Heading and Soccer: understanding cognitive risks, benefits, and the potentialmediating 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: 10909633
• 负责人: Michael Lawrence Lipton
• 金额: $ 70.97万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 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 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10909633
• 关键词: 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; Impairment; Joints; Knowledge; Longitudinal Studies; Magnetic Resonance Imaging; Measures; Mediating; Mediation; Mediator; Morbidity - disease rate; Myelin; Myelin Water Imaging; 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; 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.

项目概要/摘要 “健康人类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。足球， 地球上最受欢迎的运动，是超过 2500 万美国人的有氧运动。潜在的好处 足球的冲击力被足球头球造成的重复性头部震荡 (RSHI) 所抵消。 RSHI关联 对神经影像学和认知能力产生依赖于暴露的不良影响，独立于 碰撞和震荡。有氧运动的益处和 RSHI 相关危害之间的权衡尚不清楚。这 该提案的中心目标是研究足球运动的有氧运动益处与 RSHI 危害的关系， 研究大脑结构和功能，并探索改变这种风险收益权衡的个人因素。 有氧能力的有益影响和 RSHI 的不良亚临床影响可以通过神经影像学检测 的白色物质。然而，人们对它们对白质的共同影响以及白质如何影响知之甚少。 特征对认知功能有中介作用。有关 RSHI 风险收益平衡的基本知识可以 让我们了解足球特定背景下的 RSHI 发病率及其缓解措施，例如 其他运动和格斗。先前关于 RSHI 效应的研究并未专门测量有氧能力，而且很少有研究 了解白质是否以及如何介导暴露-结果关联。我们建议的 2 年 对 280 名年轻人进行的纵向随访研究，其中包括高水平 (n=70) 和低水平 (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) 将检验以下假设： 有氧能力带来的好处混淆并改变了 RSHI 对白质的不利影响 反过来，这又是不良认知效应的中介因素。我们将测量有氧能力 (VO2max) 和 RSHI 超过 2 年，进行髓鞘水和白质微观结构 MRI 以及认知 入学时和两年后的评估。我们将实现以下具体目标： 目标 1：评估 VO2max 和 RSHI 对白质髓鞘形成和微观结构的联合影响。目标 2：评估调解 已知 VO2max 和 RSHI 与认知表现之间的关联的白质。目标 3：探索 BDNF-Val66met 和 ApoE-ε4 基因变体作为 VO2max 和 RHSI 介导效应权衡的调节剂 关于白质。描绘足球认知表现的风险与益处可以改变人们对足球认知表现的看法 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，具有较高的 RSHI 暴露度和数十年的未来需求，有可能影响他们的 几十年来的福祉、医疗保健足迹和生产力。