Publications by authors named "Joseph N Palmisano"

Former American football players are at risk for developing traumatic encephalopathy syndrome (TES), the clinical disorder associated with neuropathologically diagnosed chronic traumatic encephalopathy (CTE). The objective of this study was to determine whether hyposmia is present in traumatic encephalopathy syndrome. The study included 119 former professional American football players, 60 former college football players, and 58 same-age asymptomatic unexposed men from the DIAGNOSE CTE Research Project.

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Article Synopsis
  • - Blood-based biomarkers are being explored to detect brain injuries from repetitive head impacts, specifically in former football players, by analyzing plasma levels of various proteins like tau and amyloid.
  • - A study involving 180 former football players and 60 control participants found that specific biomarkers (p-tau181 and p-tau231) were significantly elevated in the football players, indicating potential brain damage linked to their sport.
  • - The findings suggest that certain plasma proteins (p-tau, GFAP, NfL) could help in understanding and identifying neurological issues related to head impacts, with younger players showing more severe biomarker changes.
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Background: Chronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy more frequently found in deceased former football players. CTE has heterogeneous clinical presentations with multifactorial causes. Previous literature has shown substance use (alcohol/drug) can contribute to Alzheimer's disease and related tauopathies pathologically and clinically.

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  • The study investigates neurobehavioral dysregulation (NBD), which includes neuropsychiatric symptoms linked to repetitive head impacts, particularly in former contact sport athletes.
  • Through analyses involving questionnaires from 178 former football players, researchers identified four subconstructs of NBD: explosivity, emotional dyscontrol, impulsivity, and affective lability.
  • The results revealed four symptom profiles among participants, highlighting the complexity of NBD and serving as a basis for future research on its diagnostic criteria and neurobiological aspects.
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Plasma-to-autopsy studies are essential for validation of blood biomarkers and understanding their relation to Alzheimer's disease (AD) pathology. Few such studies have been done on phosphorylated tau (p-tau) and those that exist have made limited or no comparison of the different p-tau variants. This study is the first to use immunoprecipitation mass spectrometry (IP-MS) to compare the accuracy of eight different plasma tau species in predicting autopsy-confirmed AD.

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  • - The study investigates tau pathology in chronic traumatic encephalopathy (CTE) using tau PET imaging from 218 participants, including former professional and college football players, and a control group of individuals without head impact exposure.
  • - Elevated tau levels were found in former football players compared to controls, especially in older players over 60 with cumulative head impact exposure, but PET imaging didn't effectively distinguish between individuals with and without traumatic encephalopathy syndrome.
  • - The authors emphasize the need for further research to better understand the link between tau pathology and chronic traumatic brain injuries, as current findings only partially clarify these relationships.
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  • Former football players are at risk for chronic traumatic encephalopathy (CTE), which can include parkinsonism as a clinical feature.
  • A study assessed 120 former professional and 58 college football players, comparing them to 60 similar-aged men without repetitive head impacts, to investigate rates of parkinsonism.
  • Results showed that 12.4% of football players met parkinsonism criteria, with a higher prevalence in professional players, but overall rates were low and inconclusive regarding the effects of football exposure on parkinsonism.
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  • This study investigates the impact of repetitive head impacts (RHI) on cognitive decline and dementia by examining the brains of 571 donors exposed to RHI, focusing on 13 different neuropathologies.
  • It was found that a significant majority (77.2%) of these donors exhibited moderate to severe neurodegenerative or cerebrovascular issues, with chronic traumatic encephalopathy (CTE) being the most common pathology.
  • The research highlights that several pathologies, including Alzheimer’s disease and Lewy body disease, are interrelated and contribute significantly to cognitive impairment in individuals with a history of RHI.
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  • This study investigated the effectiveness of plasma glial fibrillary acidic protein (GFAP) as a biomarker for cognitive impairment in Alzheimer's disease (AD) compared to other biomarkers like neurofilament light chain (NfL) and phosphorylated tau (p-tau).
  • The research analyzed plasma samples from 567 participants and correlated GFAP levels with cognitive functions and dementia severity, finding that GFAP was significantly more effective in differentiating between normal cognition and AD dementia or mild cognitive impairment.
  • While higher GFAP levels were linked to worse cognitive performance and dementia symptoms, it specifically predicted memory decline over time but did not indicate progression to mild cognitive impairment or dementia.
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Background: Exposure to repetitive head impacts (RHI) in American football players can lead to cognitive impairment and dementia due to neurodegenerative disease, particularly chronic traumatic encephalopathy (CTE). The pathognomonic lesion of CTE consists of perivascular aggregates of hyper-phosphorylated tau in neurons at the depths of cortical sulci. However, it is unclear whether exposure to RHI accelerates amyloid-β (Aβ) plaque formation and increases the risk for Alzheimer's disease (AD).

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  • * The study analyzed data from 152 brain donors under 30 years old, revealing that 41.4% were diagnosed with CTE, primarily in its mild stages.
  • * CTE cases were more prevalent among older athletes, particularly males in amateur sports like football, with those diagnosed having significantly longer playing careers.
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  • Chronic traumatic encephalopathy (CTE) is a brain disease that can happen from repeated hits to the head, especially in football players.
  • Researchers made a special tool called a position exposure matrix (PEM) to estimate how much head impact different players experience based on their position and level of play.
  • The study found that how long players participate in football and the total strength of their head impacts are closely related to CTE, suggesting that stronger and more repeated hits to the head are more likely to cause this brain disease.
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Background: Patterns of cognitive impairment in former American football players are uncertain because objective neuropsychological data are lacking. This study characterized the neuropsychological test performance of former college and professional football players.

Methods: One hundred seventy male former football players (n=111 professional, n=59 college; 45-74 years) completed a neuropsychological test battery.

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Purpose: Flourine-18-flortaucipir tau positron emission tomography (PET) was developed for the detection for Alzheimer's disease. Human imaging studies have begun to investigate its use in chronic traumatic encephalopathy (CTE). Flortaucipir-PET to autopsy correlation studies in CTE are needed for diagnostic validation.

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Introduction: The presentation, risk factors, and etiologies of white matter hyperintensities (WMH) in people exposed to repetitive head impacts are unknown. We examined the burden and distribution of WMH, and their association with years of play, age of first exposure, and clinical function in former American football players.

Methods: A total of 149 former football players and 53 asymptomatic unexposed participants (all men, 45-74 years) completed fluid-attenuated inversion recovery magnetic resonance imaging, neuropsychological testing, and self-report neuropsychiatric measures.

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Importance: Repetitive head impact (RHI) exposure is the chief risk factor for chronic traumatic encephalopathy (CTE). However, the occurrence and severity of CTE varies widely among those with similar RHI exposure. Limited evidence suggests that the APOEε4 allele may confer risk for CTE, but previous studies were small with limited scope.

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Blood-based biomarkers such as tau phosphorylated at threonine 181 (phosphorylated-tau181) represent an accessible, cost-effective and scalable approach for the in vivo detection of Alzheimer's disease pathophysiology. Plasma-pathological correlation studies are needed to validate plasma phosphorylated-tau181 as an accurate and reliable biomarker of Alzheimer's disease neuropathological changes. This plasma-to-autopsy correlation study included participants from the Boston University Alzheimer's Disease Research Center who had a plasma sample analysed for phosphorylated-tau181 between 2008 and 2018 and donated their brain for neuropathological examination.

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Importance: Exposure to repetitive head impacts from playing American football (including impacts resulting in symptomatic concussions and subconcussive trauma) is associated with increased risk for later-life health problems, including cognitive and neuropsychiatric decline and neurodegenerative disease. Most research on long-term health consequences of playing football has focused on former professional athletes, with limited studies of former college players.

Objectives: To estimate the prevalence of self-reported health conditions among former college football players compared with a sample of men in the general population as well as standardized mortality ratios (SMRs) among former college football players.

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Introduction: We examined the ability of plasma hyperphosphorylated tau (p-tau) to detect cognitive impairment due to Alzheimer's disease (AD) independently and in combination with plasma total tau (t-tau) and neurofilament light (NfL).

Methods: Plasma samples were analyzed using the Simoa platform for 235 participants with normal cognition (NC), 181 with mild cognitive impairment due to AD (MCI), and 153 with AD dementia. Statistical approaches included multinomial regression and Gaussian graphical models (GGMs) to assess a network of plasma biomarkers, neuropsychological tests, and demographic variables.

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Background: In this paper, we describe the design, program details, and baseline demographics and oral health of participants in ForsythKids, a regional, comprehensive, school-based mobile caries prevention program.

Methods: We solicited all Massachusetts elementary schools with greater than 50% of students receiving free or reduced-price meals. Six schools initially elected to participate, ultimately followed by over 50 schools.

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Article Synopsis
  • Chronic traumatic encephalopathy (CTE) is a serious brain disease caused by repeated head impacts and can only be diagnosed after death; the DIAGNOSE CTE Research Project aims to develop diagnostic methods for this condition.
  • Funded by the National Institute of Neurological Disorders and Stroke, the project includes 240 male participants, focusing on former football players and asymptomatic individuals, to study various risk factors and biomarkers related to CTE.
  • The research involves extensive evaluations such as neurological exams, brain imaging, and biological sample collection, with a focus on refining clinical criteria and sharing data with the broader research community.
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Importance: Bariatric surgical weight loss is associated with reduced cardiovascular mortality; however, the mechanisms underlying this association are incompletely understood.

Objectives: To identify variables associated with vascular remodeling after bariatric surgery and to examine how sex, race, and metabolic status are associated with microvascular and macrovascular outcomes.

Design, Setting, And Participants: This population-based longitudinal cohort included 307 individuals who underwent bariatric surgery.

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Introduction: Validity of the 2014 traumatic encephalopathy syndrome (TES) criteria, proposed to diagnose chronic traumatic encephalopathy (CTE) in life, has not been assessed.

Methods: A total of 336 consecutive brain donors exposed to repetitive head impacts from contact sports, military service, and/or physical violence were included. Blinded to clinical information, neuropathologists applied National Institute on Neurological Disorders and Stroke/National Institute of Biomedical Imaging and Bioengineering CTE criteria.

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The American Heart Association (AHA) introduced Life's Simple 7 as a metric to define ideal cardiovascular health. We examined the association between cardiovascular health score (CHS) and prevalent nonalcoholic fatty liver disease (NAFLD) among Framingham Heart Study participants with varying genetic risk of NAFLD. Framingham Heart Study participants who underwent abdominal computed tomography scans were included (n = 2,773).

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Background: The Framingham Stroke Risk Profile (FSRP) was created in 1991 to estimate 10-year risk of stroke. It was revised in 2017 (rFSRP) to reflect the modern data on vascular risk factors and stroke risk.

Objective: This study examined the association between the rFSRP and cognitive and brain aging outcomes among participants from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set (UDS).

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