Subconcussive Head Impact Exposure and White Matter Tract Changes over a Single Season of Youth Football

Bahrami, Naeim; Sharma, Dev; Rosenthal, Scott L.; Davenport, Elizabeth M.; Urban, Jillian E.; Wagner, Benjamin; Jung, Youngkyoo; Vaughan, Christopher G.; Gioia, Gérard A.; Stitzel, Joel D.; Whitlow, Christopher T.; Maldjian, Joseph A.

doi:10.1148/radiol.2016160564

Cited by 179 publications

(145 citation statements)

References 53 publications

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“…These findings are corroborated by studies in which a greater risk-weighted head impact exposure index was associated with a greater number of voxels with altered FA. 6,7 Expanding to other sports, the burden of heading events in adult soccer athletes has been associated with alterations in white matter diffusion metrics and diminished performance on computerized cognitive assessment. 8,9 …”

Section: Introductionmentioning

confidence: 99%

White Matter Changes Related to Subconcussive Impact Frequency during a Single Season of High School Football

Kuzminski

Clark

Fraser

et al. 2017

AJNR Am J Neuroradiol

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Background and Purpose The effect of exposing the developing brain of a high school football player to subconcussive impacts over the course of a single season is unknown. The purpose of this pilot study was to utilize MRI diffusion tensor imaging to assess white matter changes over the course of a single high school football season, and to correlate these changes with impacts measured by helmet accelerometer data and neurocognitive test scores collected over the same time period. Materials and Methods Seventeen male athletes (mean age 16 ± 0.73 years) underwent MRI scanning before and after the season. Changes in fractional anisotropy across the white matter skeleton were assessed with tract-based spatial statistics and region-of-interest (ROI) analysis. Results The mean number of impacts over a 10g threshold sustained was 414 (±291). Voxel-wise analysis failed to show significant changes in FA across the season, nor a correlation with impact frequency, after correcting for multiple comparisons. ROI analysis showed significant (p<0.05, corrected) decreases in FA in the fornix – stria terminalis (FXST) and cingulum hippocampus (CGH), which were related to impact frequency. The effects were strongest in the FXST, where decreases in FA correlated with worsening visual memory. Conclusion Our findings suggest that subclinical neurotrauma related to participation in American football may result in white matter injury, and that alterations in white matter tracts within the limbic system may be detectable after only one season of play at the high school level.

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Section: Introductionmentioning

confidence: 99%

White Matter Changes Related to Subconcussive Impact Frequency during a Single Season of High School Football

Kuzminski

Clark

Fraser

et al. 2017

AJNR Am J Neuroradiol

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“…46 Exposure to these subconcussive head impacts during youth tackle football has been shown to result in microstructural brain changes following a single season of play. 15 RHI, in general, is associated with macro- and microstructural, neurochemical, and functional brain alterations. 47 Future work, including experimental animal models, is needed to study mechanisms that underpin the association between youth exposure to RHI and worse clinical function later in life.…”

Section: Discussionmentioning

confidence: 99%

Age of first exposure to tackle football and chronic traumatic encephalopathy

Alosco

Mez

Tripodis

et al. 2018

Annals of Neurology

121

136

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In this sample of deceased tackle football players, younger age of exposure to tackle football was not associated with CTE pathological severity, but predicted earlier neurobehavioral symptom onset. Youth exposure to tackle football may reduce resiliency to late-life neuropathology. These findings may not generalize to the broader tackle football population, and informant-report may have affected the accuracy of the estimated effects. Ann Neurol 2018;83:886-901.

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“…Two longitudinal studies on the same cohort examined change in adolescent athletes both pre- and post-season. Davenport et al [16] and Bahrami et al [18] found that a higher level of exposure to subconcussive impacts, as measured with helmet-based sensors, was associated with lower FA in the IFOF and SLF, and more voxels showing abnormal FA (2 SD above or below healthy controls) [16, 18]. These studies are small and thus more likely to be swayed by outliers.…”

Section: Introductionmentioning

confidence: 99%

Diffusion MRI in pediatric brain injury

Dennis

Babikian²,

Giza

et al. 2017

Childs Nerv Syst

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Traumatic brain injury (TBI) is a major public health issue around the world and can be especially devastating in children as TBI can derail cognitive and social development. White matter (WM) is particularly vulnerable to disruption post-TBI, as myelination is ongoing during this period. Diffusion magnetic resonance imaging (dMRI) is a versatile modality for identifying and quantifying WM disruption and can detect diffuse axonal injury (DAI or TAI (traumatic axonal injury)). This review covers dMRI studies of pediatric TBI, including mild to severe injuries, and covering all periods post-injury. While there have been considerable advances in our understanding of pediatric TBI through the use of dMRI, there are still large gaps in our knowledge, which will be filled in by larger studies and more longitudinal studies. Heterogeneity post-injury is an obstacle in all TBI studies, but we expect that larger better-characterized samples will aid in identifying clinically meaningful subgroups within the pediatric TBI patient population.

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Subconcussive Head Impact Exposure and White Matter Tract Changes over a Single Season of Youth Football

Cited by 179 publications

References 53 publications

White Matter Changes Related to Subconcussive Impact Frequency during a Single Season of High School Football

White Matter Changes Related to Subconcussive Impact Frequency during a Single Season of High School Football

Age of first exposure to tackle football and chronic traumatic encephalopathy

Diffusion MRI in pediatric brain injury

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