Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA.
Department of Clinical and Translational Science, University of Rochester Medical Center, Rochester, NY 14642, USA.
Sci Adv. 2019 Aug 7;5(8):eaau3460. doi: 10.1126/sciadv.aau3460. eCollection 2019 Aug.
The midbrain is biomechanically susceptible to force loading from repetitive subconcussive head impacts (RSHI), is a site of tauopathy in chronic traumatic encephalopathy (CTE), and regulates functions (e.g., eye movements) often disrupted in concussion. In a prospective longitudinal design, we demonstrate there are reductions in midbrain white matter integrity due to a single season of collegiate football, and that the amount of reduction in midbrain white matter integrity is related to the amount of rotational acceleration to which players' brains are exposed. We then replicate the observation of reduced midbrain white matter integrity in a retrospective cohort of individuals with frank concussion, and further show that variance in white matter integrity is correlated with levels of serum-based tau, a marker of blood-brain barrier disruption. These findings mean that noninvasive structural MRI of the midbrain is a succinct index of both clinically silent white matter injury as well as frank concussion.
中脑在生物力学上容易受到重复亚临床性头部撞击（RSHI）的力加载影响，是慢性创伤性脑病（CTE）中 tau 病的部位，并且调节功能（例如眼球运动）经常在脑震荡中受到干扰。在一项前瞻性纵向设计中，我们证明由于一个大学橄榄球赛季，中脑白质完整性会降低，并且中脑白质完整性的减少量与球员大脑所暴露的旋转加速度量有关。然后，我们在有明显脑震荡的个体的回顾性队列中复制了中脑白质完整性降低的观察结果，并进一步表明白质完整性的变化与血清 tau 水平相关，tau 是血脑屏障破坏的标志物。这些发现意味着中脑的无创性结构 MRI 是临床无症状性白质损伤和明显脑震荡的简洁指标。
