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Background: National Football League (NFL) players are exposed to multiple head collisions during their careers. Increasing awareness of the adverse long-term effects of repetitive head trauma has raised substantial concern among players, medical professionals, and the general public.

Objective: To determine whether low perfusion in specific brain regions on neuroimaging can accurately separate professional football players from healthy controls. Method: A cohort of retired and current NFL players ( n = 161) were recruited in a longitudinal study starting in 2009 with ongoing interval follow up. A healthy control group ( n = 124) was separately recruited for comparison. Assessments included medical examinations, neuropsychological tests, and perfusion neuroimaging with single photon emission computed tomography (SPECT). Perfusion estimates of each scan were quantified using a standard atlas.

We hypothesized that hypoperfusion particularly in the orbital frontal, anterior cingulate, anterior temporal, hippocampal, amygdala, insular, caudate, superior/mid occipital, and cerebellar sub-regions alone would reliably separate controls from NFL players. Cerebral perfusion differences were calculated using a one-way ANOVA and diagnostic separation was determined with discriminant and automatic linear regression predictive models. Results: NFL players showed lower cerebral perfusion on average ( p.

INTRODUCTION The current public dialogue regarding the possible risks of repetitive head trauma playing football is not unlike the sport itself, with intense exchanges of opposing perspectives []. The genesis of this recent debate was the discovery of neuropsychiatric symptoms linked to a distinct neuropathological entity in former National Football League (NFL) players, chronic traumatic encephalopathy (CTE) []. Noticeably lacking in this dialogue are assertions weighted in data from living professional football players. Several small studies have described structural and functional brain abnormalities in this group. One study of 28 former NFL players found lower hippocampal volumes in those with a history of concussion leading to loss of consciousness compared to 27 controls []. This same cohort was found to have white matter tract abnormalities on diffusion tensor imaging correlating to increased symptoms of depression [].