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Clark MD, Varangis EML, Champagne AA, Giovanello KS, Shi F, Kerr ZY, Smith JK, Guskiewicz KM. Effects of Career Duration, Concussion History, and Playing Position on White Matter Microstructure and Functional Neural Recruitment in Former College and Professional Football Athletes. Radiology 2018; 286:967-977. [PMID: 29087238 PMCID: PMC5834225 DOI: 10.1148/radiol.2017170539] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Purpose To better understand the relationship between exposure to concussive and subconcussive head impacts, white matter integrity, and functional task-related neural activity in former U.S. football athletes. Materials and Methods Between 2011 and 2013, 61 cognitively unimpaired former collegiate and professional football players (age range, 52-65 years) provided informed consent to participate in this cross-sectional study. Participants were stratified across three crossed factors: career duration, concussion history, and primary playing position. Fractional anisotropy (FA) and blood oxygen level-dependent (BOLD) percent signal change (PSC) were measured with diffusion-weighted and task-related functional magnetic resonance imaging, respectively. Analyses of variance of FA and BOLD PSC were used to determine main or interaction effects of the three factors. Results A significant interaction between career duration and concussion history was observed; former college players with more than three concussions had lower FA in a broadly distributed area of white matter compared with those with zero to one concussion (t29 = 2.774; adjusted P = .037), and the opposite was observed for former professional players (t29 = 3.883; adjusted P = .001). A separate interaction between concussion history and position was observed: Nonspeed players with more than three concussions had lower FA in frontal white matter compared with those with zero to one concussion (t25 = 3.861; adjusted P = .002). Analysis of working memory-task BOLD PSC revealed a similar interaction between concussion history and position (all adjusted P < .004). Overall, former players with lower FA tended to have lower BOLD PSC across three levels of a working memory task. Conclusion Career duration and primary playing position seem to modify the effects of concussion history on white matter structure and neural recruitment. The differences in brain structure and function were observed in the absence of clinical impairment, which suggested that multimodal imaging may provide early markers of onset of traumatic neurodegenerative disease. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Michael D. Clark
- From the Departments of Exercise and Sport Science (M.D.C., Z.Y.K.,
K.M.G.), Psychology and Neuroscience (E.M.L.V., K.S.G.), and Radiology (J.K.S.),
University of North Carolina at Chapel Hill, 209 Fetzer Hall, CB 8700, Chapel Hill,
NC 27599; Centre for Neuroscience Studies, Queen’s University, Kingston, Ont,
Canada (A.A.C.); and Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (F.S.)
| | - Eleanna M. L. Varangis
- From the Departments of Exercise and Sport Science (M.D.C., Z.Y.K.,
K.M.G.), Psychology and Neuroscience (E.M.L.V., K.S.G.), and Radiology (J.K.S.),
University of North Carolina at Chapel Hill, 209 Fetzer Hall, CB 8700, Chapel Hill,
NC 27599; Centre for Neuroscience Studies, Queen’s University, Kingston, Ont,
Canada (A.A.C.); and Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (F.S.)
| | - Allen A. Champagne
- From the Departments of Exercise and Sport Science (M.D.C., Z.Y.K.,
K.M.G.), Psychology and Neuroscience (E.M.L.V., K.S.G.), and Radiology (J.K.S.),
University of North Carolina at Chapel Hill, 209 Fetzer Hall, CB 8700, Chapel Hill,
NC 27599; Centre for Neuroscience Studies, Queen’s University, Kingston, Ont,
Canada (A.A.C.); and Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (F.S.)
| | - Kelly S. Giovanello
- From the Departments of Exercise and Sport Science (M.D.C., Z.Y.K.,
K.M.G.), Psychology and Neuroscience (E.M.L.V., K.S.G.), and Radiology (J.K.S.),
University of North Carolina at Chapel Hill, 209 Fetzer Hall, CB 8700, Chapel Hill,
NC 27599; Centre for Neuroscience Studies, Queen’s University, Kingston, Ont,
Canada (A.A.C.); and Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (F.S.)
| | - Feng Shi
- From the Departments of Exercise and Sport Science (M.D.C., Z.Y.K.,
K.M.G.), Psychology and Neuroscience (E.M.L.V., K.S.G.), and Radiology (J.K.S.),
University of North Carolina at Chapel Hill, 209 Fetzer Hall, CB 8700, Chapel Hill,
NC 27599; Centre for Neuroscience Studies, Queen’s University, Kingston, Ont,
Canada (A.A.C.); and Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (F.S.)
| | - Zachary Y. Kerr
- From the Departments of Exercise and Sport Science (M.D.C., Z.Y.K.,
K.M.G.), Psychology and Neuroscience (E.M.L.V., K.S.G.), and Radiology (J.K.S.),
University of North Carolina at Chapel Hill, 209 Fetzer Hall, CB 8700, Chapel Hill,
NC 27599; Centre for Neuroscience Studies, Queen’s University, Kingston, Ont,
Canada (A.A.C.); and Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (F.S.)
| | - J. Keith Smith
- From the Departments of Exercise and Sport Science (M.D.C., Z.Y.K.,
K.M.G.), Psychology and Neuroscience (E.M.L.V., K.S.G.), and Radiology (J.K.S.),
University of North Carolina at Chapel Hill, 209 Fetzer Hall, CB 8700, Chapel Hill,
NC 27599; Centre for Neuroscience Studies, Queen’s University, Kingston, Ont,
Canada (A.A.C.); and Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (F.S.)
| | - Kevin M. Guskiewicz
- From the Departments of Exercise and Sport Science (M.D.C., Z.Y.K.,
K.M.G.), Psychology and Neuroscience (E.M.L.V., K.S.G.), and Radiology (J.K.S.),
University of North Carolina at Chapel Hill, 209 Fetzer Hall, CB 8700, Chapel Hill,
NC 27599; Centre for Neuroscience Studies, Queen’s University, Kingston, Ont,
Canada (A.A.C.); and Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (F.S.)
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