A prospective functional MR imaging study of mild traumatic brain injury in college football players.
A prospective functional MR imaging study of mild traumatic brain injury in college football players.
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发表时间：
2004-05
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通讯作者：
K. Jantzen;B. Anderson;Fred L. Steinberg;J. Kelso
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作者：
K. Jantzen;B. Anderson;Fred L. Steinberg;J. Kelso
背景和目的虽然脑震荡在运动员中很常见，但缺乏临床评估、治疗和恢复的循证方法。我们使用了一种前瞻性的功能性神经影像学方法来评估与运动相关的脑震荡，在这种方法中，在受伤前进行成像，以便更好地了解脑震荡引起的大脑变化。方法采用功能磁共振成像技术，对8名大学生足球运动员运动性脑震荡的神经生理相关因素进行研究。季前基线水平的血氧水平依赖（BOLD）的活动期间获得的测试电池，包括数学，记忆和感觉运动协调任务的性能。四名脑震荡的球员在受伤后一周内重复了这些基线程序。剩下的控制球员在赛季结束时重新测试。结果：通过比较脑震荡后的结果与脑震荡前的基线值，在个体运动员中检测到脑震荡的特定神经特征。这些指标的有效性进行了确认，通过比较他们与相同的措施，在非受伤的对照组。当与对照组相比，脑震荡的球员有显着的受试者内增加的幅度和程度的BOLD活动在手指排序任务。主要在顶叶和侧额叶和小脑区域观察到影响。结论在没有观察到行为表现缺陷的情况下观察到神经功能的差异，这表明与单独的神经心理学评估相比，这种方法可能会增加对脑震荡的敏感性。虽然是初步的，但所提出的前瞻性神经影像学方法可能对理解轻度创伤性脑损伤和确定恢复机制具有巨大潜力。
BACKGROUND AND PURPOSE Although concussion is common among athletes, evidence-based methods for clinical evaluation, treatment, and recovery are lacking. We used a prospective, functional neuroimaging approach to assess sports-related concussion in which imaging was performed before injury so that brain changes resulting from concussion could be better understood. METHODS Neurophysiologic correlates of sports-related concussion were investigated in eight college football players by using functional MR imaging. Preseason baseline levels of blood oxygen level-dependent (BOLD) activity were acquired during the performance of a test battery that included mathematical, memory, and sensorimotor coordination tasks. Four players who had a concussion repeated these baseline procedures within 1 week of injury. The remaining control players were retested at the end of the season. RESULTS Specific neural signatures of concussion were detected in individual players by comparing postconcussion results to preconcussion baseline values. The validity of these indicators was confirmed by comparing them with the same measures in noninjured control subjects. When compared with control subjects, concussed players had marked within-subject increases in the amplitude and extent of BOLD activity during a finger-sequencing task. Effects were observed primarily in the parietal and lateral frontal and cerebellar regions. CONCLUSION Differences in neural functioning were observed in the absence of observed deficits in behavioral performance, suggesting that this approach may increase sensitivity to concussion compared with neuropsychological evaluation alone. Though preliminary, the proposed prospective neuroimaging approach may have great potential for understanding mild traumatic brain injury and identifying mechanisms underlying recovery.