青少年足球中的重复性头部撞击：描述和与白质结构的关系。
Repetitive Head Impacts in Youth Football: Description and Relationship to White Matter Structure.
机构信息
St Luke's Sports Medicine, Boise, Idaho.
St Luke's Applied Research, Boise, Idaho.
出版信息
Sports Health. 2019 Nov/Dec;11(6):507-513. doi: 10.1177/1941738119865264. Epub 2019 Aug 21.
BACKGROUND
Few studies have examined white matter with diffusion tensor imaging in 8- to 12-year-old collision sport (CS) athletes.
HYPOTHESIS
Youth CS athletes will demonstrate change in brain fractional anisotropy (FA) after a season of CS compared with an age-matched noncollision sport (NCS) cohort, and the number, magnitude, and location of hits will correlate with changes in the brain determined via FA for CS athletes.
STUDY DESIGN
Prospective cohort study.
LEVEL OF EVIDENCE
Level 3.
METHODS
Thirty-five 8- to 12-year-old males in a youth tackle football league (CS) and 12 males from local swim teams (NCS) were recruited. Participants underwent brain magnetic resonance imaging with FA before and after the football season. Number, magnitude, and direction of head impacts were recorded for CS participants throughout the season.
RESULTS
A total of 1905 hits were recorded in the CS group for the season, 341 (17.9%) collected during 7 games and 1564 (82.1%) observed during 31 practices. No significant interaction between group (CS and NCS) and time (pre- and postseason) was observed for FA ( > 0.05). Correlation analysis revealed a significantly positive and moderate relationship between increase of left cingulate cortex (CgC) FA from pre- to postseason and the total magnitude of lateral head impacts ( = 0.40; = 0.03).
CONCLUSION
There was no significant change in FA measurement of white matter integrity in a cohort of 8- to 12-year-old males after a season of youth football, nor was any difference detected in FA between youth football players and an age-matched cohort of swimmers. There was a significant correlation between total magnitude of hits sustained by youth football players and an increase in FA in the left CgC; whether this is adaptive or pathologic remains unknown.
CLINICAL RELEVANCE
These data can be used within the body of knowledge to counsel patients regarding the known risks of youth tackle football regarding brain health.
背景
仅有少数研究使用弥散张量成像（DTI）检查 8-12 岁碰撞运动（CS）运动员的白质。
假说
与年龄匹配的非碰撞运动（NCS）队列相比，青年 CS 运动员在一个赛季的 CS 后，大脑部分各向异性（FA）会发生变化，并且通过 FA 确定的 CS 运动员的大脑中的撞击次数、大小和位置与变化相关。
研究设计
前瞻性队列研究。
证据等级
3 级。
方法
招募了 35 名参加青年腰橄榄球联赛的 8-12 岁男性（CS）和 12 名来自当地游泳队的男性（NCS）。参与者在橄榄球赛季前后接受了 FA 脑磁共振成像。CS 参与者在整个赛季中记录了头部撞击的次数、大小和方向。
结果
CS 组整个赛季共记录到 1905 次撞击，其中 341 次（17.9%）发生在 7 场比赛中，1564 次（82.1%）发生在 31 次训练中。FA（>0.05）未观察到组（CS 和 NCS）和时间（前后）之间的显著相互作用。相关性分析显示，左扣带回皮质（CgC）FA 从术前到术后的增加与侧向头部撞击的总幅度呈显著正相关，中度相关（=0.40；=0.03）。
结论
在一个 8-12 岁男性青年足球赛季后，一个队列的白质完整性 FA 测量值没有显著变化，青年足球运动员与年龄匹配的游泳运动员队列之间的 FA 也没有差异。青年足球运动员承受的总撞击次数与左 CgC 中 FA 的增加之间存在显著相关性；这是适应性的还是病理性的尚不清楚。
临床意义
这些数据可以在知识体系内用于向患者提供有关青年触身橄榄球对大脑健康的已知风险的咨询。
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