Abnormal White Matter Integrity Related to Head Impact Exposure in a Season of High School Varsity Football
Abnormal White Matter Integrity Related to Head Impact Exposure in a Season of High School Varsity Football
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DOI：
10.1089/neu.2013.3233
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发表时间：
2014-10-01
影响因子：
4.2
通讯作者：
Maldjian, Joseph A.
中科院分区：
文献类型：
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作者：
Davenport, Elizabeth M.;Whitlow, Christopher T.;Maldjian, Joseph A.
这项研究的目的是确定在没有临床诊断脑震荡的情况下，高中橄榄球赛季头部撞击的累积效应是否会在大脑中产生磁共振成像(MRI)可测量的变化。当地一所高中足球队的球员在所有练习和比赛中都使用了Head Impact遥测系统(HITS(TM))。所有球员都接受了季前赛和季后赛的核磁共振检查，包括扩散张量成像(DTI)。还进行了震荡后即刻评估和认知测试(IMPACT)。根据传感器数据计算总影响和风险加权累积暴露(RWE)，包括线性(RWEL线性)、旋转(RWERotational)和组合分量(RWECP)。使用分数、线性、平面和球面各向异性(分别为F-A、C-L、C-P和C-S)以及平均扩散系数(MD)来确定异常白质体素的总数，其定义为高于或低于组平均值的2个标准差。计算每个人的德尔塔(季前赛后)影响分数，并使用Spearman的等级相关系数与DTI测量进行比较。没有球员分析有过临床脑震荡(N=24)。回归分析显示，RWECP与FA之间存在显著的线性关系。二次分析表明，在RWE(RWECP和RWEL线性)和所有DTI测量之间存在更多具有统计学意义的线性关联。DTI测量和影响的言语记忆分值的变化之间也有很强的相关性。我们证明，在没有临床脑震荡的情况下，一个赛季的足球可以产生脑部MRI的变化。类似的脑MRI变化以前也与轻度创伤性脑损伤有关。
The aim of this study was to determine whether the cumulative effects of head impacts from a season of high school football produce magnetic resonance imaging (MRI) measureable changes in the brain in the absence of clinically diagnosed concussion. Players from a local high school football team were instrumented with the Head Impact Telemetry System (HITS (TM)) during all practices and games. All players received pre- and postseason MRI, including diffusion tensor imaging (DTI). Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) was also conducted. Total impacts and risk-weighted cumulative exposure (RWE), including linear (RWELinear), rotational (RWERotational), and combined components (RWECP), were computed from the sensor data. Fractional, linear, planar, and spherical anisotropies (F-A, C-L, C-P, and C-S, respectively), as well as mean diffusivity (MD), were used to determine total number of abnormal white matter voxels defined as 2 standard deviations above or below the group mean. Delta (post-preseason) ImPACT scores for each individual were computed and compared to the DTI measures using Spearman's rank correlation coefficient. None of the players analyzed experienced clinical concussion (N = 24). Regression analysis revealed a statistically significant linear relationship between RWECP and FA. Secondary analyses demonstrated additional statistically significant linear associations between RWE (RWECP and RWELinear) and all DTI measures. There was also a strong correlation between DTI measures and change in Verbal Memory subscore of the ImPACT. We demonstrate that a single season of football can produce brain MRI changes in the absence of clinical concussion. Similar brain MRI changes have been previously associated with mild traumatic brain injury.