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Jain D, Porfido T, de Souza NL, Brown AM, Caccese JB, Czykier A, Dennis EL, Tosto-Mancuso J, Wilde EA, Esopenko C. Neural Mechanisms Associated With Postural Control in Collegiate Soccer and Non-Soccer Athletes. J Neurol Phys Ther 2024; 48:151-158. [PMID: 38709008 DOI: 10.1097/npt.0000000000000476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 01/15/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND AND PURPOSE Sport-specific training may improve postural control, while repetitive head acceleration events (RHAEs) may compromise it. Understanding the neural mechanisms underlying postural control may contextualize changes due to training and RHAE. The goal of this study was to determine whether postural sway during the Balance Error Scoring System (BESS) is related to white matter organization (WMO) in collegiate athletes. METHODS Collegiate soccer ( N = 33) and non-soccer athletes ( N = 44) completed BESS and diffusion tensor imaging. Postural sway during each BESS stance, fractional anisotropy (FA), and mean diffusivity (MD) were extracted for each participant. Partial least squares analyses determined group differences in postural sway and WMO and the relationship between postural sway and WMO in soccer and non-soccer athletes separately. RESULTS Soccer athletes displayed better performance during BESS 6, with lower FA and higher MD in the medial lemniscus (ML) and inferior cerebellar peduncle (ICP), compared to non-soccer athletes. In soccer athletes, lower sway during BESS 2, 5, and 6 was associated with higher FA and lower MD in the corticospinal tract, ML, and ICP. In non-soccer athletes, lower sway during BESS 2 and 4 was associated with higher FA and lower MD in the ML and ICP. BESS 1 was associated with higher FA, and BESS 3 was associated with lower MD in the same tracts in non-soccer athletes. DISCUSSION AND CONCLUSIONS Soccer and non-soccer athletes showed unique relationships between sway and WMO, suggesting that sport-specific exposures are partly responsible for changes in neurological structure and accompanying postural control performance and should be considered when evaluating postural control after injury.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content, available at: http://links.lww.com/JNPT/A472 ).
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Affiliation(s)
- Divya Jain
- Divya Jain and Tara Porfido are considering as co-first authors. Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York City, New York (D.J., N.L.D., A.C., C.E.); Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, New Jersey (T.P., A.M.B.); School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, Ohio (J.B.C.); Department of Neurology, University of Utah (E.L.D., E.A.W.); George E. Wahlen Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah (E.L.D., E.A.W.); and Abilities Research Center, Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York City, New York (J.T.-M.)
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2
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Bouvette V, Petit Y, De Beaumont L, Guay S, Vinet SA, Wagnac E. American Football On-Field Head Impact Kinematics: Influence of Acceleration Signal Characteristics on Peak Maximal Principal Strain. Ann Biomed Eng 2024:10.1007/s10439-024-03514-z. [PMID: 38758459 DOI: 10.1007/s10439-024-03514-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/28/2024] [Indexed: 05/18/2024]
Abstract
Recorded head kinematics from head-impact measurement devices (HIMd) are pivotal for evaluating brain stress and strain through head finite element models (hFEM). The variability in kinematic recording windows across HIMd presents challenges as they yield inconsistent hFEM responses. Despite establishing an ideal recording window for maximum principal strain (MPS) in brain tissue, uncertainties persist about the impact characteristics influencing vulnerability when this window is shortened. This study aimed to scrutinize factors within impact kinematics affecting the reliability of different recording windows on whole-brain peak MPS using a validated hFEM. Utilizing 53 on-field head impacts recorded via an instrumented mouthguard during a Canadian varsity football game, 10 recording windows were investigated with varying pre- and post-impact-trigger durations. Tukey pair-wise comparisons revealed no statistically significant differences in MPS responses for the different recording windows. However, specific impacts showed marked variability up to 40%. It was found, through correlation analyses, that impacts with lower peak linear acceleration exhibited greater response variability across different pre-trigger durations. Signal shape, analyzed through spectral analysis, influenced the time required for MPS development, resulting in specific impacts requiring a prolonged post-trigger duration. This study adds to the existing consensus on standardizing HIMd acquisition time windows and sheds light on impact characteristics leading to peak MPS variation across different head impact kinematic recording windows. Considering impact characteristics in research assessments is crucial, as certain impacts, affected by recording duration, may lead to significant errors in peak MPS responses during cumulative longitudinal exposure assessments.
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Affiliation(s)
- Véronique Bouvette
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame Street West, Montreal, QC, H3C 1K3, Canada.
- Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montreal, Canada.
- International Laboratory on Spine Imaging and Biomechanics, Montreal, Canada.
- International Laboratory on Spine Imaging and Biomechanics, Marseille, France.
| | - Y Petit
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame Street West, Montreal, QC, H3C 1K3, Canada
- Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montreal, Canada
- International Laboratory on Spine Imaging and Biomechanics, Montreal, Canada
- International Laboratory on Spine Imaging and Biomechanics, Marseille, France
| | - L De Beaumont
- Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montreal, Canada
- Department of Surgery, Université de Montréal, Montreal, Canada
| | - S Guay
- Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - S A Vinet
- Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - E Wagnac
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame Street West, Montreal, QC, H3C 1K3, Canada
- Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montreal, Canada
- International Laboratory on Spine Imaging and Biomechanics, Montreal, Canada
- International Laboratory on Spine Imaging and Biomechanics, Marseille, France
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Mavroudis I, Balmus IM, Ciobica A, Luca AC, Gorgan DL, Dobrin I, Gurzu IL. A Review of the Most Recent Clinical and Neuropathological Criteria for Chronic Traumatic Encephalopathy. Healthcare (Basel) 2023; 11:1689. [PMID: 37372807 DOI: 10.3390/healthcare11121689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/19/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Background: Chronic traumatic encephalopathy (CTE) is a complex pathological condition characterized by neurodegeneration, as a result of repeated head traumas. Currently, the diagnosis of CTE can only be assumed postmortem. Thus, the clinical manifestations associated with CTE are referred to as traumatic encephalopathy syndrome (TES), for which diagnostic multiple sets of criteria can be used. (2) Objectives: In this study, we aimed to present and discuss the limitations of the clinical and neuropathological diagnostic criteria for TES/CTE and to suggest a diagnostic algorithm enabling a more accurate diagnostic procedure. (3) Results: The most common diagnostic criteria for TES/CTE discriminate between possible, probable, and improbable. However, several key variations between the available diagnostic criteria suggest that the diagnosis of CTE can still only be given with postmortem neurophysiological examination. Thus, a TES/CTE diagnosis during life imposes a different level of certainty. Here, we are proposing a comprehensive algorithm of diagnosis criteria for TES/CTE based on the similarities and differences between the previous criteria. (4) Conclusions: The diagnosis of TES/CTE requires a multidisciplinary approach; thorough investigation for other neurodegenerative disorders, systemic illnesses, and/or psychiatric conditions that can account for the symptoms; and also complex investigations of patient history, psychiatric assessment, and blood and cerebrospinal fluid biomarker evaluation.
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Affiliation(s)
- Ioannis Mavroudis
- Department of Neurology, Leeds Teaching Hospitals NHS Trust and Leeds University, Leeds LS9 7TF, UK
| | - Ioana-Miruna Balmus
- Department of Exact Sciences and Natural Sciences, Institute of Interdisciplinary Research, Alexandru Ioan Cuza University of Iasi, Alexandru Lapusneanu Street, No. 26, 700057 Iasi, Romania
| | - Alin Ciobica
- Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University of Iasi, B dul Carol I, No. 11, 700506 Iasi, Romania
| | - Alina-Costina Luca
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania
| | - Dragos Lucian Gorgan
- Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University of Iasi, B dul Carol I, No. 11, 700506 Iasi, Romania
| | - Irina Dobrin
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania
| | - Irina Luciana Gurzu
- Department of Preventive Medicine and Interdisciplinarity, Discipline of Occupational Medicine, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania
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4
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Koerte IK, Wiegand TLT, Bonke EM, Kochsiek J, Shenton ME. Diffusion Imaging of Sport-related Repetitive Head Impacts-A Systematic Review. Neuropsychol Rev 2023; 33:122-143. [PMID: 36508043 PMCID: PMC9998592 DOI: 10.1007/s11065-022-09566-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 11/10/2022] [Indexed: 12/14/2022]
Abstract
Repetitive head impacts (RHI) are commonly observed in athletes participating in contact sports such as American football, ice hockey, and soccer. RHI usually do not result in acute symptoms and are therefore often referred to as subclinical or "subconcussive" head impacts. Epidemiological studies report an association between exposure to RHI and an increased risk for the development of neurodegenerative diseases. Diffusion magnetic resonance imaging (dMRI) has emerged as particularly promising for the detection of subtle alterations in brain microstructure following exposure to sport-related RHI. The purpose of this study was to perform a systematic review of studies investigating the effects of exposure to RHI on brain microstructure using dMRI. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to determine studies that met inclusion and exclusion criteria across three databases. Seventeen studies were identified and critically evaluated. Results from these studies suggest an association between white matter alterations and RHI exposure in youth and young adult athletes. The most consistent finding across studies was lower or decreased fractional anisotropy (FA), a measure of the directionality of the diffusion of water molecules, associated with greater exposure to sport-related RHI. Whether decreased FA is associated with functional outcome (e.g., cognition) in those exposed to RHI is yet to be determined. This review further identified areas of importance for future research to increase the diagnostic and prognostic value of dMRI in RHI and to improve our understanding of the effects of RHI on brain physiology and microstructure.
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Affiliation(s)
- Inga K Koerte
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany. .,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Mass General Brigham, Harvard Medical School, Boston, MA, 02115, USA. .,Graduate School of Systemic Neurosciences, Ludwig-Maximilians-Universität, Munich, Germany.
| | - Tim L T Wiegand
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany.,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Mass General Brigham, Harvard Medical School, Boston, MA, 02115, USA
| | - Elena M Bonke
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany.,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Mass General Brigham, Harvard Medical School, Boston, MA, 02115, USA.,Graduate School of Systemic Neurosciences, Ludwig-Maximilians-Universität, Munich, Germany
| | - Janna Kochsiek
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany.,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Mass General Brigham, Harvard Medical School, Boston, MA, 02115, USA
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Mass General Brigham, Harvard Medical School, Boston, MA, 02115, USA.,Department of Radiology, Brigham and Women's Hospital, Mass General Brigham, Harvard Medical School, Boston, MA, USA
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McDonald MA, Holdsworth SJ, Danesh-Meyer HV. Eye Movements in Mild Traumatic Brain Injury: Ocular Biomarkers. J Eye Mov Res 2022; 15:10.16910/jemr.15.2.4. [PMID: 36439911 PMCID: PMC9682364 DOI: 10.16910/jemr.15.2.4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
Mild traumatic brain injury (mTBI, or concussion), results from direct and indirect trauma to the head (i.e. a closed injury of transmitted forces), with or without loss of consciousness. The current method of diagnosis is largely based on symptom assessment and clinical history. There is an urgent need to identify an objective biomarker which can not only detect injury, but inform prognosis and recovery. Ocular motor impairment is argued to be ubiquitous across mTBI subtypes and may serve as a valuable clinical biomarker with the recent advent of more affordable and portable eye tracking technology. Many groups have positively correlated the degree of ocular motor impairment to symptom severity with a minority attempting to validate these findings with diffusion tract imaging and functional MRI. However, numerous methodological issues limit the interpretation of results, preventing any singular ocular biomarker from prevailing. This review will comprehensively describe the anatomical susceptibility, clinical measurement, and current eye tracking literature surrounding saccades, smooth pursuit, vestibulo-ocular reflex, vergence, pupillary light reflex, and accommodation in mTBI.
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Affiliation(s)
- Matthew A McDonald
- Department of Ophthalmology, University of Auckland, New Zealand
- Mātai Medical Research Institute, Gisborne, New Zealand
| | - Samantha J Holdsworth
- Department of Anatomy and Medical Imaging, University of Auckland, New Zealand
- Mātai Medical Research Institute, Gisborne, New Zealand
| | - Helen V Danesh-Meyer
- Department of Ophthalmology, University of Auckland, New Zealand
- Eye Institute, Auckland, New Zealand
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Mavroudis I, Kazis D, Chowdhury R, Petridis F, Costa V, Balmus IM, Ciobica A, Luca AC, Radu I, Dobrin RP, Baloyannis S. Post-Concussion Syndrome and Chronic Traumatic Encephalopathy: Narrative Review on the Neuropathology, Neuroimaging and Fluid Biomarkers. Diagnostics (Basel) 2022; 12:diagnostics12030740. [PMID: 35328293 PMCID: PMC8947595 DOI: 10.3390/diagnostics12030740] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 01/08/2023] Open
Abstract
Traumatic brain injury is a significant public health issue and represents the main contributor to death and disability globally among all trauma-related injuries. Martial arts practitioners, military veterans, athletes, victims of physical abuse, and epileptic patients could be affected by the consequences of repetitive mild head injuries (RMHI) that do not resume only to short-termed traumatic brain injuries (TBI) effects but also to more complex and time-extended outcomes, such as post-concussive syndrome (PCS) and chronic traumatic encephalopathy (CTE). These effects in later life are not yet well understood; however, recent studies suggested that even mild head injuries can lead to an elevated risk of later-life cognitive impairment and neurodegenerative disease. While most of the PCS hallmarks consist in immediate consequences and only in some conditions in long-termed processes undergoing neurodegeneration and impaired brain functions, the neuropathological hallmark of CTE is the deposition of p-tau immunoreactive pre-tangles and thread-like neurites at the depths of cerebral sulci and neurofibrillary tangles in the superficial layers I and II which are also one of the main hallmarks of neurodegeneration. Despite different CTE diagnostic criteria in clinical and research approaches, their specificity and sensitivity remain unclear and CTE could only be diagnosed post-mortem. In CTE, case risk factors include RMHI exposure due to profession (athletes, military personnel), history of trauma (abuse), or pathologies (epilepsy). Numerous studies aimed to identify imaging and fluid biomarkers that could assist diagnosis and probably lead to early intervention, despite their heterogeneous outcomes. Still, the true challenge remains the prediction of neurodegeneration risk following TBI, thus in PCS and CTE. Further studies in high-risk populations are required to establish specific, preferably non-invasive diagnostic biomarkers for CTE, considering the aim of preventive medicine.
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Affiliation(s)
- Ioannis Mavroudis
- Department of Neuroscience, Leeds Teaching Hospitals, NHS Trust, Leeds LS2 9JT, UK; (I.M.); (R.C.)
- Laboratory of Neuropathology and Electron Microscopy, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece; (V.C.); (S.B.)
- Research Institute for Alzheimer’s Disease and Neurodegenerative Diseases, Heraklion Langada, 57200 Thessaloniki, Greece
| | - Dimitrios Kazis
- Third Department of Neurology, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece; (D.K.); (F.P.)
| | - Rumana Chowdhury
- Department of Neuroscience, Leeds Teaching Hospitals, NHS Trust, Leeds LS2 9JT, UK; (I.M.); (R.C.)
| | - Foivos Petridis
- Third Department of Neurology, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece; (D.K.); (F.P.)
| | - Vasiliki Costa
- Laboratory of Neuropathology and Electron Microscopy, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece; (V.C.); (S.B.)
| | - Ioana-Miruna Balmus
- Department of Exact Sciences and Natural Sciences, Institute of Interdisciplinary Research, “Alexandru Ioan Cuza” University of Iași, 700057 Iași, Romania;
| | - Alin Ciobica
- Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University, 700506 Iași, Romania
- Correspondence: (A.C.); (A.-C.L.); (R.P.D.)
| | - Alina-Costina Luca
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania;
- Correspondence: (A.C.); (A.-C.L.); (R.P.D.)
| | - Iulian Radu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania;
| | - Romeo Petru Dobrin
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania;
- Correspondence: (A.C.); (A.-C.L.); (R.P.D.)
| | - Stavros Baloyannis
- Laboratory of Neuropathology and Electron Microscopy, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece; (V.C.); (S.B.)
- Research Institute for Alzheimer’s Disease and Neurodegenerative Diseases, Heraklion Langada, 57200 Thessaloniki, Greece
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7
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Career Head Impact Exposure Profile of Canadian University Football Players. J Appl Biomech 2022; 38:47-57. [PMID: 35045388 DOI: 10.1123/jab.2020-0228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/03/2021] [Accepted: 12/08/2021] [Indexed: 11/18/2022]
Abstract
This study quantified head impact exposures for Canadian university football players over their varsity career. Participants included 63 players from one team that participated in a minimum of 3 seasons between 2013 and 2018. A total of 127,192 head impacts were recorded from 258 practices and 65 games. The mean (SD) number of career impacts across all positions was 2023.1 (1296.4), with an average of 37.1 (20.3) impacts per game and 7.4 (4.4) impacts per practice. The number of head impacts that players experienced during their careers increased proportionally to the number of athletic exposures (P < .001, r = .57). Linebackers and defensive and offensive linemen experienced significantly more head impacts than defensive backs, quarterbacks, and wide receivers (P ≤ .014). Seniority did not significantly affect the number of head impacts a player experienced. Mean linear acceleration increased with years of seniority within defensive backs and offensive linemen (P ≤ .01). Rotational velocity increased with years of seniority within defensive backs, defensive and offensive linemen, running backs, and wide receivers (P < .05). These data characterize career metrics of head impact exposure for Canadian university football players and provide insights to reduce head impacts through rule modifications and contact regulations.
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Brooks JS, Allison W, Harriss A, Bian K, Mao H, Dickey JP. Purposeful Heading Performed by Female Youth Soccer Players Leads to Strain Development in Deep Brain Structures. Neurotrauma Rep 2021; 2:354-362. [PMID: 34901935 PMCID: PMC8655815 DOI: 10.1089/neur.2021.0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Head impacts in soccer have been associated with both short- and long-term neurological consequences. Youth players' brains are especially vulnerable given that their brains are still developing, and females are at an increased risk of traumatic brain injury (TBI) compared to males. Approximately 90% of head impacts in soccer occur from purposeful heading. Accordingly, this study assessed the relationship between kinematic variables and brain strain during purposeful headers in female youth soccer players. A convenience sample of 36 youth female soccer players (13.4 [0.9] years of age) from three elite youth soccer teams wore wireless sensors to quantify head impact magnitudes during games. Purposeful heading events were categorized by game scenario (e.g., throw-in, goal kick) for 60 regular season games (20 games per team). A total of 434 purposeful headers were identified. Finite element model simulations were performed to calculate average peak maximum principal strain (APMPS) in the corpus callosum, thalamus, and brainstem on a subset of 110 representative head impacts. Rotational velocity was strongly associated with APMPS in these three regions of the brain (r = 0.83-0.87). Linear acceleration was weakly associated with APMPS (r = 0.13-0.31). Game scenario did not predict APMPS during soccer games (p > 0.05). Results demonstrated considerable APMPS in the corpus callosum (mean = 0.102) and thalamus (mean = 0.083). In addition, the results support the notion that rotational velocity is a better predictor of brain strain than linear acceleration and may be a potential indicator of changes to the brain.
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Affiliation(s)
- Jeffrey S. Brooks
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Wayne Allison
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Alexandra Harriss
- Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Kewei Bian
- Department of Mechanical and Materials Engineering, Faculty of Engineering, Western University, London, Ontario, Canada
| | - Haojie Mao
- Department of Mechanical and Materials Engineering, Faculty of Engineering, Western University, London, Ontario, Canada
- School of Biomedical Engineering, Western University, London, Ontario, Canada
| | - James P. Dickey
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
- School of Biomedical Engineering, Western University, London, Ontario, Canada
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Chen H, Kevala K, Aflaki E, Marugan J, Kim HY. GPR110 ligands reduce chronic optic tract gliosis and visual deficit following repetitive mild traumatic brain injury in mice. J Neuroinflammation 2021; 18:157. [PMID: 34273979 PMCID: PMC8286622 DOI: 10.1186/s12974-021-02195-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/16/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Repetitive mild traumatic brain injury (mTBI) can result in chronic visual dysfunction. G-protein receptor 110 (GPR110, ADGRF1) is the target receptor of N-docosahexaenoylethanolamine (synaptamide) mediating the anti-neuroinflammatory function of synaptamide. In this study, we evaluated the effect of an endogenous and a synthetic ligand of GPR110, synaptamide and (4Z,7Z,10Z,13Z,16Z,19Z)-N-(2-hydroxy-2-methylpropyl) docosa-4,7,10,13,16,19-hexaenamide (dimethylsynaptamide, A8), on the mTBI-induced long-term optic tract histopathology and visual dysfunction using Closed-Head Impact Model of Engineered Rotational Acceleration (CHIMERA), a clinically relevant model of mTBI. METHODS The brain injury in wild-type (WT) and GPR110 knockout (KO) mice was induced by CHIMERA applied daily for 3 days, and GPR110 ligands were intraperitoneally injected immediately following each impact. The expression of GPR110 and proinflammatory mediator tumor necrosis factor (TNF) in the brain was measured by using real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) in an acute phase. Chronic inflammatory responses in the optic tract and visual dysfunction were assessed by immunostaining for Iba-1 and GFAP and visual evoked potential (VEP), respectively. The effect of GPR110 ligands in vitro was evaluated by the cyclic adenosine monophosphate (cAMP) production in primary microglia isolated from adult WT or KO mouse brains. RESULTS CHIMERA injury acutely upregulated the GPR110 and TNF gene level in mouse brain. Repetitive CHIMERA (rCHIMERA) increased the GFAP and Iba-1 immunostaining of glia cells and silver staining of degenerating axons in the optic tract with significant reduction of N1 amplitude of visual evoked potential at up to 3.5 months after injury. Both GPR110 ligands dose- and GPR110-dependently increased cAMP in cultured primary microglia with A8, a ligand with improved stability, being more effective than synaptamide. Intraperitoneal injection of A8 at 1 mg/kg or synaptamide at 5 mg/kg significantly reduced the acute expression of TNF mRNA in the brain and ameliorated chronic optic tract microgliosis, astrogliosis, and axonal degeneration as well as visual deficit caused by injury in WT but not in GPR110 KO mice. CONCLUSION Our data demonstrate that ligand-induced activation of the GPR110/cAMP system upregulated after injury ameliorates the long-term optic tract histopathology and visual impairment caused by rCHIMERA. Based on the anti-inflammatory nature of GPR110 activation, we suggest that GPR110 ligands may have therapeutic potential for chronic visual dysfunction associated with mTBI.
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Key Words
- A8 (4Z,7Z,10Z,13Z,16Z,19Z)-N-(2-hydroxy-2-methylpropyl) docosa-4,7,10,13,16,19-hexaenamide (dimethylsynaptamide)
- GPR110
- Histopathology
- Optic tract
- Synaptamide
- VEP
- Visual deficit
- mTBI
- repetitive CHIMERA
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Affiliation(s)
- Huazhen Chen
- Laboratory of Molecular Signaling, NIAAA, NIH, 5625 Fishers Lane, Rockville, MD, 20852, USA.,Center for Neuroscience and Regenerative Medicine, Henry M. Jackson Foundation, Bethesda, MD, 20817, USA
| | - Karl Kevala
- Laboratory of Molecular Signaling, NIAAA, NIH, 5625 Fishers Lane, Rockville, MD, 20852, USA
| | - Elma Aflaki
- Laboratory of Molecular Signaling, NIAAA, NIH, 5625 Fishers Lane, Rockville, MD, 20852, USA
| | - Juan Marugan
- Division of Pre-Clinical Innovation, NCATS, NIH, Rockville, MD, 20817, USA
| | - Hee-Yong Kim
- Laboratory of Molecular Signaling, NIAAA, NIH, 5625 Fishers Lane, Rockville, MD, 20852, USA. .,Center for Neuroscience and Regenerative Medicine, Henry M. Jackson Foundation, Bethesda, MD, 20817, USA.
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Asken BM, Rabinovici GD. Identifying degenerative effects of repetitive head trauma with neuroimaging: a clinically-oriented review. Acta Neuropathol Commun 2021; 9:96. [PMID: 34022959 PMCID: PMC8141132 DOI: 10.1186/s40478-021-01197-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/07/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND SCOPE OF REVIEW Varying severities and frequencies of head trauma may result in dynamic acute and chronic pathophysiologic responses in the brain. Heightened attention to long-term effects of head trauma, particularly repetitive head trauma, has sparked recent efforts to identify neuroimaging biomarkers of underlying disease processes. Imaging modalities like structural magnetic resonance imaging (MRI) and positron emission tomography (PET) are the most clinically applicable given their use in neurodegenerative disease diagnosis and differentiation. In recent years, researchers have targeted repetitive head trauma cohorts in hopes of identifying in vivo biomarkers for underlying biologic changes that might ultimately improve diagnosis of chronic traumatic encephalopathy (CTE) in living persons. These populations most often include collision sport athletes (e.g., American football, boxing) and military veterans with repetitive low-level blast exposure. We provide a clinically-oriented review of neuroimaging data from repetitive head trauma cohorts based on structural MRI, FDG-PET, Aβ-PET, and tau-PET. We supplement the review with two patient reports of neuropathology-confirmed, clinically impaired adults with prior repetitive head trauma who underwent structural MRI, FDG-PET, Aβ-PET, and tau-PET in addition to comprehensive clinical examinations before death. REVIEW CONCLUSIONS Group-level comparisons to controls without known head trauma have revealed inconsistent regional volume differences, with possible propensity for medial temporal, limbic, and subcortical (thalamus, corpus callosum) structures. Greater frequency and severity (i.e., length) of cavum septum pellucidum (CSP) is observed in repetitive head trauma cohorts compared to unexposed controls. It remains unclear whether CSP predicts a particular neurodegenerative process, but CSP presence should increase suspicion that clinical impairment is at least partly attributable to the individual's head trauma exposure (regardless of underlying disease). PET imaging similarly has not revealed a prototypical metabolic or molecular pattern associated with repetitive head trauma or predictive of CTE based on the most widely studied radiotracers. Given the range of clinical syndromes and neurodegenerative pathologies observed in a subset of adults with prior repetitive head trauma, structural MRI and PET imaging may still be useful for differential diagnosis (e.g., assessing suspected Alzheimer's disease).
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Affiliation(s)
- Breton M. Asken
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94143 USA
| | - Gil D. Rabinovici
- Departments of Neurology, Radiology & Biomedical Imaging, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94143 USA
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Terem I, Dang L, Champagne A, Abderezaei J, Pionteck A, Almadan Z, Lydon AM, Kurt M, Scadeng M, Holdsworth SJ. 3D amplified MRI (aMRI). Magn Reson Med 2021; 86:1674-1686. [PMID: 33949713 PMCID: PMC8252598 DOI: 10.1002/mrm.28797] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/18/2021] [Accepted: 03/17/2021] [Indexed: 12/17/2022]
Abstract
Purpose Amplified MRI (aMRI) has been introduced as a new method of detecting and visualizing pulsatile brain motion in 2D. Here, we improve aMRI by introducing a novel 3D aMRI approach. Methods 3D aMRI was developed and tested for its ability to amplify sub‐voxel motion in all three directions. In addition, 3D aMRI was qualitatively compared to 2D aMRI on multi‐slice and 3D (volumetric) balanced steady‐state free precession cine data and phase contrast (PC‐MRI) acquired on healthy volunteers at 3T. Optical flow maps and 4D animations were produced from volumetric 3D aMRI data. Results 3D aMRI exhibits better image quality and fewer motion artifacts compared to 2D aMRI. The tissue motion was seen to match that of PC‐MRI, with the predominant brain tissue displacement occurring in the cranial‐caudal direction. Optical flow maps capture the brain tissue motion and display the physical change in shape of the ventricles by the relative movement of the surrounding tissues. The 4D animations show the complete brain tissue and cerebrospinal fluid (CSF) motion, helping to highlight the “piston‐like” motion of the ventricles. Conclusions Here, we introduce a novel 3D aMRI approach that enables one to visualize amplified cardiac‐ and CSF‐induced brain motion in striking detail. 3D aMRI captures brain motion with better image quality than 2D aMRI and supports a larger amplification factor. The optical flow maps and 4D animations of 3D aMRI may open up exciting applications for neurological diseases that affect the biomechanics of the brain and brain fluids.
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Affiliation(s)
- Itamar Terem
- Department of Electrical Engineering, Stanford University, Stanford, California, USA.,Department of Structural Biology, Stanford University, Stanford, California, USA
| | - Leo Dang
- Department of Anatomy and Medical Imaging & Centre for Brain Research, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Mātai Medical Research Institute, Gisborne-Tairāwhiti, New Zealand
| | - Allen Champagne
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Javid Abderezaei
- Department of Mechanical Engineering, Stevens Institute of Technology, Hoboken, New Jersey, USA
| | - Aymeric Pionteck
- Department of Mechanical Engineering, Stevens Institute of Technology, Hoboken, New Jersey, USA
| | - Zainab Almadan
- Department of Anatomy and Medical Imaging & Centre for Brain Research, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Anna-Maria Lydon
- Centre for Advanced MRI, University of Auckland, Auckland, New Zealand
| | - Mehmet Kurt
- Department of Mechanical Engineering, Stevens Institute of Technology, Hoboken, New Jersey, USA.,Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Miriam Scadeng
- Department of Anatomy and Medical Imaging & Centre for Brain Research, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Mātai Medical Research Institute, Gisborne-Tairāwhiti, New Zealand.,Department of Radiology, University of California, San Diego, California, USA
| | - Samantha J Holdsworth
- Department of Anatomy and Medical Imaging & Centre for Brain Research, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Mātai Medical Research Institute, Gisborne-Tairāwhiti, New Zealand
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Champagne AA, Coverdale NS, Ross A, Murray C, Vallee I, Cook DJ. Characterizing changes in network connectivity following chronic head trauma in special forces military personnel: a combined resting-fMRI and DTI study. Brain Inj 2021; 35:760-768. [PMID: 33792439 DOI: 10.1080/02699052.2021.1906951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Soldiers are exposed to significant repetitive head trauma, which may disrupt functional and structural brain connectivity patterns. PURPOSE/HYPOTHESIS Integrate resting-state functional MRI (rs-fMRI) and diffusion tensor imaging (DTI) to characterize changes in connectivity biomarkers within Canadian Special Operations Forces (CANSOF), hypothesizing that alterations in architectural organization of cortical hubs may follow chronic repetitive head trauma. METHODS Fifteen CANSOFs with a history of chronic exposure to sub-concussive head trauma and concussive injuries (1.9 ± 2.0 concussions (range: [0-6])), as well as an equal age-matched cohort of controls (CTLs) were recruited. BOLD-based rs-fMRI was combined with DTI to reconstruct functional and structural networks using independent component analyses and probabilistic tractography. Connectivity markers were computed based on the distance between functional seeds to assess for possible differences in injury susceptibility of short- and long-range connections. RESULTS/DISCUSSION Significant hyper- and hypo-connectivity differences in cortical connections were observed suggesting that chronic head trauma may predispose soldiers to changes in the functional organization of brain networks. Significant structural alterations in axonal fibers directly connecting disrupted functional nodes were specific to hyper-connected long-range connections, suggesting a potential relationship between axonal injury and increases in neural recruitment following repetitive head trauma from high-exposure military duties.
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Affiliation(s)
- Allen A Champagne
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.,School of Medicine, Queen's University, Kingston, ON, Canada
| | - Nicole S Coverdale
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | | | | | - Isabelle Vallee
- Canadian Special Operations Forces Command, Ottawa, ON, Canada
| | - Douglas J Cook
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.,Department of Surgery, Queen's University, Kingston, ON, Canada
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Brooks JS, Redgrift A, Champagne AA, Dickey JP. The Hammer and the Nail: Biomechanics of Striking and Struck Canadian University Football Players. Ann Biomed Eng 2021; 49:2875-2885. [PMID: 33893576 PMCID: PMC8510945 DOI: 10.1007/s10439-021-02773-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/27/2021] [Indexed: 01/04/2023]
Abstract
This study sought to evaluate head accelerations in both players involved in a football collision. Players on two opposing Canadian university teams were equipped with helmet mounted sensors during one game per season, for two consecutive seasons. A total of 276 collisions between 58 instrumented players were identified via video and cross-referenced with sensor timestamps. Player involvement (striking and struck), impact type (block or tackle), head impact location (front, back, left and right), and play type were recorded from video footage. While struck players did not experience significantly different linear or rotational accelerations between any play types, striking players had the highest linear and rotational head accelerations during kickoff plays (p ≤ .03). Striking players also experienced greater linear and rotational head accelerations than struck players during kickoff plays (p = .001). However, struck players experienced greater linear and rotational accelerations than striking players during kick return plays (p ≤ .008). Other studies have established that the more severe the head impact, the greater risk for injury to the brain. This paper's results highlight that kickoff play rule changes, as implemented in American college football, would decrease head impact exposure of Canadian university football athletes and make the game safer.
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Affiliation(s)
- Jeffrey S. Brooks
- grid.39381.300000 0004 1936 8884School of Kinesiology, Faculty of Health Sciences, Western University, 1151 Richmond St., London, ON Canada
| | - Adam Redgrift
- grid.39381.300000 0004 1936 8884School of Kinesiology, Faculty of Health Sciences, Western University, 1151 Richmond St., London, ON Canada
| | - Allen A. Champagne
- grid.410356.50000 0004 1936 8331Centre for Neuroscience Studies, Queen’s University, Kingston, ON Canada ,grid.410356.50000 0004 1936 8331School of Medicine, Queen’s University, Kingston, ON Canada
| | - James P. Dickey
- grid.39381.300000 0004 1936 8884School of Kinesiology, Faculty of Health Sciences, Western University, 1151 Richmond St., London, ON Canada
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Montanino A, Li X, Zhou Z, Zeineh M, Camarillo D, Kleiven S. Subject-specific multiscale analysis of concussion: from macroscopic loads to molecular-level damage. BRAIN MULTIPHYSICS 2021. [DOI: 10.1016/j.brain.2021.100027] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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