Understanding the neurodevelopmental effects of youth tackle football participation

摘要 争抢足球和其他接触性运动的潜在长期影响已经创造了重大的公共健康 对儿童参与的风险的担忧。考虑到具有追溯性和横断性的 之前的工作，关于青少年参与铲球和足球的因果关系存在严重的知识差距 随后的临床结果，排除了患者和政策层面的决策。此外，还可以修改 风险因素(例如，神经肌肉控制)可能会影响与足球相关的暴露，从而影响结果 神经创伤，但预防仍未得到充分研究。在这里，我们克服了以前取得进展的一些障碍 在这一领域，通过为运动员在开始他们的第一个赛季的阻截足球和 在参与的第一年纵向跟踪他们。我们得到了俄亥俄州立大学慢性病基金的资助 脑损伤计划，并成功收集了50名青少年铲球运动员(8-12岁)的试点数据； 这些数据构成了我们当前提案的基础。目标1将确定更多接触足球的风险因素- 相关的神经创伤。我们将在一年级青少年铲球比赛中测量与足球相关的神经创伤暴露。 球员在所有练习和比赛中使用仪表式护口器。我们将使用手持测功机来 测量颈部力量，并通过视觉、前庭和反应时间测量神经肌肉控制 测试。目的2确定足球相关神经创伤暴露对大鼠神经发育的影响 以前没有接触过铲球的儿童。我们将招收已注册但尚未注册的儿童 还没有开始参加青少年铲球足球，以及注册参加非接触性运动的儿童和儿童 不参加任何运动。目标2a将决定认知功能和大脑结构的短期变化 从季前赛到季后赛足球相关神经创伤暴露所致的功能障碍。目标2b将 通过在休赛期检查球员来确定参加比赛的第一年的长期变化 就在下个赛季开始之前。目标2c将确定哪些因素(例如，与足球有关的神经创伤 暴露、暴露于不良童年事件、先前存在的神经发育障碍)有助于 与典型发展的不同。我们假设青少年踢足球会让孩子们暴露在重复的环境中 神经快速发育期的神经创伤，导致可见的认知障碍和 大脑的结构和功能变化，很可能是在注意力控制网络中。我们的建议结合了 一种最先进的方法来确定足球相关的神经创伤对神经发育的影响， 与俄亥俄州的青年体育项目进行富有成效的合作，社区参与和外联，以及 多学科专家团队。这些发现的社会和临床影响怎么强调都不为过。在……里面 量化足球相关神经创伤暴露(目标1)及其对神经发育的影响(目标2) 青少年参与铲球第一年，我们的预期结果将告知社区利益相关者 以及政策制定者对儿童参与青少年铲球足球的成本和收益进行评估。

ABSTRACT Potential long-term effects of tackle football and other contact sports have created significant public health concerns about the risk of childhood participation. Considering the retrospective and cross-sectional nature of prior work, there are critical knowledge gaps regarding the causality of youth tackle football participation and subsequent clinical outcomes that preclude decision-making at the patient and policy level. Further, modifiable risk factors (e.g., neuromuscular control) may influence exposure to and thus, outcomes from football-related neurotrauma, but prevention remains understudied. Here we overcome some of the previous barriers to progress in this field by acquiring a “true baseline” for athletes before they begin their first season of tackle football and following them longitudinally across the first year of participation. We received funding from Ohio State’s Chronic Brain Injury Program and successfully collected pilot data on 50 youth tackle football players (ages 8-12 years); these data form the basis of our current proposal. Aim 1 will identify risk factors for higher exposure to football- related neurotrauma. We will measure football-related neurotrauma exposure in first-year youth tackle football players during all practices and games using instrumented mouthguards. We will use handheld dynamometry to measure neck strength and will measure neuromuscular control through visual, vestibular, and reaction time testing. Aim 2 will determine the effects of football-related neurotrauma exposure on neurodevelopment in children with no previous tackle football exposure. We will enroll children who are registered for, but have not yet begun participating in youth tackle football, as well as children registered for non-contact sports and children not playing any sports. Aim 2a will determine short-term changes in cognitive function and brain structure and function caused by football-related neurotrauma exposure from pre-season to post-season. Aim 2b will determine longer-term changes across the first year of participation by examining players during the off-season just prior to the start of the next season. Aim 2c will determine what factors (e.g., football-related neurotrauma exposure, exposure to adverse childhood events, pre-existing neurodevelopmental disorders) contribute to differences from typical development. We hypothesize that youth tackle football exposes children to repetitive neurotrauma during a period of rapid neurodevelopment, resulting in observable cognitive impairments and structural and functional changes in the brain, most likely in attentional control networks. Our proposal combines a state-of-the-art approach to determining the effects of football-related neurotrauma on neurodevelopment, a productive collaboration with youth sports programs in Ohio, community engagement and outreach, and a multidisciplinary team of experts. The societal and clinical impact of these findings cannot be overstated. In quantifying football-related neurotrauma exposure (Aim 1) and its effects on neurodevelopment (Aim 2) across the first year of youth tackle football participation, our expected outcomes will inform community stakeholders and policy-makers in their appraisal of the cost and benefit of children participating in youth tackle football.