Champagne Allen A, Coverdale Nicole S, Germuska Michael, Cook Douglas J
a Centre for Neuroscience Studies, Queen's University , Kingston , ON , Canada.
b Cardiff University Brain Research Imaging Center, Cardiff University , Cardiff , UK.
Brain Inj. 2019;33(11):1479-1489. doi: 10.1080/02699052.2019.1644375. Epub 2019 Jul 27.
: Identify alterations in cerebrovascular reactivity (CVR) based on the history of sport-related concussion (SRC). Further explore possible mechanisms underlying differences in vascular physiology using hemodynamic parameters modeled using calibrated magnetic resonance imaging (MRI). : End-tidal targeting and dual-echo MRI were combined to probe hypercapnic and hyperoxic challenges in athletes with (n = 32) and without (n = 31) a history of SRC. Concurrent blood oxygenation level dependent (BOLD) and arterial spin labeling (ASL) data were used to compute BOLD-CVR, ASL-CVR, and other physiological parameters including resting oxygen extraction fraction (OEF) and cerebral blood volume (CBV). Multiple linear and logistic regressions were then used to identify dominant parameters driving group-differences in BOLD-CVR. : Robust evidence for elevated BOLD-CVR were found in athletes with SRC history spreading over parts of the cortical hemispheres. Follow-up analyses showed co-localized differences in ASL-CVR (representing modulation of cerebral blood flow) and hemodynamic factors representing static vascular (i.e., CBV) and metabolic (i.e., OEF) effects suggesting that group-based differences in BOLD-CVR may be driven by a mixed effect from factors with vascular metabolic origins. : These results emphasize that while BOLD-CVR offers promises as a surrogate non-specific biomarker for cerebrovascular health following SRC, multiple hemodynamic parameters can affect its relative measurements. : [dHb]: concentration of deoxyhemoglobin; AFNI: Analysis of Functional NeuroImages ( https://afni.nimh.nih.gov ); ASL: arterial spin labeling; BIG: position group: defensive and offensive linemen; BIG-SKILL: position group: full backs, linebackers, running backs, tight-ends; BOLD: blood oxygen level dependent; CBF: cerebral blood flow; CMRO2: cerebral metabolic rate of oxygen consumption; CTL: group of control subjects; CVR: cerebrovascular reactivity; fMRI: functional magnetic resonance imaging; FSL: FMRIB software library ( https://fsl.fmrib.ox.ac.uk/fsl/fslwiki/ ); HC: hypercapnia; HO: hyperoxia; HX: group with history of concussion; M: maximal theoretical BOLD signal upon complete removal of venous dHb; pCASL: pseudo-continuous arterial spin labeling; PCO: end-tidal carbon dioxide; PO: end-tidal oxygen; SCAT: sport-concussion assessment tool; SKILL: position group: defensive backs, kickers, quarterbacks, safeties, wide-receivers; SRC: sport-related concussion.
基于运动相关脑震荡(SRC)病史识别脑血管反应性(CVR)的改变。使用校准磁共振成像(MRI)建模的血流动力学参数,进一步探索血管生理差异背后的潜在机制。:将呼气末靶向和双回波MRI相结合,对有(n = 32)和无(n = 31)SRC病史的运动员进行高碳酸血症和高氧血症挑战测试。同时使用血氧水平依赖(BOLD)和动脉自旋标记(ASL)数据来计算BOLD-CVR、ASL-CVR以及其他生理参数,包括静息氧摄取分数(OEF)和脑血容量(CBV)。然后使用多元线性和逻辑回归来确定驱动BOLD-CVR组间差异的主要参数。:在有SRC病史的运动员中,发现了BOLD-CVR升高的有力证据,这种升高分布在部分皮质半球。后续分析显示,ASL-CVR(代表脑血流量的调节)以及代表静态血管(即CBV)和代谢(即OEF)效应的血流动力学因素存在共同定位差异,这表明基于组别的BOLD-CVR差异可能由血管代谢起源的因素的混合效应驱动。:这些结果强调,虽然BOLD-CVR有望作为SRC后脑血管健康的替代非特异性生物标志物,但多个血流动力学参数会影响其相对测量值。:[dHb]:脱氧血红蛋白浓度;AFNI:功能神经影像分析(https://afni.nimh.nih.gov);ASL:动脉自旋标记;BIG:位置组:防守和进攻前锋;BIG-SKILL:位置组:全卫、线卫、跑卫、近端锋;BOLD:血氧水平依赖;CBF:脑血流量;CMRO2:脑氧代谢率;CTL:对照组;CVR:脑血管反应性;fMRI:功能磁共振成像;FSL:FMRIB软件库(https://fsl.fmrib.ox.ac.uk/fsl/fslwiki/);HC:高碳酸血症;HO:高氧血症;HX:有脑震荡病史的组;M:完全去除静脉血dHb后的最大理论BOLD信号;pCASL:伪连续动脉自旋标记;PCO:呼气末二氧化碳;PO:呼气末氧气;SCAT:运动脑震荡评估工具;SKILL:位置组:防守后卫、踢球者、四分卫、安全员、外接手;SRC:运动相关脑震荡