Heading and Soccer: understanding cognitive risks, benefits, and the potential mediating role of white matter

头球和足球：了解认知风险、益处以及白质的潜在中介作用

• 批准号: 10522024
• 负责人: Michael Lawrence Lipton
• 金额: $ 74.39万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10522024
• 关键词: Address; Adult; Adverse effects; Aerobic; Age; Alleles; American; Anisotropy; Attenuated; Benefits and Risks; Brain; Brain Concussion; Brain Injuries; Brain-Derived Neurotrophic Factor; Cognitive; Diffusion; Diffusion Magnetic Resonance Imaging; Enrollment; Equilibrium; Exhibits; Exposure to; Follow-Up Studies; Foundations; Future; Goals; Harm Reduction; Health; Healthcare; Image; Impairment; Joints; Knowledge; Longitudinal Studies; Magnetic Resonance Imaging; Measures; Mediating; Mediation; Mediator of activation protein; Morbidity - disease rate; Myelin; Nerve Degeneration; Outcome; Participant; Personal Satisfaction; Persons; Physical activity; Planet Earth; Play; Productivity; Reporting; Risk; Role; Sampling; Soccer; Sports; Structure; Testing; Time; VO2max; Water; Work; apolipoprotein E-4; attenuation; base; brain health; central nervous system injury; cognitive change; cognitive enhancement; cognitive function; cognitive performance; cognitive testing; combat; genetic variant; head impact; improved; indexing; injury and repair; insight; myelination; neuroimaging; protective effect; public health relevance; risk perception; subconcussion; white matter; white matter change; young adult

PROJECT SUMMARY/ABSTRACT A key goal of “Healthy People 2030” is to improve the health of adults through aerobic physical activity. Soccer, the most popular sport on earth, is an aerobic outlet for more than 25 million Americans. The potential benefits of soccer are offset by repetitive subconcussive head impacts (RSHI) from soccer heading. RSHI are associated with exposure-dependent adverse effects on neuroimaging and on cognitive performance, independent of collisions and concussion. The tradeoffs between aerobic benefits and RSHI-related harms are not known. The central aim of this proposal is to examine the aerobic benefits of soccer play, in relation to RSHI harms, for brain structure and function, and to explore person-level factors that modify this risk-benefit tradeoff. Beneficial effects of aerobic capacity and adverse subclinical effects of RSHI can be detected with neuroimaging of white matter. However, little is known about their joint impact on white matter and, in turn, how white matter features mediate effects on cognitive function. Fundamental knowledge on the RSHI risk-benefit balance can inform our understanding of RSHI morbidity and its mitigation beyond the specific context of soccer, such as other sports and combat. Prior work on RSHI effects has not specifically measured aerobic capacity, and little is known about whether and how white matter mediates exposure-outcome associations. Our proposed 2-year longitudinal follow up study of 280 young adults, including soccer players with high (n=70) and low (n=70) exposure to RSHI, non-collision athletes (n=70) and non-athlete controls (n=70), will test the hypothesis that aerobic capacity-engendered benefits confound and modify the adverse effects of RSHI on white matter that, in turn, is a mediator of adverse cognitive effects. We will measure aerobic capacity (VO2max) and RSHI over 2 years and perform Myelin Water and Microstructure MRI of white matter as well as cognitive assessments, at enrollment and 2 years later. We will address the following specific aims: Aim 1: Evaluate the joint effects of VO2max and RSHI on white matter myelination and microstructure. Aim 2: Assess mediation by white matter of the known associations of VO2max and RSHI with cognitive performance. Aim 3: Explore the BDNF-Val66met and ApoE-ε4 gene variants as modifiers of the tradeoff of VO2max and RHSI-mediated effects on white matter. Delineating risk vs. benefit to cognitive performance from soccer can transform perception of risk by stakeholders, facilitate choice and guidance on soccer participation and heading. Choices that impact young adult players, with high RSHI exposure and decades of future needs, have the potential to impact their wellbeing, healthcare footprint and productivity for decades.

项目总结/摘要 “健康人2030”的一个关键目标是通过有氧体育活动改善成年人的健康状况。足球， 作为地球上最受欢迎的运动，它是超过2500万美国人的有氧运动。的潜在利益 的足球是抵消了重复subconcussive头部冲击（RSHI）从足球头球。RSHI与 对神经影像学和认知能力具有依赖性不良影响，与 碰撞和脑震荡有氧益处和RSHI相关危害之间的权衡尚不清楚。的 这项建议的主要目的是研究足球运动的有氧益处，与RSHI危害的关系， 大脑结构和功能，并探索改变这种风险-效益权衡的个人因素。 有氧能力的有益效果和RSHI的不良亚临床效应可以通过神经影像学检测 是白色物质。然而，关于它们对白色物质的共同影响以及白色物质如何影响它们的行为， 特征介导对认知功能的影响。关于RSHI风险-收益平衡的基本知识可以 告知我们对RSHI发病率的理解及其在足球特定背景之外的缓解，例如 其他运动和战斗。先前关于RSHI效应的研究并没有专门测量有氧能力， 关于白色物质是否以及如何介导确定性-结果关联的研究。我们建议的2年 对280名年轻人进行了纵向随访研究，包括高（n=70）和低（n=70）的足球运动员 暴露于RSHI，非碰撞运动员（n=70）和非运动员对照组（n=70），将检验假设， 有氧能力产生的好处混淆和修改RSHI对白色物质的不利影响 这反过来又是负面认知效应的中介。我们将测量有氧能力（VO 2 max）， RSHI超过2年，并进行白色物质的髓鞘水和微结构MRI以及认知 评估，在登记和2年后。我们将讨论以下具体目标：目标1：评估 VO 2 max和RSHI对白色髓鞘形成和微结构的联合作用。目标2：通过以下方式评估调解 已知VO 2 max和RSHI与认知表现之间的关联的白色物质。目标3：探索 BDNF-Val 66 met和ApoE-ε4基因变异体作为VO 2 max和RHSI介导效应的折衷修饰剂 在白色物质上。从足球中描述认知表现的风险与益处可以改变人们对足球的看法。 利益相关者的风险，促进对足球参与和头球的选择和指导。影响的选择 年轻的成年球员，高RSHI暴露和几十年的未来需求，有可能影响他们的 健康、医疗足迹和生产力。