Concussion history in rugby union players is associated with depressed cerebrovascular reactivity and cognition.
Concussion history in rugby union players is associated with depressed cerebrovascular reactivity and cognition.
复制标题
橄榄球联盟球员的脑震荡史与脑血管反应性和认知能力下降有关。
DOI：
10.1111/sms.14046
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
and Damian M. Bailey.
中科院分区：
文献类型：
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作者：
Thomas S. Owens;Thomas A. Calverley;Benjamin S. Stacey;George A. Rose;Lewis Fall;Hayato Tsukamoto;Gareth L. Jones;Robin Corkill;Edouard Tuaillon;Christophe Hirtz;Sylvain Lehmann;Nicola Marchi;Christopher J. Marley;and Damian M. Bailey.
橄榄球联盟中的经常性接触和脑震荡仍然是一个重大的公共卫生问题，因为在以后的生活中神经退行性疾病的风险可能会增加。本研究确定了既往复发性接触在多大程度上影响了支持当前有脑震荡史的职业橄榄球联盟运动员认知的分子血流动力学生物标志物。对20名职业橄榄球联盟运动员进行了测量，他们平均有16年（四分位数间距[IQR] 13-19）的比赛史，报告了3次（IQR 1-4）脑震荡。他们与17名性别-年龄-身体活动-和教育匹配的非接触对照进行了比较，这些对照没有自我报告的脑震荡病史。直接测定静脉血中的抗坏血酸自由基（A·−电子顺磁共振光谱法）、一氧化氮代谢物（NO还原性臭氧化学发光）和神经血管单位完整性的选定生物标志物（NVU化学发光/ELISA）。采用大脑中动脉血流速度（MCAv多普勒超声）测定基础灌注和对高/低碳酸血症的脑血管反应性（CVR）（）。认知能力通过神经心理测量测试进行评估。通过增加A·−（p< 0.001）和抑制NO生物利用度（p< 0.001），在运动员中证实了全身氧化-亚硝化应激的升高。这伴随着较低的CVR范围（p= 0.045），神经丝轻链（p= 0.010）升高，即时记忆（p = 0.001）、延迟回忆（p= 0.048）和精细运动协调（p< 0.001）的额颞叶损伤。既往复发性接触和脑震荡史后认知功能加速下降与自由基介导的CVR抑制和神经元损伤相关，提供了重要的机制见解，可能有助于更好地为临床管理提供信息。
Recurrent contact and concussion in rugby union remains a significant public health concern given the potential increased risk of neurodegeneration in later life. This study determined to what extent prior‐recurrent contact impacts molecular‐hemodynamic biomarkers underpinning cognition in current professional rugby union players with a history of concussion. Measurements were performed in 20 professional rugby union players with an average of 16 (interquartile range [IQR] 13–19) years playing history reporting 3 (IQR 1–4) concussions. They were compared to 17 sex‐age‐physical activity‐and education‐matched non‐contact controls with no prior history of self‐reported concussion. Venous blood was assayed directly for the ascorbate free radical (A•−electron paramagnetic resonance spectroscopy) nitric oxide metabolites (NO reductive ozone‐based chemiluminescence) and select biomarkers of neurovascular unit integrity (NVU chemiluminescence/ELISA). Middle cerebral artery blood flow velocity (MCAv doppler ultrasound) was employed to determine basal perfusion and cerebrovascular reactivity (CVR) to hyper/hypocapnia (). Cognition was assessed by neuropsychometric testing. Elevated systemic oxidative‐nitrosative stress was confirmed in the players through increased A•−(p< 0.001) and suppression of NO bioavailability (p< 0.001). This was accompanied by a lower CVR range (;p= 0.045) elevation in neurofilament light‐chain (p= 0.010) and frontotemporal impairments in immediate‐memory (p= 0.001) delayed‐recall (p= 0.048) and fine‐motor coordination (p< 0.001). Accelerated cognitive decline subsequent to prior‐recurrent contact and concussion history is associated with a free radical‐mediated suppression of CVR and neuronal injury providing important mechanistic insight that may help better inform clinical management.