Wright David K, Gardner Andrew J, Wojtowicz Magdalena, Iverson Grant L, O'Brien Terence J, Shultz Sandy R, Stanwell Peter
Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Hunter New England Local Health District Sports Concussion Program, New Lambton Heights, New South Wales, Australia.
J Neurotrauma. 2021 Apr 15;38(8):983-988. doi: 10.1089/neu.2019.6886. Epub 2020 Jun 3.
The topic of potential long-term neurological consequences from having multiple concussions during a career in collision sports is controversial. We sought to investigate white matter microstructure using diffusion tensor imaging (DTI) in retired professional Australian National Rugby League (NRL) players ( = 11) with a history of multiple self-reported concussions compared with age- and education-matched controls ( = 13) who have had no history of brain trauma. Diffusion-weighted images were acquired with a Siemens 3T scanner. All participants completed a clinical interview. There were no significant differences between groups on measures of depression, anxiety, stress, or post-concussion symptoms; however, NRL players scored significantly higher on the alcohol use disorder identification test (AUDIT). Voxelwise analyses of DTI measures were performed using tract-based spatial statistics (TBSS) with age and AUDIT scores included as covariates. TBSS revealed significantly reduced fractional anisotropy (FA), and increased radial diffusivity (RD), axial diffusivity (AD), and trace (TR) in white matter regions of recently retired NRL players compared with controls. FA was significantly reduced in the right superior longitudinal fasciculus and right corticospinal tract while TR, RD, and AD were increased in these regions, as well as the corpus callosum, forceps major, right uncinate fasciculus, and left corticospinal tract. In summary, DTI in a small cohort of recently retired professional NRL players with a history of multiple concussions showed differences in white matter microstructure compared with age- and education-matched controls with no history of brain trauma.
在对抗性运动职业生涯中多次脑震荡所带来的潜在长期神经后果这一话题存在争议。我们试图使用扩散张量成像（DTI）对退役的澳大利亚国家橄榄球联盟（NRL）职业球员（n = 11）进行白质微观结构研究，这些球员有多次自我报告的脑震荡病史，将其与年龄和教育程度相匹配且无脑外伤史的对照组（n = 13）进行比较。使用西门子3T扫描仪采集扩散加权图像。所有参与者都完成了一次临床访谈。在抑郁、焦虑、压力或脑震荡后症状的测量方面，两组之间没有显著差异；然而，NRL球员在酒精使用障碍识别测试（AUDIT）中的得分显著更高。使用基于束的空间统计学（TBSS）对DTI测量值进行体素分析，并将年龄和AUDIT分数作为协变量纳入。TBSS显示，与对照组相比，近期退役的NRL球员白质区域的分数各向异性（FA）显著降低，径向扩散率（RD）、轴向扩散率（AD）和迹线（TR）增加。右侧上纵束和右侧皮质脊髓束的FA显著降低，而这些区域以及胼胝体、主要钳状束、右侧钩束和左侧皮质脊髓束的TR、RD和AD增加。总之，在一小群有多次脑震荡病史的近期退役的NRL职业球员中，DTI显示其白质微观结构与年龄和教育程度相匹配且无脑外伤史的对照组存在差异。
