai See outside Icahn School of Medicine at Mount Sinai, Mount Sinai, United States Victor Alvarez, Boston University CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Bertrand Huber, Boston University CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Thor Stein, Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Ann McKee, Boston University CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Michael Alosco, Boston University CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Jesse Mez, Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Category: Inclusion and Diversity/Multiculturalism Keyword 1: diversity Keyword 2: inclusion Keyword 3: sports-related neuropsychology Objective: Brain donation and neuropathological evaluation are essential to the study of Alzheimer’s disease (AD) and related dementias including chronic traumatic encephalopathy (CTE). CTE is a unique tauopathy caused, in part, by repetitive head impacts (RHI) that currently can only be diagnosed by post-mortem examination. Autopsy studies of neurodegenerative diseases often consist of predominantly White samples (93% in the National Alzheimer’s Coordinating Center Database). The Understanding Neurologic Injury and Traumatic Encephalopathy (UNITE) Brain Bank, the world's largest tissue repository from donors with RHI and CTE, is comparatively well-represented with Black brain donors. The objective of this study was to characterize the Black male brain donors from the UNITE Brain Bank to provide insights regarding recruitment of Black participants into brain donation programs. Participants and Methods: This sample included 99 deceased Black male brain donors from the UNITE Brain Bank (~13% of the Brain Bank) with a history of RHI from contact and collision sports (CCS). Retrospective structured and semi-structured interviews with informants of brain donors were completed to ascertain demographic, medical, clinical, and athletic histories; informants reported the race of the donor. Informants completed modified standardized scales of cognitive and neuropsychiatric symptoms and functional abilities; these included the Apathy Evaluation Scale (AES), Barratt Impulsivity Scale (BIS-11), Behavioral Regulation Index (BRI), Cognitive Difficulty Scale (CDS), Functional Activities Questionnaire (FAQ), and Geriatric Depression Scale (GDS); the Neuropsychiatric Inventory-Questionnaire (NPI-Q) was also completed. Using published criteria, an assessment for neurodegenerative disease was conducted by a neuropathologist who was blinded from the clinical data. Dementia diagnoses were made during multidisciplinary diagnostic consensus conferences. Results: Forty-three percent had a college degree. The average age of first exposure to CCS was 11; the average total years of play was 17. Ninety-five percent played American football; the most common level was professional (76%). The most and least played positions were defensive back (22%), and quarterback/special teams (1.1%, for each), respectively. The most popular alternative sport was amateur wrestling (7.1%). Ninety-six percent reported a TBI history, with 67% reporting loss of consciousness (LOC); 97% experienced mild TBI. The primary cause was from a fall/being hit (including during sports) (91%). The median number of concussions was 24. Most participants had elevated AES (69%), BRI (70%), and GDS (72%) scores, suggesting a high prevalence of apathy, impulsivity, and depression, respectively. The most common symptom reported on the NPI-Q was depression (84%). The average age of death was 53. The primary cause was cardiovascular disease (20%). Upon neuropathological examination, 3% had AD; 6% had Lewy Body Disease, separated morphologically by brainstem (2%) and limbic/neocortical (4%) predominance; 3% had frontotemporal dementia and MND, each. The most prevalent diagnosis was CTE (82%), with stage III being predominant (43%). Furthermore, 87% had CTE without comorbid neurodegenerative disease. Conclusions: Black donors tended to be college educated former professional American football players with early age at death from non-neurodegenerative causes, despite most having CTE neuropathology. Most reported elevated depression, anxiety, and impulsivity. Young age, elite football play, and neuropsychiatric symptoms might be key factors driving brain donation.

Poster

02/17/2024
10:45 am - 12:00 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 11: Cultural Neuropsychology | Education/Training | Professional Practice Issues

Final Abstract #80

Characterizing Black Male Athlete Brain Donors in the UNITE Brain Bank: Insights into Racial Disparities in Brain Donation Programs

Erika Pettway, Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States
Stephanie Gonzalez Gil, Boston University CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States
Robert Turner II, The George Washington University School of Medicine & Health Science, Washington, D.C., United States
Jacob Labonte, Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States
Tahlia Bragg, Boston University CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States
Robert Stern, Boston University Chobanian & Avedisian School of Medicine, Boston, United States
Joseph Palmisano, Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States
Brett Martin, Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States
Yorghos Tripodis, Boston University Chobanian & Avedisian School of Medicine, Boston, United States
Daniel Daneshvar, Harvard Medical School, Boston, United States
Christopher Nowinski, Boston University CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States
Kristen Dams-O’Connor, Icahn School of Medicine at Mount Sinai, Mount Sinai, United States
John Crary, See photos Map of Icahn School of Medicine at Mount Sinai See outside Icahn School of Medicine at Mount Sinai, Mount Sinai, United States
Victor Alvarez, Boston University CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States
Bertrand Huber, Boston University CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States
Thor Stein, Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States
Ann McKee, Boston University CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States
Michael Alosco, Boston University CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States
Jesse Mez, Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, United States

Category: Inclusion and Diversity/Multiculturalism

Keyword 1: diversity
Keyword 2: inclusion
Keyword 3: sports-related neuropsychology

Objective:

Brain donation and neuropathological evaluation are essential to the study of Alzheimer’s disease (AD) and related dementias including chronic traumatic encephalopathy (CTE). CTE is a unique tauopathy caused, in part, by repetitive head impacts (RHI) that currently can only be diagnosed by post-mortem examination. Autopsy studies of neurodegenerative diseases often consist of predominantly White samples (93% in the National Alzheimer’s Coordinating Center Database). The Understanding Neurologic Injury and Traumatic Encephalopathy (UNITE) Brain Bank, the world's largest tissue repository from donors with RHI and CTE, is comparatively well-represented with Black brain donors. The objective of this study was to characterize the Black male brain donors from the UNITE Brain Bank to provide insights regarding recruitment of Black participants into brain donation programs.

Participants and Methods:

This sample included 99 deceased Black male brain donors from the UNITE Brain Bank (~13% of the Brain Bank) with a history of RHI from contact and collision sports (CCS). Retrospective structured and semi-structured interviews with informants of brain donors were completed to ascertain demographic, medical, clinical, and athletic histories; informants reported the race of the donor. Informants completed modified standardized scales of cognitive and neuropsychiatric symptoms and functional abilities; these included the Apathy Evaluation Scale (AES), Barratt Impulsivity Scale (BIS-11), Behavioral Regulation Index (BRI), Cognitive Difficulty Scale (CDS), Functional Activities Questionnaire (FAQ), and Geriatric Depression Scale (GDS); the Neuropsychiatric Inventory-Questionnaire (NPI-Q) was also completed. Using published criteria, an assessment for neurodegenerative disease was conducted by a neuropathologist who was blinded from the clinical data. Dementia diagnoses were made during multidisciplinary diagnostic consensus conferences.

Results:

Forty-three percent had a college degree. The average age of first exposure to CCS was 11; the average total years of play was 17. Ninety-five percent played American football; the most common level was professional (76%). The most and least played positions were defensive back (22%), and quarterback/special teams (1.1%, for each), respectively. The most popular alternative sport was amateur wrestling (7.1%).

Ninety-six percent reported a TBI history, with 67% reporting loss of consciousness (LOC); 97% experienced mild TBI. The primary cause was from a fall/being hit (including during sports) (91%). The median number of concussions was 24.

Most participants had elevated AES (69%), BRI (70%), and GDS (72%) scores, suggesting a high prevalence of apathy, impulsivity, and depression, respectively. The most common symptom reported on the NPI-Q was depression (84%).

The average age of death was 53. The primary cause was cardiovascular disease (20%). Upon neuropathological examination, 3% had AD; 6% had Lewy Body Disease, separated morphologically by brainstem (2%) and limbic/neocortical (4%) predominance; 3% had frontotemporal dementia and MND, each. The most prevalent diagnosis was CTE (82%), with stage III being predominant (43%). Furthermore, 87% had CTE without comorbid neurodegenerative disease.

Conclusions:

Black donors tended to be college educated former professional American football players with early age at death from non-neurodegenerative causes, despite most having CTE neuropathology. Most reported elevated depression, anxiety, and impulsivity. Young age, elite football play, and neuropsychiatric symptoms might be key factors driving brain donation.