The ENIGMA sports injury working group:– an international collaboration to further our understanding of sport-related brain injury

Abstract

Sport-related brain injury is very common, and the potential long-term effects include a wide range of neurological and psychiatric symptoms, and potentially neurodegeneration. Around the globe, researchers are conducting neuroimaging studies on primarily homogenous samples of athletes. However, neuroimaging studies are expensive and time consuming, and thus current findings from studies of sport-related brain injury are often limited by small sample sizes. Further, current studies apply a variety of neuroimaging techniques and analysis tools which limit comparability among studies. The ENIGMA Sports Injury working group aims to provide a platform for data sharing and collaborative data analysis thereby leveraging existing data and expertise. By harmonizing data from a large number of studies from around the globe, we will work towards reproducibility of previously published findings and towards addressing important research questions with regard to diagnosis, prognosis, and efficacy of treatment for sport-related brain injury. Moreover, the ENIGMA Sports Injury working group is committed to providing recommendations for future prospective data acquisition to enhance data quality and scientific rigor. Keywords Concussion. ENIGMA. Repetitive head impacts. Sport-related brain injury Sport-related brain injury Sport-related brain injury is a broad term that describes alterations in brain structure and function resulting from mechanical forces to the head sustained while participating in sports. The most common forms of sport-related brain trauma are typically categorized as sport-related concussion (SRC) and exposure to repetitive head impacts (RHI) which may have cumulative effects on brain structure and function. Stages of brain alterations due to sport-related brain injury have been described as acute/subacute, chronic but static, and progressive neurodegenerative decline, as shown in Fig. 1. Sport-related Concussion (SRC) is common in athletes. An estimated 1.6 to 3.8 million people suffer from SRC annually in the United States alone (Daneshvar et al. 2011; Laker 2015; Langlois et al. 2006). SRC occurs in all sports, but incidence rates are highest in contact and collision sports such as football, soccer, rugby, or ice hockey (Guskiewicz et al. 2000; Laker 2015; Marar et al. 2012; Meehan et al. 2010). SRC is characterized by a sudden, but typically, transient impairment in brain function following an impact to the head, face, neck, or body. Symptoms of SRC include headache, dizziness, visual ocular dysfunction, loss of memory, and confusion and resolve within weeks in adults and up to a month in children

Top cited articles in concussion: A bibliometric analysis of the state of the science

“…1 The scale of this injury and its potential for long-term sequelae [2][3][4] prompted the formation of the many international and national research taskforces aimed at advancing our understanding concussion and how to manage it. [5][6][7][8][9] Multidisciplinary collaboration has also worked towards this goal, bringing together perspectives ranging from neurology to sports medicine to rehabilitation sciences to further concussion research. As suggested by these initiatives, and in general, research interest in concussion has heightened.…”

Current and Emerging Techniques in Neuroimaging of Sport-Related Concussion

“…91,92 The Enhancing NeuroImaging Genetics through Meta-Analysis Brain Injury working group aims to investigate brain trauma occurring across different subpopulations, 93,94 with one of the groups focusing particularly on sport-related brain injury. 95 The collection of prospectively or retrospectively harmonized measures across multiple sites is a significant strength of consortium studies. However, a significant challenge of these studies is the interpretation of neuroimaging data from multiple locations.…”

“…91,92 The Enhancing NeuroImaging Genetics through Meta-Analysis Brain Injury working group aims to investigate brain trauma occurring across different subpopulations, 93,94 with one of the groups focusing particularly on sport-related brain injury. 95…”

Diffusion Imaging of Sport-related Repetitive Head Impacts—A Systematic Review

“…Many pressing research questions, including whether there are effects of biological sex following exposure to RHI, could be addressed using larger samples (for review of sex differences in sports concussion see Koerte et al, 2020). One way to overcome the limitation of small sample sizes is to use large-scale study approaches applied to retrospective data analysis such as those performed by the ENIGMA consortium (Thompson et al, 2020) and by the ENIGMA sports brain injury working group (Koerte et al, 2021).…”