Roby Patricia R, Duquette Peter, Kerr Zachary Y, Register-Mihalik Johna, Stoner Lee, Mihalik Jason P
Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Curriculum in Human Movement Science, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
J Neurotrauma. 2021 Apr 1;38(7):837-847. doi: 10.1089/neu.2020.7350. Epub 2020 Nov 23.
The purpose of this study was to determine how subconcussive head impact exposure in high school collision sport student-athletes influenced cerebrovascular function. Transcranial Doppler was used to assess pre- to post-season changes in: (1) resting middle (MCA) and posterior cerebral arteries (PCA), (2) cerebrovascular reactivity (CVR) via breath-holding index (BHI), vasomotor reactivity response (VMRr) and overall MCA response curve, and (3) neurovascular coupling (NVC) via NVC response magnitude and overall PCA response curve. Fifty-three high school-aged athletes (age = 15.8 ± 1.2years, height = 175.8 ± 8.1cm, mass = 69.4 ± 13.5kg) were recruited into two groups (collision vs. non-collision sport). All participants completed a pre-season cerebrovascular function assessment. Following a 4- to 5-month window (118.6 ± 12.2 days), 48 athletes from the original sample (age = 16.0 ± 1.2 years, height = 175.5 ± 8.1 cm, mass = 68.6 ± 4.0 kg) repeated the cerebrovascular assessment. There were no group differences in any cerebrovascular measures at pre-season testing ( > 0.05). At post-season testing, collision sport athletes demonstrated greater positive change in BHI (t = -2.21, = 0.03) while non-collision sport athletes demonstrated greater negative change in the NVC response magnitude to the reading task (t = 1.98, = 0.048), and lower overall PCA response curve to the reading task ( = 101.54, < 0.001). All other pre- to post-season change values were non-significant ( > 0.05). Our data indicate that single-season changes in cerebrovascular outcomes may differ between collision and non-collision sport athletes. Although the clinical interpretation is still unclear, our study demonstrates that CVR and NVC assessments may be sensitive to the dynamic cerebrovascular changes occurring in adolescent athletes. Future research should continue to assess these outcomes following both subconcussive head impact exposure and throughout the recovery trajectory following concussion.
本研究的目的是确定高中碰撞类运动学生运动员的次脑震荡性头部撞击暴露如何影响脑血管功能。经颅多普勒用于评估赛季前到赛季后的变化：（1）静息状态下的大脑中动脉（MCA）和大脑后动脉（PCA）；（2）通过屏气指数（BHI）、血管舒缩反应（VMRr）和MCA整体反应曲线评估脑血管反应性（CVR）；（3）通过NVC反应幅度和PCA整体反应曲线评估神经血管耦合（NVC）。53名高中年龄的运动员（年龄=15.8±1.2岁，身高=175.8±8.1厘米，体重=69.4±13.5千克）被招募到两组（碰撞类运动组与非碰撞类运动组）。所有参与者都完成了赛季前的脑血管功能评估。在4至5个月的时间段（118.6±12.2天）后，原始样本中的48名运动员（年龄=16.0±1.2岁，身高=175.5±8.1厘米，体重=68.6±4.0千克）重复进行了脑血管评估。在赛季前测试中，两组在任何脑血管测量指标上均无差异（P>0.05）。在赛季后测试中，碰撞类运动运动员的BHI表现出更大的正向变化（t=-2.21，P=0.03），而非碰撞类运动运动员在阅读任务的NVC反应幅度上表现出更大的负向变化（t=1.98，P=0.048），并且在阅读任务的PCA整体反应曲线上更低（F=101.54，P<0.001）。所有其他赛季前到赛季后的变化值均无统计学意义（P>0.05）。我们的数据表明，碰撞类运动和非碰撞类运动运动员在脑血管结果的单赛季变化可能有所不同。尽管临床解释仍不明确，但我们的研究表明，CVR和NVC评估可能对青少年运动员发生的动态脑血管变化敏感。未来的研究应继续在次脑震荡性头部撞击暴露后以及脑震荡后的整个恢复轨迹中评估这些结果。
