Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin.
Hum Brain Mapp. 2019 Mar;40(4):1211-1220. doi: 10.1002/hbm.24440. Epub 2018 Nov 19.
There has been a recent call for longitudinal imaging studies to better characterize the time course of physiological recovery following sport-related concussion (SRC) and its relationship with clinical recovery. To address this, we evaluated changes to resting-state functional connectivity (rs-FC) of the whole-brain network following SRC and explored associations between rs-FC and measures of clinical outcome. High school and collegiate football athletes were enrolled during preseason. Athletes that suffered SRC (N = 62) were assessed across the acute (within 48 hr) and sub-acute (days 8, 15, and 45) phases. Matched football athletes without concussion served as controls (N = 60) and participated in similar visits. Multi-band resting-state fMRI was used to assess whole-brain rs-FC at each visit using network-based statistic and average nodal strength from regions of interest defined using a common whole-brain parcellation. Concussed athletes had elevated symptoms, psychological distress, and oculomotor, balance, and memory deficits at 48 hr postconcussion relative to controls, with diminished yet significant elevations in symptoms and psychological distress at 8 days. Both rs-FC analyses showed that concussed athletes had a global increase in connectivity at 8 days postconcussion relative to controls, with no differences at the 48-hr, 15-day, or 45-day visits. Further analysis revealed the group effect at the 8-day visit was driven by the large minority of concussed athletes still symptomatic at their visit; asymptomatic concussed athletes did not differ from controls. Findings from this large-scale, prospective study suggest whole-brain rs-FC alterations following SRC are delayed in onset but associated with the presence of self-reported symptoms.
最近有人呼吁进行纵向影像学研究，以更好地描述运动相关脑震荡 (SRC) 后生理恢复的时间过程及其与临床恢复的关系。为了解决这个问题，我们评估了 SRC 后全脑网络静息状态功能连接 (rs-FC) 的变化，并探讨了 rs-FC 与临床结果测量之间的关联。在季前赛期间招募了高中和大学橄榄球队运动员。评估了患有 SRC 的运动员 (N=62) 在急性 (48 小时内) 和亚急性 (第 8、15 和 45 天) 阶段的情况。匹配的无脑震荡橄榄球运动员作为对照组 (N=60) 并参加了类似的访问。使用多带静息态 fMRI 在每个访问时使用基于网络的统计和来自使用常见全脑分割定义的感兴趣区域的平均节点强度评估全脑 rs-FC。与对照组相比，在脑震荡后 48 小时，脑震荡运动员的症状、心理困扰以及眼球运动、平衡和记忆缺陷升高，而在第 8 天，症状和心理困扰仍显著升高。两项 rs-FC 分析均显示，与对照组相比，脑震荡运动员在脑震荡后 8 天的连接性普遍增加，而在 48 小时、15 天或 45 天的访问中没有差异。进一步的分析表明，第 8 天访问时的组效应是由少数仍有症状的脑震荡运动员驱动的；无症状脑震荡运动员与对照组没有区别。这项大规模前瞻性研究的结果表明，SRC 后全脑 rs-FC 的改变是延迟发生的，但与自我报告的症状的存在有关。
