Soccer heading damages brain regions affected in CTE
Radiological Society of North America
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Diffusion MRI shows the effect of soccer heading on brain regions. RHI = repetitive head impacts
view moreCredit: Radiological Society of North America (RSNA) and Michael L. Lipton, M.D., Ph.D.
CHICAGO – Soccer heading may cause more damage to the brain than previously thought, according to a study being presented next week at the annual meeting of the Radiological Society of North America (RSNA).
Heading is a widely used technique in soccer where the players control the direction of the ball by hitting it with their head. In recent years, research has been done that suggests a link between repeated head impacts and neurodegenerative diseases, such as chronic traumatic encephalopathy (CTE).
“The potential effects of repeated head impacts in sport are much more extensive than previously known and affect locations similar to where we’ve seen CTE pathology,” said study senior author Michael L. Lipton, M.D., Ph.D., professor of radiology at Columbia University Irving Medical Center in New York. “This raises concern for delayed adverse effects of head impacts.”
While prior studies have identified injuries to the brain’s white matter in soccer players, Dr. Lipton and colleagues utilized a new approach to an advanced brain imaging technique called diffusion MRI to analyze microstructure close to the surface of the brain.
To identify how repeated head impacts affect the brain, the researchers compared brain MRIs of 352 male and female amateur soccer players, ranging in age from 18 to 53, to brain MRIs of 77 non-collision sport athletes, such as runners.
Soccer players who headed the ball at high levels showed abnormality of the brain’s white matter adjacent to sulci, which are deep grooves in the brain’s surface. Abnormalities in this region of the brain are known to occur in very severe traumatic brain injuries.
The abnormalities were most prominent in the frontal lobe of the brain, an area most susceptible to damage from trauma and frequently impacted during soccer heading. More repetitive head impacts were also associated with poorer verbal learning.
“Our analysis showed that the white matter abnormalities represent a mechanism by which heading leads to worse cognitive performance,” Dr. Lipton said.
Most of the participants of the study had never sustained a concussion or been diagnosed with a traumatic brain injury. This suggests that repeated head impacts that don’t result in serious injury may still adversely affect the brain.
“The study identifies structural brain abnormalities from repeated head impacts among healthy athletes,” Dr. Lipton said. “The abnormalities occur in the locations most characteristic of CTE, are associated with worse ability to learn a cognitive task and could affect function in the future.”
The results of this study are also relevant to head injuries from other contact sports. The researchers stress the importance of knowing the risks of repeated head impacts and their potential to harm brain health over time.
“Characterizing the potential risks of repetitive head impacts can facilitate safer sport engagement to maximize benefits while minimizing potential harms,” Dr. Lipton said. “The next phase of the study is ongoing and examines the brain mechanisms underlying the MRI effects and potential protective factors.”
Co-authors are Bluyé Demessie, A.B., M.S., Walter F. Stewart, Ph.D., Richard B. Lipton, M.D., Molly E. Zimmerman, Ph.D., Mimi Kim, Sc.D., Kenny Ye, Ph.D., Thomas Kaminski and Roman Fleysher, Ph.D.
This study was funded by the National Institutes of Health and The Dana Foundation.
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Note: Copies of RSNA 2024 news releases and electronic images will be available online at RSNA.org/press24.
RSNA is an association of radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Illinois. (RSNA.org)
For patient-friendly information on brain MRI, visit RadiologyInfo.org
Concussions slow brain activity of high school football players
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Magnetoencephalography (MEG) equipment. Pre- and post-season resting-state MEG data was collected from 91 high school football players, of whom 10 were diagnosed with a concussion. MEG is a neuroimaging technique that measures the magnetic fields that the brain’s electrical currents produce.
view moreCredit: Radiological Society of North America (RSNA)
CHICAGO – A new study of high school football players found that concussions affect an often-overlooked but important brain signal. The findings are being presented next week at the annual meeting of the Radiological Society of North America (RSNA).
Reports have emerged in recent years warning about the potential harms of youth contact sports on developing brains. Contact sports, including high school football, carry a risk of concussion. Symptoms of concussion commonly include cognitive disturbances, such as difficulty with balancing, memory or concentration.
Many concussion studies focus on periodic brain signals. These signals appear in rhythmic patterns and contribute to brain functions such as attention, movement or sensory processing. Not much is known about how concussions affect other aspects of brain function, specifically, brain signals that are not rhythmic.
“Most previous neuroscience research has focused on rhythmic brain signaling, which is also called periodic neurophysiology,” said study lead author Kevin C. Yu, B.S., a neuroscience student at Wake Forest University School of Medicine in Winston-Salem, North Carolina. “On the other hand, aperiodic neurophysiology refers to brain signals that are not rhythmic.”
Aperiodic activity is typically treated as ‘background noise’ on brain scans, but recent studies have shown that this background noise may play a key role in how the brain functions.
“While it’s often overlooked, aperiodic activity is important because it reflects brain cortical excitability,” said study senior author Christopher T. Whitlow, M.D., Ph.D., M.H.A., Meschan Distinguished Professor and Enterprise Chair of Radiology at Wake Forest University School of Medicine.
Cortical excitability is a vital part of brain function. It reflects how nerve cells, or neurons, in the brain’s cortex respond to stimulation and plays a key role in cognitive functions like learning and memory, information processing, decision making, motor control, wakefulness and sleep.
To gain a better understanding of brain rhythms and trauma, the researchers sought to identify the impacts of concussions on aperiodic activity.
Pre- and post-season resting-state magnetoencephalography (MEG) data was collected from 91 high school football players, of whom 10 were diagnosed with a concussion. MEG is a neuroimaging technique that measures the magnetic fields that the brain’s electrical currents produce.
A clinical evaluation tool for concussions called the Post-Concussive Symptom Inventory was correlated with pre- and post-season physical, cognitive and behavioral symptoms.
High school football players who sustained concussions displayed slowed aperiodic activity. Aperiodic slowing was strongly associated with worse post-concussion cognitive symptoms and test scores.
Slowed aperiodic activity was present in areas of the brain that contain chemicals linked with concussion symptoms like impaired concentration and memory.
“This study is important because it provides insight into both the mechanisms and the clinical implications of concussion in the maturing adolescent brain,” said co-lead author Alex I. Wiesman, Ph.D., assistant professor at Simon Fraser University in Burnaby, British Columbia, Canada. “Reduced excitability is conceptually a very different brain activity change than altered rhythms and means that a clear next step for this work is to see whether these changes are related to effects of concussion on the brain’s chemistry.”
The results highlight the importance of protective measures in contact sports. The researchers cautioned that young players should always take the necessary time to fully recover from a concussion before returning to any sport.
The findings from the study may also influence tracking of post-concussion symptoms and aid in finding new treatments to improve recovery.
“Our study opens the door to new ways of understanding and diagnosing concussions, using this novel type of brain activity that is associated with concussion symptoms,” Dr. Whitlow said. “It highlights the importance of monitoring kids carefully after any head injury and taking concussions seriously.”
Other co-authors are Elizabeth M. Davenport, Ph.D., Laura A. Flashman, Ph.D., Jillian Urban, Ph.D., Srikantam S. Nagarajan, Ph.D., Kiran Solingapuram Sai, Ph.D., Joel Stitzel, Ph.D., and Joseph A. Maldjian, M.D.
This work was supported by the National Institutes of Health (NIH) grants R01NS082453 and R01NS091602, NIH grant F32-NS119375, a Canadian Institutes of Health Research (CIHR) Banting Postdoctoral Fellowship (BPF-186555), and a CIHR Canada Research Chair (CRC-2023-00300).
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Note: Copies of RSNA 2024 news releases and electronic images will be available online at RSNA.org/press24.
RSNA is an association of radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Illinois. (RSNA.org)
For patient-friendly information on brain imaging, visit RadiologyInfo.org.
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