Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
J Neurotrauma. 2021 May 15;38(10):1358-1367. doi: 10.1089/neu.2020.7143. Epub 2021 Feb 16.
There is concern that previous concussion and contact-sport exposure may have negative effects on brain structure and function. Accurately quantifying previous concussion is complicated by the fact that multiple definitions exist, with recent definitions allowing for diagnosis based on the presence of symptoms alone (Concussion in Sport Group criteria; CISG) rather than the presence of acute injury characteristics such as alterations in mental status (American Congress of Rehabilitation Medicine criteria; ACRM). The goals of the current work were to determine the effects of previous concussion and contact-sport exposure on gray matter structure and clinical measures in healthy, young-adult athletes and determine the extent to which these associations are influenced by diagnostic criteria used to retrospectively quantify concussions. One-hundred eight collegiate-aged athletes were enrolled; 106 athletes were included in final analyses (age, 21.37 ± 1.69; 33 female). Participants completed a clinical battery of self-report and neurocognitive measures and magnetic resonance imaging to quantify subcortical volumes and cortical thickness. Semistructured interviews were conducted to measure exposure to contact sports and the number of previous concussions based on CISG and ACRM criteria. There was a significant association of concussion-related and psychological symptoms with previous concussions based on ACRM (s < 0.05), but not CISG, criteria. Hippocampal volume was inversely associated with the number of previous concussions for both criteria (s < 0.05). Findings provide evidence that previous concussions are associated with smaller hippocampal volumes and greater subjective clinical symptoms in otherwise healthy athletes and highlight the importance of diagnostic criteria used to quantify previous concussion.
人们担心以前的脑震荡和接触性运动暴露可能对大脑结构和功能产生负面影响。以前的脑震荡很难准确地量化，因为存在多种定义，最近的定义允许仅根据症状存在进行诊断（运动性脑震荡组标准；CISG），而不是根据急性损伤特征，如精神状态改变（美国康复医学大会标准；ACRM）。目前这项工作的目的是确定以前的脑震荡和接触性运动暴露对健康年轻运动员的灰质结构和临床指标的影响，并确定用于回顾性量化脑震荡的诊断标准对这些关联的影响程度。共有 108 名大学生运动员参加了这项研究，其中 106 名运动员最终纳入了分析（年龄 21.37±1.69 岁，33 名女性）。参与者完成了一系列临床自我报告和神经认知测试以及磁共振成像，以量化皮质下体积和皮质厚度。进行半结构化访谈，根据 CISG 和 ACRM 标准，测量接触性运动的暴露情况和以前的脑震荡次数。根据 ACRM（s<0.05）而不是 CISG 标准，脑震荡相关和心理症状与以前的脑震荡有显著相关性。海马体体积与两种标准的以前脑震荡次数呈负相关（s<0.05）。这些发现提供了证据，表明以前的脑震荡与健康运动员的海马体体积较小和更多的主观临床症状有关，并强调了用于量化以前脑震荡的诊断标准的重要性。
