使用定量磁化率映射研究脑震荡和接触性运动暴露史与脑微结构的关联。

Investigating the Association of Concussion and Contact Sport Exposure History With Brain Microstructure Using Quantitative Susceptibility Mapping.

作者信息

España Lezlie Y, Brett Benjamin L, Mayer Andrew R, Nencka Andrew S, Swearingen Brad, Koch Kevin M, Meier Timothy B

机构信息

Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

出版信息

Hum Brain Mapp. 2025 Apr 1;46(5):e70213. doi: 10.1002/hbm.70213.

Abstract

A growing body of evidence suggests that repeated concussions and exposure to repetitive head impacts may be associated with subtle abnormalities in neurological health. Prior studies have demonstrated associations of prior concussion and repetitive head impacts with the brain's microstructure, typically using diffusion magnetic resonance imaging, though the direction of these relationships has varied across groups. Quantitative susceptibility mapping is a quantitative extension of susceptibility weighted imaging that is sensitive to pathophysiology associated with neurotrauma and thus represents an alternative method to characterize the effects of concussion and repetitive head impact exposure on brain microstructure. The goal of this work was to characterize the association of prior concussion and years of contact sport exposure (a proxy of repetitive head impacts) with magnetic susceptibility in a cohort of otherwise healthy male and female collegiate-aged athletes. We hypothesized that concussion and contact sport exposure would be independently associated with lower susceptibility in white matter regions. Higher general symptom severity and psychological symptoms were observed in athletes with a greater history of concussion, but not years of contact sport exposure. No associations between concussion or years of exposure with cognitive performance were observed. Voxel-wise analyses found that individuals with more prior concussions also had lower magnetic susceptibility in two predominantly white matter clusters including the superior longitudinal fasciculi and forceps major. No associations of susceptibility and contact sport exposure were observed. Finally, lower susceptibility in the identified regions was associated with worse psychological symptoms, worse general symptoms, and worse performance on a composite measure of fluid cognition tasks. Current results suggest that more prior concussions in otherwise healthy collegiate-aged athletes are associated with decreases in susceptibility that are in turn associated with elevated symptom reporting and poorer cognitive performance.

摘要

越来越多的证据表明,反复的脑震荡以及反复遭受头部撞击可能与神经健康的细微异常有关。先前的研究已经证明了既往脑震荡和反复头部撞击与大脑微观结构之间的关联,通常使用扩散磁共振成像,不过这些关系的方向在不同组之间有所不同。定量磁化率图谱是磁化率加权成像的一种定量扩展,它对与神经创伤相关的病理生理学敏感,因此是一种表征脑震荡和反复头部撞击暴露对脑微观结构影响的替代方法。这项工作的目的是在一组其他方面健康的男女大学生运动员队列中,表征既往脑震荡和多年接触性运动暴露(反复头部撞击的一个替代指标)与磁化率之间的关联。我们假设脑震荡和接触性运动暴露将分别与白质区域较低的磁化率相关。在有更多脑震荡病史的运动员中观察到了更高的一般症状严重程度和心理症状,但在多年接触性运动暴露的运动员中未观察到。未观察到脑震荡或暴露年限与认知表现之间的关联。基于体素的分析发现,有更多既往脑震荡的个体在两个主要为白质的簇中也有较低的磁化率,包括上纵束和胼胝体压部。未观察到磁化率与接触性运动暴露之间的关联。最后,在确定区域中较低的磁化率与更差的心理症状、更差的一般症状以及在流体认知任务综合测量中的更差表现相关。目前的结果表明,在其他方面健康的大学生运动员中,更多的既往脑震荡与磁化率降低有关,而磁化率降低又与症状报告增加和认知表现较差有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/206c/11997015/4382f3b2f1fc/HBM-46-e70213-g001.jpg

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