Association of Cavum Septum Pellucidum and Cavum Vergae With Cognition, Mood, and Brain Volumes in Professional Fighters

Lee, Jonathan K.; Wu, Janet; Bullen, Jennifer; Banks, Sarah J.; Bernick, Charles; Modic, Michael T.; Ruggieri, Paul; Bennett, Lauren; Jones, Stephen E.

doi:10.1001/jamaneurol.2019.2861

Cited by 31 publications

(21 citation statements)

References 48 publications

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“…39 However, studies have suggested that their presence is associated with cognitive dysfunction in patients with prior head trauma. 61 Also, the size and frequency of cavum septi pellucidi and cavum vergae were greater in patients with schizophrenia, alcoholism, and prior head trauma. 62 The cavum septi pellucidi is a normal finding in fetuses between 18 and 37 weeks of gestation, and its absence is associated with multiple significant CNS abnormalities.…”

Section: Cavum Septi Pellucidi Cavum Vergae and Cavum Veli Interpositimentioning

confidence: 90%

The Lateral Ventricles: A Detailed Review of Anatomy, Development, and Anatomic Variations

Scelsi

Rahim

Morris

et al. 2020

AJNR Am J Neuroradiol

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The cerebral ventricles have been studied since the fourth century BC and were originally thought to harbor the soul and higher executive functions. During the infancy of neuroradiology, alterations to the ventricular shape and position on pneumoencephalography and ventriculography were signs of mass effect or volume loss. However, in the current era of high-resolution cross-sectional imaging, variation in ventricular anatomy is more easily detectable and its clinical significance is still being investigated. Interpreting radiologists must be aware of anatomic variations of the ventricular system to prevent mistaking normal variants for pathology. We will review of the anatomy and development of the lateral ventricles and discuss several ventricular variations.

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Section: Cavum Septi Pellucidi Cavum Vergae and Cavum Veli Interpositimentioning

confidence: 90%

The Lateral Ventricles: A Detailed Review of Anatomy, Development, and Anatomic Variations

Scelsi

Rahim

Morris

et al. 2020

AJNR Am J Neuroradiol

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“…Subcortically, lower thalamic volumes have been associated with earlier age of initiating American football participation among retired professionals [ 48 ]. The Professional Fighters Brain Health Study investigated 476 active and former professional fighters (boxers and mixed martial artists; 92% active fighters and otherwise healthy) compared to 63 unexposed controls and found lower thalamus and corpus callosum volumes among fighters [ 49 ].…”

Section: Structural Mrimentioning

confidence: 99%

Identifying degenerative effects of repetitive head trauma with neuroimaging: a clinically-oriented review

Asken

Rabinovici

2021

acta neuropathol commun

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Background and Scope of Review Varying severities and frequencies of head trauma may result in dynamic acute and chronic pathophysiologic responses in the brain. Heightened attention to long-term effects of head trauma, particularly repetitive head trauma, has sparked recent efforts to identify neuroimaging biomarkers of underlying disease processes. Imaging modalities like structural magnetic resonance imaging (MRI) and positron emission tomography (PET) are the most clinically applicable given their use in neurodegenerative disease diagnosis and differentiation. In recent years, researchers have targeted repetitive head trauma cohorts in hopes of identifying in vivo biomarkers for underlying biologic changes that might ultimately improve diagnosis of chronic traumatic encephalopathy (CTE) in living persons. These populations most often include collision sport athletes (e.g., American football, boxing) and military veterans with repetitive low-level blast exposure. We provide a clinically-oriented review of neuroimaging data from repetitive head trauma cohorts based on structural MRI, FDG-PET, Aβ-PET, and tau-PET. We supplement the review with two patient reports of neuropathology-confirmed, clinically impaired adults with prior repetitive head trauma who underwent structural MRI, FDG-PET, Aβ-PET, and tau-PET in addition to comprehensive clinical examinations before death. Review Conclusions Group-level comparisons to controls without known head trauma have revealed inconsistent regional volume differences, with possible propensity for medial temporal, limbic, and subcortical (thalamus, corpus callosum) structures. Greater frequency and severity (i.e., length) of cavum septum pellucidum (CSP) is observed in repetitive head trauma cohorts compared to unexposed controls. It remains unclear whether CSP predicts a particular neurodegenerative process, but CSP presence should increase suspicion that clinical impairment is at least partly attributable to the individual’s head trauma exposure (regardless of underlying disease). PET imaging similarly has not revealed a prototypical metabolic or molecular pattern associated with repetitive head trauma or predictive of CTE based on the most widely studied radiotracers. Given the range of clinical syndromes and neurodegenerative pathologies observed in a subset of adults with prior repetitive head trauma, structural MRI and PET imaging may still be useful for differential diagnosis (e.g., assessing suspected Alzheimer’s disease).

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“…An enlarged CSP has been reported in contemporary neuroimaging (MRI) studies of boxers ( 25 ), active and retired mixed martial arts fighters ( 26 ), and retired professional football players ( 27 – 29 ). Additionally, Wilde et al identified expansion of the frontal horns of the lateral ventricles in a mixed cohort of active and retired boxers using the Evans' index (i.e., the ratio of the maximal transverse diameter of the frontal horns of the lateral ventricles to the maximal internal diameter of the cranium).…”

Section: Introductionmentioning

confidence: 90%

Examining for Cavum Septum Pellucidum and Ventricular Enlargement in Retired Elite-Level Rugby League Players

et al. 2022

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ObjectiveA cavum septum pellucidum (CSP) has been reported as a visible brain anomaly in normal individuals as well in some former combat and collision sport athletes. The appearance of CSP with fenestrations and ventricular enlargement are considered associated features of the neuropathological diagnosis of chronic traumatic encephalopathy. The current study examined CSP anatomic features and lateral ventricle size in retired elite rugby league players and controls.MethodsForty-one retired rugby league players and 41 healthy community controls, similar in age and education, underwent structural MRI scans. CSP grade, CSP length, corpus callosum septal length, and Evans' ratio (for lateral ventricle size) were rated by two of the current study authors. All participants also self-reported concussion exposure histories, depressive symptoms, daytime sleepiness, and impulsivity. They completed a neuropsychological test battery assessing premorbid intellectual functioning, attention, processing speed, language, visuospatial skills, memory, and aspects of executive functioning.ResultsThe two raters had high agreement for CSP grade (Cohen's κ = 0.80), CSP length [intraclass correlation (ICC) = 0.99], corpus callosum septal length (ICC = 0.73), the CSP/septal ratio (ICC = 0.99), and the Evans' ratio (ICC = 0.75). Twenty-five retired players (61.0%) had an abnormal CSP compared to 17 controls [41.5%; χ(1, 82)2 = 3.12, p = 0.08, odds ratio = 2.21]. The CSP/septal ratio was larger for retired players than for the controls. The Evans' ratio did not differ between the two groups. In the retired rugby league players (n = 41), those with normal (n = 16) and abnormal (n = 25) CSP grades did not differ across age, age of first exposure to collision sport, years of sport exposure, concussion history, or 23 clinical and cognitive variables.ConclusionThis study revealed a difference in the size of the CSP between retired professional rugby league players and controls. There was no significant difference in the size of the ventricles between the two groups. There were no significant differences between those with vs. without an abnormal CSP on age of first exposure to rugby league, years of exposure to repetitive neurotrauma, number of lifetime concussions, depression, impulsivity, perceived cognitive decline, or on any neuropsychological test.

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Association of Cavum Septum Pellucidum and Cavum Vergae With Cognition, Mood, and Brain Volumes in Professional Fighters

Cited by 31 publications

References 48 publications

The Lateral Ventricles: A Detailed Review of Anatomy, Development, and Anatomic Variations

The Lateral Ventricles: A Detailed Review of Anatomy, Development, and Anatomic Variations

Identifying degenerative effects of repetitive head trauma with neuroimaging: a clinically-oriented review

Examining for Cavum Septum Pellucidum and Ventricular Enlargement in Retired Elite-Level Rugby League Players

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