RESUMO
This prospective longitudinal trial aimed to (1) determine the role of head impact exposure on behavioral/cognitive outcomes, and (2) assess the protective effect(s) of a jugular vein compression (JVC) collar on behavioral/cognitive outcomes after one season of high-school football. Participants included 284 male high-school football players aged 13-18 years enrolled from seven Midwestern high-schools. Schools were allocated to the JVC collar intervention (four teams, 140 players) or no collar/no intervention control (three teams, 144 players) condition. Head impact exposure was measured throughout the season using CSx accelerometers. Outcome measures included post-season parent and adolescent report on Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Scale (SWAN) and Post-Concussion Symptom Inventory (PCSI), as well as adolescent performance on Attention Network Task (ANT), digital Trail Making Task (dTMT), and Cued Switching task. No significant effect of head impact exposure or JVC collar use on post-season SWAN or PCSI scores or performance on dTMT and Cued Switching task were noted. There was no effect of head impact exposure on ANT performance; however, the JVC collar group had greater post-season Alerting network scores than the no collar group (p = 0.026, d = 0.22). Findings provide preliminary evidence that the JVC collar may provide some protection to the alerting attention system. These findings should be interpreted cautiously as a greater understanding of the long-term sequelae of head impact exposure and the role of cumulative head impact exposure behavioral/cognitive outcomes is required.
Assuntos
Concussão Encefálica , Futebol Americano , Adolescente , Concussão Encefálica/psicologia , Cognição , Humanos , Veias Jugulares , Masculino , Estudos Prospectivos , Instituições Acadêmicas , Estações do AnoRESUMO
The purpose of this clinical trial was to examine whether internal jugular vein compression (JVC)-using an externally worn neck collar-modulated the relationships between differential head impact exposure levels and pre- to postseason changes in diffusion tensor imaging (DTI)-derived diffusivity and anisotropy metrics of white matter following a season of American tackle football. Male high-school athletes (n = 284) were prospectively assigned to a non-collar group or a collar group. Magnetic resonance imaging data were collected from participants pre- and postseason and head impact exposure was monitored by accelerometers during every practice and game throughout the competitive season. Athletes' accumulated head impact exposure was systematically thresholded based on the frequency of impacts of progressively higher magnitudes (10 g intervals between 20 to 150 g) and modeled with pre- to postseason changes in DTI measures of white matter as a function of JVC neck collar wear. The findings revealed that the JVC neck collar modulated the relationships between greater high-magnitude head impact exposure (110 to 140 g) and longitudinal changes to white matter, with each group showing associations that varied in directionality. Results also revealed that the JVC neck collar group partially preserved longitudinal changes in DTI metrics. Collectively, these data indicate that a JVC neck collar can provide a mechanistic response to the diffusion and anisotropic properties of brain white matter following the highly diverse exposure to repetitive head impacts in American tackle football. Clinicaltrials.gov: NCT# 04068883.
Assuntos
Lesões Encefálicas Traumáticas/prevenção & controle , Bandagens Compressivas , Futebol Americano/lesões , Traumatismos Cranianos Fechados/complicações , Veias Jugulares , Equipamentos de Proteção , Substância Branca/lesões , Esportes Juvenis/lesões , Acelerometria , Adolescente , Lesões Encefálicas Traumáticas/diagnóstico por imagem , Lesões Encefálicas Traumáticas/etiologia , Imagem de Tensor de Difusão , Desenho de Equipamento , Traumatismos Cranianos Fechados/epidemiologia , Humanos , Veias Jugulares/fisiopatologia , Masculino , Modelos Neurológicos , Cooperação do Paciente , Estudos Prospectivos , Recidiva , Estados Unidos , Substância Branca/diagnóstico por imagem , Substância Branca/patologiaRESUMO
OBJECTIVE: This study's purpose was to utilize a prospective dataset to examine differences in functional brain connectivity in male high school athletes who suffered an anterior cruciate ligament (ACL) injury relative to their non-injured peers. METHODS: Sixty-two male high school football players were evaluated using functional magnetic resonance imaging prior to their competitive season to evaluate resting-state functional brain connectivity. Three athletes later experienced an ACL injury and were matched to 12 teammates who did not go on to sustain an ACL injury (controls) based on school, age, height, weight, and year in school. Twenty-five knee-motor regions of interest (ROIs) were created to identify differences in connectivity between the two groups. Between-subject F and t tests were used to identify significant ROI differences using a false discovery rate correction for multiple comparisons. RESULTS: There was significantly less connectivity between the left secondary somatosensory cortex and the left supplementary motor area (pâ¯=â¯0.025), right pre-motor cortex (pâ¯=â¯0.026), right supplementary motor area (pâ¯=â¯0.026), left primary somatosensory cortex (superior division; pâ¯=â¯0.026), left primary somatosensory cortex (inferior division; pâ¯=â¯0.026), and left primary motor cortex (pâ¯=â¯0.048) for the ACL-injured compared to the control subjects. No other ROI-to-ROI comparisons were significantly different between the groups (all pâ¯>â¯0.05). CONCLUSION: Our preliminary data indicate a potential sensorimotor disruption for male football players who go on to experience an ACL injury. Future studies with larger sample sizes and complementary measures of neuromuscular control are needed to support these findings.