White and Gray Matter Abnormalities in Australian Footballers With a History of Sports-Related Concussion: An MRI Study

Major, Brendan; Symons, Georgia F; Sinclair, Benjamin; O’Brien, William T.; Costello, Daniel; Wright, David K.; Clough, Meaghan; Mutimer, Steven; Sun, Mujun; Yamakawa, Glenn R.; Brady, Rhys D.; O’Sullivan, Michael; Mychasiuk, Richelle; McDonald, Stuart J.; O’Brien, Terence J.; Law, Meng; Kolbe, Scott; Shultz, Sandy R.

doi:10.1093/cercor/bhab161

Cited by 12 publications

(10 citation statements)

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“…The rCFL players had a BDI-II score of 8.15 ± 7.03, which was significantly higher (p = 0.0021) compared to healthy age/sex matched controls (2.2 ± 2.68). The rCFL group mean score of 8.15 fell within the none to minimal depression category (0-13), with only some rCFL players scoring mild depression (10)(11)(12)(13)(14)(15)(16)(17)(18). But on average, the rCFL population reported almost 4 times greater levels of depressionlike symptoms than controls.…”

Section: Clinical Testing Resultsmentioning

confidence: 92%

“…12 Extensive research has been focused on the neuroimaging-based assessment of subjects in the acute (hours to days) and sub-acute (days to weeks) periods post-concussion. [12][13][14] Studies have shown that participation in collision sports can lead to widespread grey and white matter abnormalities, 15,16 however, neuroimaging research into the chronic effects of a history of concussion in older adults has produced variable and potentially contradictory results. For example, Terry et al (2019) found only minimal white matter damage in the internal capsule in former high school football players with a history of at least two concussions, now aged between 40 to 65, 17 compared to Guell et al (2020) who found widespread functional connectivity dysfunction in the cerebrum and cerebellum in aging, retired athletes 18 or Clark et al (2018) who found white and grey matter alterations that were associated with number of concussions and career length in former collegiate athletes.…”

Section: Introductionmentioning

confidence: 99%

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Years of play alter MRI measures of brain health in former Canadian Football League athletes: a pilot study

Doughty,

Danielli,

Boshra

et al. 2023

Journal of Concussion

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Introduction: Concussive and sub-concussive blows are commonly sustained during contact sports. Through a detailed neuroimaging analysis, this pilot study aimed to determine if a history of sport-related concussions exacerbated cognitive decline later in life. It was hypothesized that clinical health assessments and magnetic resonance imaging (MRI) techniques would provide insight into lasting health and well-being, structural, microstructural, and functional alterations caused by a history of concussive injuries. Materials and Methods: Twenty aging, retired Canadian Football League (rCFL) players (aged 56.9 ± 6.9) had clinical testing and MRI data acquired. Cortical thickness, voxel-wise diffusion tensor imaging (DTI), and Default Mode Network (DMN) connectivity data was collected for each subject and compared against healthy controls. Retired athlete age, playing position, and career length were also examined. Results: This study found widespread cortical thinning, significantly increased mean diffusivity, increased axial diffusivity, and both hyperactivity and hypoactivity within the DMN. Athlete age, position, and career length all influenced microstructural integrity. On average, retired athletes scored about 4 times greater depression-like and concussion-related symptoms and scored significantly lower in all health categories compared to healthy controls. Conclusions: These findings suggested that lasting signs of neurological injuries were present years after retiring from professional play.

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Section: Clinical Testing Resultsmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Years of play alter MRI measures of brain health in former Canadian Football League athletes: a pilot study

Doughty,

Danielli,

Boshra

et al. 2023

Journal of Concussion

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“…A questionnaire was administered pertaining to factors including demographics (ie, age, gender, height, weight), sporting history (ie, sports played, age they commenced collision sports, age they commenced all sport, years participating in collision sport, years participating in all sports), years of education and history of concussion (number and dates of previous concussions). 4 , 24 - 29 The ‘sport concussion assessment tool’ (SCAT; SCAT3 for 2017/18 players, SCAT5 for 2019 players) assessed symptom severity (maximum 132) at 2-, 6- and 13-days after SRC.…”

Section: Methodsmentioning

confidence: 99%

Decrease in Plasma miR-27a and miR-221 After Concussion in Australian Football Players

et al. 2022

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Introduction: Sports-related concussion (SRC) is a common form of brain injury that lacks reliable methods to guide clinical decisions. MicroRNAs (miRNAs) can influence biological processes involved in SRC, and measurement of miRNAs in biological fluids may provide objective diagnostic and return to play/recovery biomarkers. Therefore, this prospective study investigated the temporal profile of circulating miRNA levels in concussed male and female athletes. Methods: Pre-season baseline blood samples were collected from amateur Australian rules football players (82 males, 45 females). Of these, 20 males and 8 females sustained an SRC during the subsequent season and underwent blood sampling at 2-, 6- and 13-days post-injury. A miRNA discovery Open Array was conducted on plasma to assess the expression of 754 known/validated miRNAs. miRNA target identified were further investigated with quantitative real-time PCR (qRT-PCR) in a validation study. Data pertaining to SRC symptoms, demographics, sporting history, education history and concussion history were also collected. Results: Discovery analysis identified 18 candidate miRNA. The consequent validation study found that plasma miR-221-3p levels were decreased at 6d and 13d, and that miR-27a-3p levels were decreased at 6d, when compared to baseline. Moreover, miR-27a and miR-221-3p levels were inversely correlated with SRC symptom severity. Conclusion: Circulating levels of miR-27a-3p and miR-221-3p were decreased in the sub-acute stages after SRC, and were inversely correlated with SRC symptom severity. Although further studies are required, these analyses have identified miRNA biomarker candidates of SRC severity and recovery that may one day assist in its clinical management.

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“…A number of promising biomarkers have been developed with the aim of objectively determining recovery. Magnetic resonance imaging (MRI) techniques including magnetic resonance spectroscopy [ 4 ] and diffusion weighted imaging [ 5 – 8 ] have been used to investigate a range of often subtle physiological cascades that follow SRC. Quantitative susceptibility mapping (QSM) is a comparatively new technique that utilizes MR phase images to map tissue susceptibility ( χ ) [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Sub-acute Changes on MRI Measures of Cerebral Blood Flow and Venous Oxygen Saturation in Concussed Australian Rules Footballers

2022

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Background Sports-related concussion (SRC) is common in collision sport athletes. There is growing evidence that repetitive SRC can have serious neurological consequences, particularly when the repetitive injuries occur when the brain has yet to fully recover from the initial injury. Hence, there is a need to identify biomarkers that are capable of determining SRC recovery so that they can guide clinical decisions pertaining to return-to-play. Cerebral venous oxygen saturation (SvO2) and cerebral blood flow (CBF) can be measured using magnetic resonance imaging (MRI) and may provide insights into changing energy demands and recovery following SRC. Results In this study we therefore investigated SvO2 and CBF in a cohort of concussed amateur Australian Football athletes (i.e., Australia’s most participated collision sport). Male and female Australian footballers (n = 13) underwent MRI after being cleared to return to play following a mandatory 13-day recovery period and were compared to a group of control Australian footballers (n = 16) with no recent history of SRC (i.e., > 3 months since last SRC). Despite the concussed Australian footballers being cleared to return to play at the time of MRI, we found evidence of significantly increased susceptibility in the global white matter (p = 0.020) and a trend (F5,21 = 2.404, p = 0.071) for reduced relative CBF (relCBF) compared to the control group. Further, there was evidence of an interaction between sex and injury in straight sinus susceptibility values (F1,25 = 3.858, p = 0.061) which were decreased in female SRC athletes (p = 0.053). Of note, there were significant negative correlations between straight sinus susceptibility and relCBF suggesting impaired metabolic function after SRC. Conclusions These findings support the use of quantitative susceptibility mapping (QSM) and relCBF as sensitive indicators of SRC, and raise further concerns related to SRC guidelines that allow for return-to-play in less than two weeks.

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White and Gray Matter Abnormalities in Australian Footballers With a History of Sports-Related Concussion: An MRI Study

Cited by 12 publications

References 50 publications

Years of play alter MRI measures of brain health in former Canadian Football League athletes: a pilot study

Years of play alter MRI measures of brain health in former Canadian Football League athletes: a pilot study

Decrease in Plasma miR-27a and miR-221 After Concussion in Australian Football Players

Sub-acute Changes on MRI Measures of Cerebral Blood Flow and Venous Oxygen Saturation in Concussed Australian Rules Footballers

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