Neuroscience Research Program, St. Michael's Hospital, Toronto ON, M5B 1M8, Canada.
Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto ON, M5B 1M8, Canada.
Sci Rep. 2020 Feb 3;10(1):1643. doi: 10.1038/s41598-020-58073-9.
Neuroimaging has been used to describe the pathophysiology of sport-related concussion during early injury, with effects that may persist beyond medical clearance to return-to-play (RTP). However, studies are typically cross-sectional, comparing groups of concussed and uninjured athletes. It is important to determine whether these findings are consistent with longitudinal change at the individual level, relative to their own pre-injury baseline. A cohort of N = 123 university-level athletes were scanned with magnetic resonance imaging (MRI). Of this group, N = 12 acquired a concussion and were re-scanned at early symptomatic injury and at RTP. A sub-group of N = 44 uninjured athletes were also re-imaged, providing a normative reference group. Among concussed athletes, abnormalities were identified for white matter fractional anisotropy and mean diffusivity, along with grey matter cerebral blood flow, using both cross-sectional (CS) and longitudinal (LNG) approaches. The spatial patterns of abnormality for CS and LNG were distinct, with median fractional overlap below 0.10 and significant differences in the percentage of abnormal voxels. However, the analysis methods did not differ in the amount of change from symptomatic injury to RTP and in the direction of observed abnormalities. These results highlight the impact of using pre-injury baseline data when evaluating concussion-related brain abnormalities at the individual level.
神经影像学已被用于描述运动相关性脑震荡早期损伤期间的病理生理学，其影响可能在医学许可重返赛场（RTP）后持续存在。然而，这些研究通常是横断面的，比较了脑震荡和未受伤运动员的群体。重要的是要确定这些发现是否与个体水平的纵向变化一致，相对于他们自己的受伤前基线。一组 N = 123 名大学水平的运动员接受了磁共振成像（MRI）扫描。在这组中，N = 12 人遭受了脑震荡，并在早期症状性损伤和 RTP 时重新扫描。N = 44 名未受伤的运动员的亚组也进行了重新成像，提供了一个规范的参考组。在脑震荡运动员中，使用横断面（CS）和纵向（LNG）方法，确定了白质各向异性分数和平均扩散率以及灰质脑血流的异常。CS 和 LNG 的异常空间模式明显不同，中位数分数重叠低于 0.10，异常体素的百分比存在显著差异。然而，分析方法在从症状性损伤到 RTP 的变化量以及观察到的异常方向上没有差异。这些结果强调了在个体水平评估与脑震荡相关的大脑异常时使用受伤前基线数据的影响。
