Wright David K, Symons Georgia F, O'Brien William T, McDonald Stuart J, Zamani Akram, Major Brendan, Chen Zhibin, Costello Daniel, Brady Rhys D, Sun Mujun, Law Meng, O'Brien Terence J, Mychasiuk Richelle, Shultz Sandy R
Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC 3004, Australia.
Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, VIC 3086, Australia.
Cereb Cortex. 2021 Aug 26;31(10):4411-4419. doi: 10.1093/cercor/bhab095.
Sports-related concussion (SRC) is a serious health concern. However, the temporal profile of neuropathophysiological changes after SRC and how these relate to biological sex are still poorly understood. This preliminary study investigated whether diffusion-weighted magnetic resonance imaging (dMRI) was sensitive to neuropathophysiological changes following SRC; whether these changes were sex-specific; and whether they persisted beyond the resolution of self-reported symptoms. Recently concussed athletes (n = 14), and age- and education-matched nonconcussed control athletes (n = 16), underwent MRI 24-48-h postinjury and again at 2-week postinjury (i.e., when cleared to return-to-play). Male athletes reported more symptoms and greater symptom severity compared with females. dMRI revealed white matter differences between athletes with SRC and their nonconcussed counterparts at 48-h postinjury. These differences were still present at 2-week postinjury, despite SRC athletes being cleared to return to play and may indicate increased cerebral vulnerability beyond the resolution of subjective symptoms. Furthermore, we identified sex-specific differences, with male SRC athletes having significantly greater white matter disruption compared with female SRC athletes. These results have important implications for the management of concussion, including guiding return-to-play decisions, and further improve our understanding regarding the role of sex in SRC outcomes.
与运动相关的脑震荡（SRC）是一个严重的健康问题。然而，SRC后神经病理生理学变化的时间特征以及这些变化与生物性别的关系仍知之甚少。这项初步研究调查了扩散加权磁共振成像（dMRI）对SRC后神经病理生理学变化是否敏感；这些变化是否具有性别特异性；以及它们是否在自我报告症状消失后仍持续存在。近期发生脑震荡的运动员（n = 14）以及年龄和教育程度匹配的未发生脑震荡的对照运动员（n = 16）在受伤后24 - 48小时接受了MRI检查，并在受伤后2周（即获准恢复比赛时）再次接受检查。与女性相比，男性运动员报告的症状更多且症状更严重。dMRI显示，受伤后48小时，发生SRC的运动员与未发生脑震荡的对应运动员之间存在白质差异。尽管发生SRC的运动员被获准恢复比赛，但这些差异在受伤后2周时仍然存在，这可能表明在主观症状消失后大脑的易损性增加。此外，我们还发现了性别特异性差异，与女性SRC运动员相比，男性SRC运动员的白质破坏明显更严重。这些结果对脑震荡的管理具有重要意义，包括指导恢复比赛的决策，并进一步增进我们对性别在SRC结果中的作用的理解。
