Neuroimaging of sport concussion: persistent alterations in brain structure and function at medical clearance.

Neuroimaging of sport concussion: persistent alterations in brain structure and function at medical clearance.
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运动脑震荡的神经影像学:大脑结构和医疗清除功能的持续改变。

DOI:
10.1038/s41598-017-07742-3
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发表时间:
2017-08-24
期刊:
影响因子:
4.6
通讯作者:
Schweizer TA
Schweizer TA
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Churchill NW;Hutchison MG;Richards D;Leung G;Graham SJ;Schweizer TA

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运动性脑震荡后是否重返赛场(RTP)的医疗决定在很大程度上是基于分级运动方案后的症状状态。然而,目前尚不清楚脑结构和功能的客观标记物与临床康复的关系。这项研究的目的是确定急性损伤时大脑结构和功能的差异是否仍然存在于RTP。在这项纵向研究中,54名活跃的大学运动队运动员接受了磁共振成像(MRI)扫描,其中包括27名最近发生脑震荡的运动员,在急性损伤和医疗许可时都进行了成像,并与27名匹配的对照组进行了对比。用弥散张量成像测量脑白质的分数各向异性(FA)和平均弥散率(MD),用静息状态功能磁共振成像(FMRI)测量脑白质的整体功能连接性(Gconn)。在急性损伤时,脑震荡运动员的FA减少,MD增加,Gconn升高;这些影响在RTP中仍然存在。达到RTP的时间更长的运动员也显示出背侧脑区Gconn升高,但没有明显的白质影响。这项研究首次提出了在医学上批准RTP时大脑结构和功能发生变化的证据,恢复时间越长的运动员大脑功能变化越大。
The medical decision of return to play (RTP) after a sport concussion is largely based on symptom status following a graded exercise protocol. However, it is currently unknown how objective markers of brain structure and function relate to clinical recovery. The goal of this study was to determine whether differences in brain structure and function at acute injury remain present at RTP. In this longitudinal study, 54 active varsity athletes were scanned using magnetic resonance imaging (MRI), including 27 with recent concussion, imaged at both acute injury and medical clearance, along with 27 matched controls. Diffusion tensor imaging was used to measure fractional anisotropy (FA) and mean diffusivity (MD) of white matter and resting-state functional MRI was used to measure global functional connectivity (Gconn). At acute injury, concussed athletes had reduced FA and increased MD, along with elevated Gconn; these effects remained present at RTP. Athletes who took longer to reach RTP also showed elevated Gconn in dorsal brain regions, but no significant white matter effects. This study presents the first evidence of altered brain structure and function at the time of medical clearance to RTP, with greater changes in brain function for athletes with a longer recovery time.
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