Liu Zexuan, Dudley Jonathan A, Diekfuss Jed A, Ahmed Nadine, Edmondson Alex D, Cecil Kim M, Yuan Weihong, Zuleger Taylor M, Slutsky-Ganesh Alexis B, Barber Foss Kim D, Myer Gregory D, Fleischer Candace C
Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA.
Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
J Magn Reson Imaging. 2025 Apr;61(4):1738-1750. doi: 10.1002/jmri.29581. Epub 2024 Aug 23.
While changes in brain metabolites after injury have been reported, relationships between metabolite changes and head impacts are less characterized.
To investigate alterations in neurochemistry in high school athletes as a function of head impacts, concussion, and the use of a jugular vein compression (JVC) collar.
Prospective controlled trial.
A total of 284 male American football players, divided into JVC collar and noncollar groups; 215 included in final analysis (age = 15.9 ± 1.0 years; 114 in collar group).
FIELD STRENGTH/SEQUENCE: 3 Tesla/T-weighted gradient echo, H point resolved spectroscopy, acquired between August and November 2018.
Head impacts were quantified using accelerometers. Concussion was diagnosed by medical professionals for each team. Pre- to postseason differences in total N-acetylaspartate (tNAA), total choline (tCho), myo-inositol (myoI), and glutamate + glutamine (Glx), in primary motor cortex (M1) and anterior cingulate cortex (ACC), relative to total creatine (tCr), were determined.
Group-wise comparisons were performed using Wilcoxon signed-rank, Friedman's, and Mann-Whitney U tests. Relationships between ∆metabolite/tCr and mean g-force were analyzed using linear regressions accounting for concussion and JVC collar. Significance was set at P ≤ 0.05.
In participants without concussion, a significant decrease in tCho/tCr (0.233 ± 1.40 × 10 to 0.227 ± 1.47 × 10) and increase in Glx/tCr (1.60 ± 8.75 × 10 to 1.63 ± 1.08 × 10) in ACC were observed pre- to postseason. The relationship between ∆tCho/tCr in M1 and ACC and mean g-force from >80 g to >140 g differed significantly between participants with and without concussion (M1 β ranged from 3.9 × 10 to 2.1 × 10; ACC β ranged from 2.7 × 10 to 2.1 × 10). Posthoc analyses revealed increased tCho/tCr in M1 was positively associated with mean g-force >100 g (β = 3.6 × 10) and >110 g (β = 2.9 × 10) in participants with concussion. Significant associations between in ACC and mean g-force >110 g (β = -1.1 × 10) and >120 g (β = -1.1 × 10) were observed in the collar group only.
Diagnosed concussion and the use of a JVC collar result in distinct neurochemical trends after repeated head impacts.
2 TECHNICAL EFFICACY: Stage 3.
虽然已有报道称损伤后脑代谢物会发生变化，但代谢物变化与头部撞击之间的关系仍不太明确。
研究高中运动员神经化学的改变与头部撞击、脑震荡以及颈静脉压迫（JVC）项圈使用之间的关系。
前瞻性对照试验。
共284名美国高中男橄榄球运动员，分为JVC项圈组和无项圈组；最终纳入分析215名（年龄 = 15.9 ± 1.0岁；项圈组114名）。
场强/序列：3特斯拉/T加权梯度回波，H点分辨波谱，于2018年8月至11月采集。
使用加速度计对头部撞击进行量化。由各队的医学专业人员诊断脑震荡。测定赛季前至赛季后初级运动皮层（M1）和前扣带回皮层（ACC）中总N - 乙酰天门冬氨酸（tNAA）、总胆碱（tCho）、肌醇（myoI）以及谷氨酸 + 谷氨酰胺（Glx）相对于总肌酸（tCr）的差异。
采用Wilcoxon符号秩检验、Friedman检验和Mann - Whitney U检验进行组间比较。使用考虑脑震荡和JVC项圈的线性回归分析代谢物/tCr变化与平均重力之间的关系。显著性设定为P≤0.05。
在未发生脑震荡的参与者中，观察到赛季前至赛季后ACC中tCho/tCr显著降低（从0.233 ± 1.40×10降至0.227 ± 1.47×10），Glx/tCr升高（从1.60 ± 8.75×10升至1.63 ± 1.08×10）。有脑震荡和无脑震荡的参与者中，M1和ACC中∆tCho/tCr与80g至140g的平均重力之间的关系存在显著差异（M1的β范围为3.9×10至2.1×10；ACC的β范围为2.7×10至2.1×10）。事后分析显示，发生脑震荡的参与者中，M1中tCho/tCr升高与平均重力>100g（β = 3.6×(10)）和>110g（β = 2.9×(10)）呈正相关。仅在项圈组中观察到ACC中与平均重力>110g（β = -1.1×(10)）和>120g（β = -1.1×(10)）存在显著关联。
诊断为脑震荡以及使用JVC项圈会导致反复头部撞击后出现不同的神经化学变化趋势。
2 技术效能：3级
