1 Department of Neurosurgery, Medical College of Wisconsin , Milwaukee, Wisconsin.
2 The Mind Research Network/Lovelace Biomedical and Environmental Research Institute , Albuquerque, New Mexico .
J Neurotrauma. 2017 Nov 15;34(22):3143-3152. doi: 10.1089/neu.2017.5002. Epub 2017 Aug 17.
There is an urgent need to characterize the acute physiological effects of sport-related concussion (SRC). We investigated the effects of SRC on gray matter structure and diffusion metrics in collegiate athletes at 1.64 (T1; n = 33), 8.33 (T2; n = 30), and 32.15 days (T3; n = 36) post-concussion, with healthy collegiate contact-sport athletes serving as controls (HA; n = 46). Plasma levels of glial fibrillary acidic protein (GFAP) were assessed in a subset of athletes. We hypothesized that acute SRC would be associated with increased fractional anisotropy (FA), decreased mean diffusivity (MD), and increased GFAP relative to noninjured HA, without acute differences in gray matter volume or cortical thickness. Further, we hypothesized that neither diffusion nor structure would show longitudinal changes across the first month post-SRC. Finally, we hypothesized that gray matter diffusion metrics would correlate with plasma GFAP levels, as indicated by pre-clinical literature. Consistent with our hypothesis, acute SRC was associated with decreased MD in the left pallidum, increased FA in the right amygdala, and a significantly greater number and volume of subject-specific clusters with increased FA compared to HA. No differences in gray matter volume, cortical thickness, or GFAP were observed between groups. There were no longitudinal changes in any measure across the first month post-SRC. Finally, FA in the right amygdala was inversely correlated with GFAP at T2. These results suggest that gray matter diffusion metrics may be useful in determining the physiological effects of SRC.
目前迫切需要对与运动相关的脑震荡（SRC）的急性生理影响进行特征描述。我们调查了 SRC 对大学生运动员的灰质结构和扩散指标的影响，这些运动员在脑震荡后 1.64 天（T1；n=33）、8.33 天（T2；n=30）和 32.15 天（T3；n=36）接受了检测，健康的大学生接触性运动运动员作为对照组（HA；n=46）。对一组运动员的神经胶质纤维酸性蛋白（GFAP）的血浆水平进行了评估。我们假设急性 SRC 与各向异性分数（FA）增加、平均弥散度（MD）降低以及与未受伤的 HA 相比 GFAP 升高相关，在急性损伤后 1 个月内灰质体积或皮质厚度无差异。此外，我们假设扩散和结构都不会随着时间的推移而在脑震荡后第一个月内发生纵向变化。最后，我们假设灰质扩散指标与血浆 GFAP 水平相关，这是临床前文献表明的。与我们的假设一致，急性 SRC 与左侧苍白球 MD 降低、右侧杏仁核 FA 增加以及与 HA 相比，出现更多且体积更大的 FA 增加的特定于个体的簇有关。各组间灰质体积、皮质厚度或 GFAP 无差异。在脑震荡后第一个月内，任何指标均无纵向变化。最后，右侧杏仁核的 FA 与 T2 时的 GFAP 呈负相关。这些结果表明，灰质扩散指标可能有助于确定 SRC 的生理影响。
