This study did not include genetic profiling, despite the C9orf72 genetic mutations having a relatively high prevalence in Italy compared to other countries.49 Another study focusing on soccer players, found that neurodegenerative disease was highest for defenders [hazard ratio (HR) 4.98 95% CI, 3.18–7.79, P < 0.001] and lowest for goalkeepers (HR 1.83, 95% CI 0.93–3.6, P = 0.08) implying that anaerobic activity is more important in the causation of ALS.26 This study had a much larger sample size of 30 704 males, therefore the results have higher statistical power. Here, C9orf72 is linked to amyotrophic lateral sclerosis.