Medical College of Wisconsin, Department of Neurosurgery, United States.
Medical College of Wisconsin, Department of Radiology, United States.
Neuroimage Clin. 2023;40:103538. doi: 10.1016/j.nicl.2023.103538. Epub 2023 Nov 9.
Cerebral blood flow (CBF) change, a non-invasive marker of head injury, has yet to be thoroughly investigated as a potential consequence of repetitive head impacts (RHI) via contact sport participation in youth athletes. We examined pre-to post-season differences in relative CBF (rCBF), arterial transit time (ATT), and neurocognition between adolescent contact sport (CS; 79.4% of which were football players) and non-contact sport (NCS) athletes.
Adolescent athletes (N = 57; age = 14.70 ± 1.97) completed pre- and post-season clinical assessments and neuroimaging. Brain perfusion was evaluated using an advanced 3D pseudo-continuous ASL sequence with Hadamard encoded multiple post-labeling delays. Mixed-effect models tested group-by-time interactions for rCBF, ATT, and neurocognition.
A significant group-by-time interaction was observed for rCBF in a cluster consisting primarily of frontal and parietal lobe regions, with regional rCBF increasing in CS and decreasing among NCS athletes. No significant interaction was observed for ATT. A significant group-by-time interaction was observed for verbal memory and visual motor speed, with NCS athletes improving and CS athletes exhibiting lower performance from pre-to post-season in comparison.
Alterations in rCBF and variability in cognition, not purported neurovasculature changes (measured by ATT), were observed following one season of CS participation. Further study surrounding the clinical meaningfulness of these findings, as they related to adverse long-term outcomes, is needed.
脑血流(CBF)变化是头部损伤的一种非侵入性标志物,但其作为青少年运动员参与接触性运动(CS)重复性头部冲击(RHI)的潜在后果尚未得到充分研究。我们研究了相对脑血流量(rCBF)、动脉渡越时间(ATT)和神经认知在青少年接触性运动(CS;其中 79.4%为足球运动员)和非接触性运动(NCS)运动员中,赛季前至赛季后的差异。
青少年运动员(N=57;年龄=14.70±1.97)完成了赛季前和赛季后的临床评估和神经影像学检查。使用具有 Hadamard 编码的多后标记延迟的先进 3D 伪连续 ASL 序列评估脑灌注。混合效应模型测试了 rCBF、ATT 和神经认知的组间时间交互作用。
在一个主要由额区和顶区组成的聚类中观察到 rCBF 的显著组间时间交互作用,CS 组的区域 rCBF 增加,而 NCS 组的区域 rCBF 减少。ATT 没有观察到显著的交互作用。在言语记忆和视觉运动速度方面观察到显著的组间时间交互作用,与 NCS 运动员相比,CS 运动员在赛季前至赛季后的表现有所提高,而 CS 运动员的表现则有所下降。
在参与一个赛季的 CS 后,观察到 rCBF 的变化和认知的变化,而不是假定的神经血管变化(通过 ATT 测量)。需要进一步研究这些发现的临床意义,因为它们与不良的长期结果有关。