Universidade de São Paulo, Faculdade de Medicina, Instituto de Radiologia, São Paulo SP, Brazil.
Universidade de São Paulo, Faculdade de Medicina, Centro de Medicina Nuclear, São Paulo SP, Brazil.
Arq Neuropsiquiatr. 2023 May;81(5):433-443. doi: 10.1055/s-0043-1768666. Epub 2023 May 31.
Professional soccer athletes are exposed to repetitive head impacts and are at risk of developing chronic traumatic encephalopathy.
To evaluate regional brain glucose metabolism (rBGM) and gray matter (GM) volume in retired soccer players (RSPs).
Male RSPs and age and sex-matched controls prospectively enrolled between 2017 and 2019 underwent neurological and neuropsychological evaluations, brain MRI and [18F]FDG-PET in a 3.0-Tesla PET/MRI scanner. Visual analysis was performed by a blinded neuroradiologist and a blinded nuclear physician. Regional brain glucose metabolism and GM volume were assessed using SPM8 software. Groups were compared using appropriate statistical tests available at SPM8 and R.
Nineteen RSPs (median [IQR]: 62 [50-64.5] years old) and 20 controls (60 [48-73] years old) were included. Retired soccer players performed worse on mini-mental state examination, digit span, clock drawing, phonemic and semantic verbal fluency tests, and had reduced rBGM in the left temporal pole (pFDR = 0.008) and the anterior left middle temporal gyrus (pFDR = 0.043). Semantic verbal fluency correlated with rBGM in the right hippocampus, left temporal pole, and posterior left middle temporal gyrus (p ≤ 0.042). Gray matter volume reduction was observed in similar anatomic regions but was less extensive and did not survive correction for multiple comparisons (pFDR ≥ 0.085). Individual [18F]FDG-PET visual analysis revealed seven RSPs with overt hypometabolism in the medial and lateral temporal lobes, frontal lobes, and temporoparietal regions. Retired soccer players had a higher prevalence of abnormalities on MRI.
Retired soccer players had reduced rBGM and GM volume in the temporal lobes and abnormalities, findings possibly related to repetitive head impacts.
职业足球运动员经常受到重复性头部冲击，存在罹患慢性创伤性脑病的风险。
评估退役足球运动员（RSP）的局部脑葡萄糖代谢（rBGM）和灰质（GM）体积。
2017 年至 2019 年期间，前瞻性纳入男性 RSP 和年龄、性别匹配的对照组，在 3.0 Tesla PET/MRI 扫描仪上进行神经学和神经心理学评估、脑 MRI 和 [18F]FDG-PET。由一位盲法神经放射科医生和一位盲法核医学医师进行视觉分析。使用 SPM8 软件评估局部脑葡萄糖代谢和 GM 体积。使用 SPM8 和 R 中提供的适当统计检验比较组间差异。
19 名 RSP（中位数[IQR]：62 [50-64.5]岁）和 20 名对照组（60 [48-73]岁）纳入研究。与对照组相比，退役足球运动员在简易精神状态检查、数字跨度、画钟、音位和语义流畅性测试中表现更差，左侧颞极（pFDR = 0.008）和左侧前中颞叶（pFDR = 0.043）的 rBGM 降低。语义流畅性与右侧海马体、左侧颞极和左侧后中颞叶的 rBGM 相关（p ≤ 0.042）。在相似的解剖区域观察到 GM 体积减少，但范围较小，且未通过多重比较校正（pFDR ≥ 0.085）。个别 [18F]FDG-PET 视觉分析显示，7 名 RSP 患者存在中颞叶、额叶和颞顶叶内侧和外侧代谢减退。退役足球运动员的 MRI 异常更为常见。
退役足球运动员的颞叶 rBGM 和 GM 体积降低，且存在异常，这些发现可能与重复性头部冲击有关。
