Subcortical auditory processing in sports-related concussions and contact/collision sports

摘要 因为脑震荡的诊断标准依赖于自我报告-这在最近的一次 脑震荡个体-这个项目的目标是识别脑震荡的神经标记物，不需要 病人的努力。脑震荡对许多领域都有不利影响，我们有充分的理由相信， 初步数据支持，听觉系统中的神经处理受到运动的负面影响- 相关脑震荡。通过使用听觉处理的客观电生理测量，这项工作已经 很有可能扩大对脑震荡对感觉加工的影响的理解，并消除 脑震荡的诊断和治疗中的主要陷阱。 这项提议使用了一种新的方法来理解头部损伤对感觉处理的影响： 对语音的频率跟随反应(FFR)。中心假设是这种客观的神经生理学 听觉处理的测量可作为中枢神经系统功能受损的标志 脑震荡。与西北大学田径队合作，这是一项前瞻性的纵向研究 脑震荡和长期参加接触/碰撞运动，每年约有500名学生运动员参加 (总计约875人)在运动季内和跨运动季。在典型的一年里，高达15%的学生运动员被诊断出 因为运动医学医生的脑震荡。这为调查影响提供了一个有力的机会。 脑震荡在短期(受伤后立即)和长期(受伤后)对听觉处理的影响 一到四年的大学体育生涯)。在一大群没有脑震荡的运动员中，这个项目将 确定是否如假设的那样，随着时间的推移，个体的听觉处理能力会受到更多损害 参加接触/碰撞运动。 本项目可以阐明脑震荡和长期参与脑震荡的生理机制 接触性运动会扰乱中枢神经系统。FFR将提供细粒度的洞察，了解 脑震荡的生理印记。大型队列中的纵向设计提供了强大的内部和 基于短期和长期运动跟踪头部损伤和损伤风险的受试者间对照 阶段，以及研究内复制的机会。如果成功，FFR有朝一日可能会成为一种快速、 目的，和可扩展的临床辅助工具，通过指示一个 个体在一次或多次脑震荡后的听觉处理情况。

Abstract Because diagnostic criteria of concussion rely upon self-reporting—which may be unreliable in a recently concussed individual—the goal of this project is to identify a neural marker of concussion that does not require effort from the patient. Concussion adversely affects many domains and there is strong reason to believe, and preliminary data to support, that neural processing in the auditory system is negatively influenced by sports- related concussion. By using an objective electrophysiological measure of auditory processing, this work has strong potential to broaden the understanding of concussion's effect on sensory processing and to eliminate a major pitfall in diagnosis and management of concussion. This proposal uses a novel approach to understand the impact of head injury on sensory processing: the frequency-following response (FFR) to speech. The central hypothesis is this objective neurophysiological measure of auditory processing serves as a marker of disruptions to central nervous system function following concussion. In collaboration with Northwestern University Athletics, this is a prospective, longitudinal study of concussion and prolonged participation in contact/collision sports that follows ~500 student-athletes annually (~875 total) within and across sports seasons. In a typical year up to 15% of student-athletes are diagnosed with a concussion by a sports medicine physician. This provides a potent opportunity to investigate the impact of concussion on auditory processing in both the short-term (immediately after injury) and long-term (after a one- to four-year college athletic career). In the large group of non-concussed athletes, this project will establish whether, as hypothesized, auditory processing is more compromised over time in individuals participating in contact/collision sports. This project can elucidate the physiological mechanisms by which concussions and long-term participation in contact sports disrupt the central nervous system. The FFR will provide fine-grained insight into the nature of the physiological imprint of concussion. The longitudinal design in a large cohort provides powerful within- and between-subject controls for tracking head injuries and risk of injury based on sport in the short- and long-term stages, and opportunities for within-study replications. If successful, the FFR could one day serve as a fast, objective, and scalable clinical adjunct to assist in concussion diagnosis and management by indicating an individual's auditory processing profile following one or more concussions.