McAllister Derek, Akers Carolyn, Boldt Brian, Mitchell Lex A, Tranvinh Eric, Douglas David, Goubran Maged, Rosenberg Jarrett, Georgiadis Marios, Karimpoor Mahta, DiGiacomo Phillip, Mouchawar Nicole, Grant Gerald, Camarillo David, Wintermark Max, Zeineh Michael M
Department of Radiology, Stanford School of Medicine, Stanford, CA, United States.
Department of Radiology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.
Front Neurol. 2021 Aug 11;12:701948. doi: 10.3389/fneur.2021.701948. eCollection 2021.
Athletes participating in high-contact sports experience repeated head trauma. Anatomical findings, such as a cavum septum pellucidum, prominent CSF spaces, and hippocampal volume reductions, have been observed in cases of mild traumatic brain injury. The extent to which these neuroanatomical findings are associated with high-contact sports is unknown. The purpose of this study was to determine whether there are subtle neuroanatomic differences between athletes participating in high-contact sports compared to low-contact athletic controls. We performed longitudinal structural brain MRI scans in 63 football (high-contact) and 34 volleyball (low-contact control) male collegiate athletes with up to 4 years of follow-up, evaluating a total of 315 MRI scans. Board-certified neuroradiologists performed semi-quantitative visual analysis of neuroanatomic findings, including: cavum septum pellucidum type and size, extent of perivascular spaces, prominence of CSF spaces, white matter hyperintensities, arterial spin labeling perfusion asymmetries, fractional anisotropy holes, and hippocampal size. At baseline, cavum septum pellucidum length was greater in football compared to volleyball controls ( = 0.02). All other comparisons were statistically equivalent after multiple comparison correction. Within football at baseline, the following trends that did not survive multiple comparison correction were observed: more years of prior football exposure exhibited a trend toward more perivascular spaces ( = 0.03 uncorrected), and lower baseline Standardized Concussion Assessment Tool scores toward more perivascular spaces ( = 0.02 uncorrected) and a smaller right hippocampal size ( = 0.02 uncorrected). Head impacts in high-contact sport (football) athletes may be associated with increased cavum septum pellucidum length compared to low-contact sport (volleyball) athletic controls. Other investigated neuroradiology metrics were generally equivalent between sports.
参与高对抗性运动的运动员会经历反复的头部创伤。在轻度创伤性脑损伤病例中,已观察到一些解剖学发现,如透明隔腔、明显的脑脊液间隙和海马体积减小。这些神经解剖学发现与高对抗性运动的关联程度尚不清楚。本研究的目的是确定参与高对抗性运动的运动员与低对抗性运动的对照运动员之间是否存在细微的神经解剖学差异。我们对63名橄榄球(高对抗性)和34名排球(低对抗性对照)男性大学生运动员进行了纵向结构性脑MRI扫描,随访时间长达4年,共评估了315次MRI扫描。获得认证的神经放射科医生对神经解剖学发现进行了半定量视觉分析,包括:透明隔腔的类型和大小、血管周围间隙的范围、脑脊液间隙的突出程度、白质高信号、动脉自旋标记灌注不对称、各向异性分数孔洞和海马大小。在基线时,橄榄球运动员的透明隔腔长度比排球对照运动员更长(P = 0.02)。经过多重比较校正后,所有其他比较在统计学上都是等效的。在橄榄球运动员基线时,观察到以下未通过多重比较校正的趋势:之前参加橄榄球运动的年限越长,血管周围间隙越多的趋势越明显(未校正P = 0.03),基线时标准化脑震荡评估工具得分越低,血管周围间隙越多(未校正P = 0.02),右侧海马体积越小(未校正P = 0.02)。与低对抗性运动(排球)的对照运动员相比,高对抗性运动(橄榄球)运动员的头部撞击可能与透明隔腔长度增加有关。其他研究的神经放射学指标在不同运动之间总体上是等效的。