1
|
Fitzgerald B, Bari S, Vike N, Lee TA, Lycke RJ, Auger JD, Leverenz LJ, Nauman E, Goñi J, Talavage TM. Longitudinal changes in resting state fMRI brain self-similarity of asymptomatic high school American football athletes. Sci Rep 2024; 14:1747. [PMID: 38243048 PMCID: PMC10799081 DOI: 10.1038/s41598-024-51688-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 01/08/2024] [Indexed: 01/21/2024] Open
Abstract
American football has become the focus of numerous studies highlighting a growing concern that cumulative exposure to repetitive, sports-related head acceleration events (HAEs) may have negative consequences for brain health, even in the absence of a diagnosed concussion. In this longitudinal study, brain functional connectivity was analyzed in a cohort of high school American football athletes over a single play season and compared against participants in non-collision high school sports. Football athletes underwent four resting-state functional magnetic resonance imaging sessions: once before (pre-season), twice during (in-season), and once 34-80 days after the contact activities play season ended (post-season). For each imaging session, functional connectomes (FCs) were computed for each athlete and compared across sessions using a metric reflecting the (self) similarity between two FCs. HAEs were monitored during all practices and games throughout the season using head-mounted sensors. Relative to the pre-season scan session, football athletes exhibited decreased FC self-similarity at the later in-season session, with apparent recovery of self-similarity by the time of the post-season session. In addition, both within and post-season self-similarity was correlated with cumulative exposure to head acceleration events. These results suggest that repetitive exposure to HAEs produces alterations in functional brain connectivity and highlight the necessity of collision-free recovery periods for football athletes.
Collapse
Affiliation(s)
- Bradley Fitzgerald
- Elmore Family School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA.
| | - Sumra Bari
- Elmore Family School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
- Department of Computer Science, University of Cincinnati, Cincinnati, OH, USA
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA
| | - Nicole Vike
- Department of Computer Science, University of Cincinnati, Cincinnati, OH, USA
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA
- Department of Basic Medical Sciences, Purdue University, West Lafayette, IN, USA
| | - Taylor A Lee
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA
| | - Roy J Lycke
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA
- Department of Electrical and Computer Engineering, Rice University, Houston, TX, USA
| | - Joshua D Auger
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA
| | - Larry J Leverenz
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, USA
| | - Eric Nauman
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA
- Department of Basic Medical Sciences, Purdue University, West Lafayette, IN, USA
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Joaquín Goñi
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
- School of Industrial Engineering, Purdue University, West Lafayette, IN, USA
- Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, USA
| | - Thomas M Talavage
- Elmore Family School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| |
Collapse
|
2
|
Brett BL, Cohen AD, McCrea MA, Wang Y. Longitudinal alterations in cerebral perfusion following a season of adolescent contact sport participation compared to non-contact athletes. Neuroimage Clin 2023; 40:103538. [PMID: 37956583 PMCID: PMC10666028 DOI: 10.1016/j.nicl.2023.103538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 11/03/2023] [Accepted: 11/05/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Cerebral blood flow (CBF) change, a non-invasive marker of head injury, has yet to be thoroughly investigated as a potential consequence of repetitive head impacts (RHI) via contact sport participation in youth athletes. We examined pre-to post-season differences in relative CBF (rCBF), arterial transit time (ATT), and neurocognition between adolescent contact sport (CS; 79.4% of which were football players) and non-contact sport (NCS) athletes. METHODS Adolescent athletes (N = 57; age = 14.70 ± 1.97) completed pre- and post-season clinical assessments and neuroimaging. Brain perfusion was evaluated using an advanced 3D pseudo-continuous ASL sequence with Hadamard encoded multiple post-labeling delays. Mixed-effect models tested group-by-time interactions for rCBF, ATT, and neurocognition. RESULTS A significant group-by-time interaction was observed for rCBF in a cluster consisting primarily of frontal and parietal lobe regions, with regional rCBF increasing in CS and decreasing among NCS athletes. No significant interaction was observed for ATT. A significant group-by-time interaction was observed for verbal memory and visual motor speed, with NCS athletes improving and CS athletes exhibiting lower performance from pre-to post-season in comparison. CONCLUSIONS Alterations in rCBF and variability in cognition, not purported neurovasculature changes (measured by ATT), were observed following one season of CS participation. Further study surrounding the clinical meaningfulness of these findings, as they related to adverse long-term outcomes, is needed.
Collapse
Affiliation(s)
- Benjamin L Brett
- Medical College of Wisconsin, Department of Neurosurgery, United States.
| | - Alex D Cohen
- Medical College of Wisconsin, Department of Radiology, United States
| | - Michael A McCrea
- Medical College of Wisconsin, Department of Neurosurgery, United States
| | - Yang Wang
- Medical College of Wisconsin, Department of Radiology, United States.
| |
Collapse
|
3
|
Smith JL, Diekfuss JA, Dudley JA, Ahluwalia V, Zuleger TM, Slutsky-Ganesh AB, Yuan W, Foss KDB, Gore RK, Myer GD, Allen JW. Visuo-vestibular and cognitive connections of the vestibular neuromatrix are conserved across age and injury populations. J Neuroimaging 2023; 33:1003-1014. [PMID: 37303280 DOI: 10.1111/jon.13136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND AND PURPOSE Given the prevalence of vestibular dysfunction in pediatric concussion, there is a need to better understand pathophysiological disruptions within vestibular and associated cognitive, affective, and sensory-integrative networks. Although current research leverages established intrinsic connectivity networks, these are nonspecific for vestibular function, suggesting that a pathologically guided approach is warranted. The purpose of this study was to evaluate the generalizability of the previously identified "vestibular neuromatrix" in adults with and without postconcussive vestibular dysfunction to young athletes aged 14-17. METHODS This retrospective study leveraged resting-state functional MRI data from two sites. Site A included adults with diagnosed postconcussive vestibular impairment and healthy adult controls and Site B consisted of young athletes with preseason, postconcussion, and postseason time points (prospective longitudinal data). Adjacency matrices were generated from preprocessed resting-state data from each sample and assessed for overlap and network structure in MATLAB. RESULTS Analyses indicated the presence of a conserved "core" network of vestibular regions as well as areas subserving visual, spatial, and attentional processing. Other vestibular connections were also conserved across samples but were not linked to the "core" subnetwork by regions of interest included in this study. CONCLUSIONS Our results suggest that connections between central vestibular, visuospatial, and known intrinsic connectivity networks are conserved across adult and pediatric participants with and without concussion, evincing the significance of this expanded, vestibular-associated network. Our findings thus support this network as a workable model for investigation in future studies of dysfunction in young athlete populations.
Collapse
Affiliation(s)
- Jeremy L Smith
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jed A Diekfuss
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
- Emory Sports Medicine Center, Atlanta, Georgia, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jonathan A Dudley
- Pediatric Neuroimaging Research Consortium, Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Vishwadeep Ahluwalia
- Georgia State University/Georgia Tech Center for Advanced Brain Imaging (CABI), Atlanta, Georgia, USA
| | - Taylor M Zuleger
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
- Emory Sports Medicine Center, Atlanta, Georgia, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, USA
- Neuroscience Graduate Program, University of Cincinnati, Cincinnati, Ohio, USA
| | - Alexis B Slutsky-Ganesh
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Weihong Yuan
- Pediatric Neuroimaging Research Consortium, Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Kim D Barber Foss
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
| | - Russell K Gore
- Mild TBI Brain Health and Recovery Lab, Shepherd Center, Atlanta, Georgia, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA
| | - Gregory D Myer
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
- Emory Sports Medicine Center, Atlanta, Georgia, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, USA
- Youth Physical Development Centre, Cardiff Metropolitan University, Wales, UK
| | - Jason W Allen
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| |
Collapse
|
4
|
Fickling SD, Poel DN, Dorman JC, D’Arcy RCN, Munce TA. Subconcussive changes in youth football players: objective evidence using brain vital signs and instrumented accelerometers. Brain Commun 2021; 4:fcab286. [PMID: 35291689 PMCID: PMC8914875 DOI: 10.1093/braincomms/fcab286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/05/2021] [Accepted: 10/11/2021] [Indexed: 11/25/2022] Open
Abstract
Brain vital signs, measured by EEG, were used for portable, objective,
neurophysiological evaluation of cognitive function in youth tackle football
players. Specifically, we investigated whether previously reported pre- and
post-season subconcussive changes detected in youth ice hockey players were
comparably detected in football. The two objectives were to: (i) replicate
previously published results showing subconcussive cognitive deficits; and (ii)
the relationship between brain vital sign changes and head-impact exposure.
Using a longitudinal design, 15 male football players (age
12.89 ± 0.35 years) were tested pre- and
post-season, with none having a concussion diagnosis during the season. Peak
latencies and amplitudes were quantified for Auditory sensation (N100), Basic
attention (P300) and Cognitive processing (N400). Regression analyses tested the
relationships between these brain vital signs and exposure to head impacts
through both number of impacts sustained, and total sessions (practices and
games) participated. The results demonstrated significant pre/post differences
in N400 latencies, with ∼70 ms delay
(P < 0.01), replicating prior findings.
Regression analysis also showed significant linear relationships between brain
vital signs changes and head impact exposure based on accelerometer data and
games/practices played (highest
R = 0.863, P
< 0.001 for overall sessions). Number of head impacts in youth
football (age 12–14 years) findings corresponded most closely
with prior Junior-A ice hockey (age 16–21 years) findings,
suggesting comparable contact levels at younger ages in football. The predictive
relationship of brain vital signs provided a notable complement to instrumented
accelerometers, with a direct physiological measure of potential individual
exposure to subconcussive impacts.
Collapse
Affiliation(s)
- Shaun D Fickling
- Faculty of Sciences and Applied Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
- BrainNET, Health and Technology District, Surrey, BC V3V 0C6, Canada
- Center for Neurology Studies, HealthTech Connex, Surrey, BC V3V 0C6, Canada
| | - Daniel N Poel
- Sanford Sports Science Institute, Sanford Health, Sioux Falls, SD 57107, USA
- Environmental Influences on Health and Disease Group, Sanford Research, Sioux Falls, SD 57104, USA
| | - Jason C Dorman
- Sanford Sports Science Institute, Sanford Health, Sioux Falls, SD 57107, USA
- Environmental Influences on Health and Disease Group, Sanford Research, Sioux Falls, SD 57104, USA
| | - Ryan C N D’Arcy
- Faculty of Sciences and Applied Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
- BrainNET, Health and Technology District, Surrey, BC V3V 0C6, Canada
- Center for Neurology Studies, HealthTech Connex, Surrey, BC V3V 0C6, Canada
| | - Thayne A Munce
- Sanford Sports Science Institute, Sanford Health, Sioux Falls, SD 57107, USA
- Environmental Influences on Health and Disease Group, Sanford Research, Sioux Falls, SD 57104, USA
| |
Collapse
|
5
|
Chen A, Zhang Z, Cao C, Lu J, Wu S, Ma S, Feng Y, Wang S, Xu G, Song J. Altered Attention Network in Paratroopers Exposed to Repetitive Subconcussion: Evidence Based on Behavioral and Event-Related Potential Results. J Neurotrauma 2021; 38:3306-3314. [PMID: 34549595 DOI: 10.1089/neu.2021.0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Cognitive impairment caused by repetitive subconcussion has received increasing attention in recent years. Although the dysfunction of attention has been confirmed by neuropsychological research using scales, there is no event-related potentials (ERPs) research. The Attention Network Test (ANT) has been widely used to evaluate the three separate components of attention processing (alerting, orienting, and executive control). Twenty-seven paratroopers exposed to repetitive subconcussion (subconcussion group) and 25 matched healthy control participants (HCs group) were enrolled, and all of them performed the ANT test while continuous scalp electroencephalography data were recorded. On the behavioral performance level, the subconcussion group showed a slower task response, with an especially significant slower reaction time in alerting. Concerning ERP results, reduction amplitudes of cue-N1 in the alerting network were observed, indicating that this group was less able to make efficient use of cues and maintain an alerting state for incoming information. For the orienting network, no difference in N1 amplitude was observed between the two groups. Moreover, there was a reduced P3 amplitude in the executive control network in the subconcussion group compared with the HCs group, suggesting a dysfunction of attentional resource allocation and inhibition control in the former group. This study is, to our knowledge, the first analysis of the altered attention network caused by repetitive subconcussion from the perspectives of behavioral and neuropsychology levels. These preliminary results revealed the possible damage of the alerting and executive control networks and provided a reference for further research on subconcussion cognitive impairment.
Collapse
Affiliation(s)
- Aobo Chen
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan, China
| | - Zhihao Zhang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan, China
| | - Chenglong Cao
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan, China.,Department of Cognitive Neuroscience, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jinjiang Lu
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan, China
| | - Shukai Wu
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan, China
| | - Shenghui Ma
- Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan, China.,Medical College, Wuhan University of Science and Technology, Wuhan, China
| | - Yu Feng
- Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan, China.,Medical College, Wuhan University of Science and Technology, Wuhan, China
| | - Shuochen Wang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan, China
| | - Guozheng Xu
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan, China
| | - Jian Song
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan, China
| |
Collapse
|
6
|
DeSimone JC, Davenport EM, Urban J, Xi Y, Holcomb JM, Kelley ME, Whitlow CT, Powers AK, Stitzel JD, Maldjian JA. Mapping default mode connectivity alterations following a single season of subconcussive impact exposure in youth football. Hum Brain Mapp 2021; 42:2529-2545. [PMID: 33734521 PMCID: PMC8090779 DOI: 10.1002/hbm.25384] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 12/14/2022] Open
Abstract
Repetitive head impact (RHI) exposure in collision sports may contribute to adverse neurological outcomes in former players. In contrast to a concussion, or mild traumatic brain injury, “subconcussive” RHIs represent a more frequent and asymptomatic form of exposure. The neural network‐level signatures characterizing subconcussive RHIs in youth collision‐sport cohorts such as American Football are not known. Here, we used resting‐state functional MRI to examine default mode network (DMN) functional connectivity (FC) following a single football season in youth players (n = 50, ages 8–14) without concussion. Football players demonstrated reduced FC across widespread DMN regions compared with non‐collision sport controls at postseason but not preseason. In a subsample from the original cohort (n = 17), players revealed a negative change in FC between preseason and postseason and a positive and compensatory change in FC during the offseason across the majority of DMN regions. Lastly, significant FC changes, including between preseason and postseason and between in‐ and off‐season, were specific to players at the upper end of the head impact frequency distribution. These findings represent initial evidence of network‐level FC abnormalities following repetitive, non‐concussive RHIs in youth football. Furthermore, the number of subconcussive RHIs proved to be a key factor influencing DMN FC.
Collapse
Affiliation(s)
- Jesse C. DeSimone
- Advanced Neuroscience Imaging Research (ANSIR) LaboratoryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
- Department of RadiologyUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Elizabeth M. Davenport
- Advanced Neuroscience Imaging Research (ANSIR) LaboratoryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
- Department of RadiologyUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Jillian Urban
- Department of Biomedical EngineeringWake Forest School of MedicineWinston SalemNorth CarolinaUSA
- Virginia Tech – Wake Forest School of Biomedical EngineeringWake Forest School of MedicineWinston SalemNorth CarolinaUSA
| | - Yin Xi
- Department of RadiologyUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - James M. Holcomb
- Advanced Neuroscience Imaging Research (ANSIR) LaboratoryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
- Department of RadiologyUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Mireille E. Kelley
- Department of Biomedical EngineeringWake Forest School of MedicineWinston SalemNorth CarolinaUSA
- Virginia Tech – Wake Forest School of Biomedical EngineeringWake Forest School of MedicineWinston SalemNorth CarolinaUSA
| | - Christopher T. Whitlow
- Virginia Tech – Wake Forest School of Biomedical EngineeringWake Forest School of MedicineWinston SalemNorth CarolinaUSA
- Department of Radiology – NeuroradiologyWake Forest School of MedicineWinston SalemNorth CarolinaUSA
- Clinical and Translational Sciences InstituteWake Forest School of MedicineWinston SalemNorth CarolinaUSA
| | - Alexander K. Powers
- Department of NeurosurgeryWake Forest School of MedicineWinston SalemNorth CarolinaUSA
| | - Joel D. Stitzel
- Department of Biomedical EngineeringWake Forest School of MedicineWinston SalemNorth CarolinaUSA
- Virginia Tech – Wake Forest School of Biomedical EngineeringWake Forest School of MedicineWinston SalemNorth CarolinaUSA
- Clinical and Translational Sciences InstituteWake Forest School of MedicineWinston SalemNorth CarolinaUSA
- Childress Institute for Pediatric TraumaWake Forest School of MedicineWinston SalemNorth CarolinaUSA
| | - Joseph A. Maldjian
- Advanced Neuroscience Imaging Research (ANSIR) LaboratoryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
- Department of RadiologyUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| |
Collapse
|