American Football Position-Specific Neurometabolic Changes in High School Athletes: A Magnetic Resonance Spectroscopic Study

Vike, Nicole L.; Bari, Sumra; Susnjar, Antonia; Lee, Taylor; Lycke, Roy; Auger, Joshua; Music, Jacob; Nauman, Eric A.; Talavage, Thomas M.; Rispoli, Joseph V.

doi:10.1089/neu.2021.0186

Cited by 5 publications

(13 citation statements)

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“…The growing concern surrounding football-related injuries has further increased demand for research to understand injury risk factors and prevention. Topics of research relating to football are broad, ranging from performance to injury-related topics 4 , 17 , 56 , 107 to social and political issues. 38 , 101 , 103 With such a wide scope of research, it has become difficult to identify the most significant and impactful findings relating to football injuries.…”

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confidence: 99%

The 50 Most Cited Papers Pertaining to American Football: Analysis of Studies From the Past 40 Years

Jenkins

Moore

Pollock

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Bibliometric citation analyses have been widely used in medicine to help researchers gain foundational knowledge about a topic and identify subtopics of popular interest for further investigations. Purpose: To identify the 50 most cited research publications related to American football. Study Design: Cross-sectional study. Methods: The Clarivate Analytics Web of Science database was used to generate a list of publications relating to football. Articles were filtered by the total number of citations, and the top 50 most cited articles studying the sport of football were selected for this analysis. Articles were analyzed by author, publication year, country of origin, institution affiliation, journal, article type, main research topic area, competitive level, and the level of evidence. A total of 247 articles were reviewed to reach the top 50 articles. Results: The most studied topic within the top 50 articles was concussion/chronic traumatic encephalopathy (n = 40). Collegiate football was the most studied level of competition (n = 25). The journal publishing the greatest number of top articles was Neurosurgery. Two institutions, the University of North Carolina at Chapel Hill and Boston University School of Medicine, produced over one-third of top 50 articles (n = 18). Conclusion: Our analysis indicated that most of the top 50 publications related to the sport of football focused on concussion and CTE, were observational, and were published during or after 2000. The most studied level of competition was collegiate football.

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confidence: 99%

The 50 Most Cited Papers Pertaining to American Football: Analysis of Studies From the Past 40 Years

Jenkins

Moore

Pollock

et al. 2022

Orthopaedic Journal of Sports Medicine

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“…Contact/collision sports included American football ( n = 4), soccer ( n = 4), rugby union ( n = 3), ice‐hockey ( n = 2), lacrosse ( n = 1), field hockey ( n = 1), basketball ( n = 1) and water polo ( n = 1; two studies (Bari et al., 2019; Churchill et al., 2017) reported on multiple contact/collision sports). Subconcussive head impacts were verified in four of nine studies (44%) via either head impact sensors ( n = 3; Bari et al., 2019; Poole et al., 2014; Vike et al., 2022; note that head impact sensor data for (Poole et al., 2014) was published in (Poole et al., 2015)) or standardised retrospective questionnaires ( n = 1; Koerte et al., 2015).…”

Section: Resultsmentioning

confidence: 98%

“…Nine studies (Bari et al., 2019; Chamard et al., 2012; Churchill et al., 2017; Koerte et al., 2015; Lefebvre et al., 2018; Poole et al., 2014; Schranz et al., 2018, 2020; Vike et al., 2022) were included in this review (Figure 1). Two used longitudinal (cohort) designs (Chamard et al., 2012; Schranz et al., 2018) and three used case–control designs (Churchill et al., 2017; Koerte et al., 2015; Lefebvre et al., 2018).…”

Section: Resultsmentioning

confidence: 99%

“…The four remaining studies utilised ‘mixed’ designs (i.e. had a control population and a longitudinal element; Bari et al., 2019; Poole et al., 2014; Schranz et al., 2020; Vike et al., 2022). Notably, none of the studies using mixed designs contained eligible case–control data (i.e.…”

Section: Resultsmentioning

confidence: 99%

“…If none of this information was available, the SD Δ was estimated using the following formula (Higgins et al., 2022:

{SD}_{Δ} goodbreak= \sqrt{()(, {SD}_{Baseline}^{2} goodbreak+ {SD}_{Assessment}^{2}) - ()(, 2 goodbreak\times R goodbreak\times {SD}_{Baseline} goodbreak\times {SD}_{Assessment})}

where R is the correlation coefficient calculated for each neurometabolite using raw values or p values derived from t ‐tests, from three studies (Chamard et al., 2012; Schranz et al., 2018; Vike et al., 2022; NAA: R = 0.16 [ n = 9 effect estimates], Glx: R = 0.11 [ n = 8 effect estimates], tCr: R = 0.08 [ n = 6 effect estimates], tCho: R = 0.19 [ n = 6 effect estimates] and mI: R = 0.09 [ n = 8 effect estimates]). The robustness of the analysis to the imputed R was determined via sensitivity analysis using R = 0.50 and R = 0.90.…”

Section: Methodsmentioning

confidence: 99%

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The effect of contact/collision sport participation without concussion on neurometabolites: A systematic review and meta‐analysis of magnetic resonance spectroscopy studies

Delang,

Irwin,

Peek

et al. 2023

Journal of Neurochemistry

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The aim of this study was to systematically review prior research investigating the effects of contact/collision sport participation on neurometabolite levels in the absence of concussion. Four online databases were searched to identify studies that measured neurometabolite levels in contact/collision sport athletes (without concussion) using proton (1H) or phosphorus (31P) magnetic resonance spectroscopy (MRS). All study designs were acceptable for inclusion. Meta‐analytic procedures were used to quantify the effect of contact/collision sport participation on neurometabolite levels and explore the impact of specific moderating factors (where sufficient data were available). Narrative synthesis was used to describe outcomes that could not be meta‐analysed. Nine observational studies involving 300 contact/collision sport athletes were identified. Six studies (providing 112 effect estimates) employed longitudinal (cohort) designs and three (that could not be meta‐analysed) employed case–control designs. N‐acetylaspartate (NAA; g = −0.331, p = 0.013) and total creatine (tCr; creatine + phosphocreatine; g = −0.524, p = 0.029), but not glutamate–glutamine (Glx), myo‐inositol (mI) or total choline (tCho; choline‐containing compounds; p's > 0.05), decreased between the pre‐season and mid−/post‐season period. Several moderators were statistically significant, including: sex (Glx: 6 female/23 male, g = −0.549, p = 0.013), sport played (Glx: 22 American football/4 association football [soccer], g = 0.724, p = 0.031), brain region (mI: 2 corpus callosum/9 motor cortex, g = −0.804, p = 0.015), and the MRS quantification approach (mI: 18 absolute/3 tCr‐referenced, g = 0.619, p = 0.003; and tCho: 18 absolute/3 tCr‐referenced, g = 0.554, p = 0.005). In case–control studies, contact/collision sport athletes had higher levels of mI, but not NAA or tCr compared to non‐contact sport athletes and non‐athlete controls. Overall, this review suggests that contact/collision sport participation has the potential to alter neurometabolites measured via 1H MRS in the absence of concussion. However, further research employing more rigorous and consistent methodologies (e.g. interventional studies with consistent 1H MRS pulse sequences and quantifications) is required to confirm and better understand the clinical relevance of observed effects.image

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Associations Between Brain Metabolites Measured With MR Spectroscopy and Head Impacts in High School American Football Athletes

Liu,

Dudley,

Diekfuss

et al. 2024

Magnetic Resonance Imaging

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BackgroundWhile changes in brain metabolites after injury have been reported, relationships between metabolite changes and head impacts are less characterized.PurposeTo investigate alterations in neurochemistry in high school athletes as a function of head impacts, concussion, and the use of a jugular vein compression (JVC) collar.Study TypeProspective controlled trial.SubjectsA total of 284 male American football players, divided into JVC collar and noncollar groups; 215 included in final analysis (age = 15.9 ± 1.0 years; 114 in collar group).Field Strength/Sequence3 Tesla/T1‐weighted gradient echo, 1H point resolved spectroscopy, acquired between August and November 2018.AssessmentHead impacts were quantified using accelerometers. Concussion was diagnosed by medical professionals for each team. Pre‐ to postseason differences in total N‐acetylaspartate (tNAA), total choline (tCho), myo‐inositol (myoI), and glutamate + glutamine (Glx), in primary motor cortex (M1) and anterior cingulate cortex (ACC), relative to total creatine (tCr), were determined.Statistical TestsGroup‐wise comparisons were performed using Wilcoxon signed‐rank, Friedman's, and Mann–Whitney U tests. Relationships between ∆metabolite/tCr and mean g‐force were analyzed using linear regressions accounting for concussion and JVC collar. Significance was set at P ≤ 0.05.ResultsIn participants without concussion, a significant decrease in tCho/tCr (0.233 ± 1.40 × 10−3 to 0.227 ± 1.47 × 10−7) and increase in Glx/tCr (1.60 ± 8.75 × 10−3 to 1.63 ± 1.08 × 10−2) in ACC were observed pre‐ to postseason. The relationship between ∆tCho/tCr in M1 and ACC and mean g‐force from >80 g to >140 g differed significantly between participants with and without concussion (M1 β ranged from 3.9 × 10−3 to 2.1 × 10−3; ACC β ranged from 2.7 × 10−3 to 2.1 × 10−3). Posthoc analyses revealed increased tCho/tCr in M1 was positively associated with mean g‐force >100 g (β = 3.6 × 10−3) and >110 g (β = 2.9 × 10−3) in participants with concussion. Significant associations between in ACC and mean g‐force >110 g (β = −1.1 × 10−3) and >120 g (β = −1.1 × 10−3) were observed in the collar group only.Data ConclusionDiagnosed concussion and the use of a JVC collar result in distinct neurochemical trends after repeated head impacts.Level of Evidence2Technical EfficacyStage 3

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American Football Position-Specific Neurometabolic Changes in High School Athletes: A Magnetic Resonance Spectroscopic Study

Cited by 5 publications

References 57 publications

The 50 Most Cited Papers Pertaining to American Football: Analysis of Studies From the Past 40 Years

The 50 Most Cited Papers Pertaining to American Football: Analysis of Studies From the Past 40 Years

The effect of contact/collision sport participation without concussion on neurometabolites: A systematic review and meta‐analysis of magnetic resonance spectroscopy studies

Associations Between Brain Metabolites Measured With MR Spectroscopy and Head Impacts in High School American Football Athletes

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