Persistent, long-term cerebral white matter changes after sports-related repetitive head impacts.
Persistent, long-term cerebral white matter changes after sports-related repetitive head impacts.
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DOI：
10.1371/journal.pone.0094734
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Blackman EG
中科院分区：
文献类型：
--
作者：
Bazarian JJ;Zhu T;Zhong J;Janigro D;Rozen E;Roberts A;Javien H;Merchant-Borna K;Abar B;Blackman EG
在接触性运动中持续的重复性头部撞击（RHI）被认为是慢性创伤性脑病（CTE）长期发展的必要条件。我们的目标是：1）表征RHI诱导的白色物质（WM）变化的幅度和持续性; 2）确定其与RHI运动学测量的关系; 3）探索其临床相关性。在2011-12赛季期间，对10名三级联赛大学足球运动员和5名非运动员对照进行了前瞻性观察研究。所有受试者在赛季前（时间1）、赛季后（时间2）和无接触休息6个月后（时间3）接受弥散张量成像（DTI）、生理、认知和平衡测试。头部撞击的测量是用头盔上的加速计记录的。确定每例受试者从时间1至2和时间1至3的各向异性分数（FA）和平均扩散率（MD）发生显著变化的全脑WM体素百分比，并将其与头部撞击和临床测量结果相关联。本赛季的总人数从431人到1850人不等。没有运动员遭受临床上明显的脑震荡。与对照组相比，运动员从时间1到2以及时间1到3经历了更大的FA和MD变化;时间2的大部分差异持续到时间3。在运动员中，从时间1到2 FA降低的体素百分比与几种头盔冲击措施呈正相关。从时间1至3的WM变化的持续性也与血清ApoA 1和S100 B自身抗体的变化相关。WM的变化与认知或平衡并不一致。一个没有临床明显脑震荡的RHI足球赛季导致WM变化，与多个头盔影响措施相关，并在6个月的无接触休息后持续存在。这种缺乏WM恢复可能会导致随后的RHI暴露累积WM变化。
Repetitive head impacts (RHI) sustained in contact sports are thought to be necessary for the long-term development of chronic traumatic encephalopathy (CTE). Our objectives were to: 1) characterize the magnitude and persistence of RHI-induced white matter (WM) changes; 2) determine their relationship to kinematic measures of RHI; and 3) explore their clinical relevance. Prospective, observational study of 10 Division III college football players and 5 non-athlete controls during the 2011-12 season. All subjects underwent diffusion tensor imaging (DTI), physiologic, cognitive, and balance testing at pre-season (Time 1), post-season (Time 2), and after 6-months of no-contact rest (Time 3). Head impact measures were recorded using helmet-mounted accelerometers. The percentage of whole-brain WM voxels with significant changes in fractional anisotropy (FA) and mean diffusivity (MD) from Time 1 to 2, and Time 1 to 3 was determined for each subject and correlated to head impacts and clinical measures. Total head impacts for the season ranged from 431–1,850. No athlete suffered a clinically evident concussion. Compared to controls, athletes experienced greater changes in FA and MD from Time 1 to 2 as well as Time 1 to 3; most differences at Time 2 persisted to Time 3. Among athletes, the percentage of voxels with decreased FA from Time 1 to 2 was positively correlated with several helmet impact measures. The persistence of WM changes from Time 1 to 3 was also associated with changes in serum ApoA1 and S100B autoantibodies. WM changes were not consistently associated with cognition or balance. A single football season of RHIs without clinically-evident concussion resulted in WM changes that correlated with multiple helmet impact measures and persisted following 6 months of no-contact rest. This lack of WM recovery could potentially contribute to cumulative WM changes with subsequent RHI exposures.
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影响因子：
3.7
作者：
Marchi, Nicola;Bazarian, Jeffrey J.;Janigro, Damir
通讯作者：
Janigro, Damir
影响因子：
2.4
作者：
Jantzen, Kelly J.
通讯作者：
Jantzen, Kelly J.
DOI：
10.1249/mss.0b013e3181dd9156
发表时间：
2010-11-01
期刊：
MEDICINE AND SCIENCE IN SPORTS AND EXERCISE
影响因子：
--
作者：
Broglio, Steven P.;Schnebel, Brock;Zimmerman, Jerrad
通讯作者：
Zimmerman, Jerrad
影响因子：
14.5
作者：
McKee, Ann C.;Stein, Thor D.;Cantu, Robert C.
通讯作者：
Cantu, Robert C.
影响因子：
4.8
作者：
Marar, Mallika;McIlvain, Natalie M.;Comstock, R. Dawn
通讯作者：
Comstock, R. Dawn