Repetitive Head Impacts in Youth Football: Description and Relationship to White Matter Structure

Nilsson, Kurt J.; Flint, Hilary; Gao, Yong; Kendrick, Leslie E.; Cutchin, Steve; Pentecost, Ryoko; Pardue, Kristi

doi:10.1177/1941738119865264

Cited by 7 publications

(3 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 30 Of note, high school players had significant reductions in mean diffusivity, radial diffusivity and axial diffusivity, the latter of which occurred to a greater extent than in youth players. Nilsson et al 31 found no pre/post-season FA changes in youth football players (8–12 years), and no differences in FA changes over time compared to age- and sex-matched swimmers. However, these investigators did find a significant relationship between one metric of HIE (magnitude of lateral head impacts) and FA in the left cingulate cortex.…”

Section: Discussionmentioning

confidence: 97%

Subconcussive changes in youth football players: objective evidence using brain vital signs and instrumented accelerometers

Fickling

Poel

Dorman

et al. 2021

Brain Communications

View full text Add to dashboard Cite

Brain vital signs, measured by electroencephalography (EEG), were used for portable, objective, neurophysiological evaluation of cognitive function in youth tackle football players. Specifically, we investigated whether previously reported pre- and post-season subconcussive changes detected in youth ice hockey players were comparably detected in football. The two objectives were to: 1) replicate previously published results showing subconcussive cognitive deficits; and 2) the relationship between brain vital sign changes and head-impact exposure. Using a longitudinal design, 15 male football players (age 12.89 ± 0.35 years) were tested pre- and post-season, with none having a concussion diagnosis during the season. Peak latencies and amplitudes were quantified for Auditory sensation (N100), Basic attention (P300) and Cognitive processing (N400). Regression analyses tested the relationships between these brain vital signs and exposure to head impacts through both number of impacts sustained, and total sessions (practices and games) participated. The results demonstrated significant pre/post differences in N400 latencies, with a ∼70ms delay (p < 0.01), replicating prior findings. Regression analysis also showed significant linear relationships between brain vital signs changes and head impact exposure based on accelerometer data and games/practices played (highest R = 0.863, p < 0.001 for overall sessions). Number of head impacts in youth football (age 12–14 years) findings corresponded most closely with prior Junior-A ice hockey (age 16–21 years) findings, suggesting comparable contact levels at younger ages in football. The predictive relationship of brain vital signs provided a notable complement to instrumented accelerometers, with a direct physiological measure of potential individual exposure to subconcussive impacts.

show abstract

Section: Discussionmentioning

confidence: 97%

Subconcussive changes in youth football players: objective evidence using brain vital signs and instrumented accelerometers

Fickling

Poel

Dorman

et al. 2021

Brain Communications

View full text Add to dashboard Cite

show abstract

“…Some have documented detrimental short-term effects of repetitive sub-concussive head impacts on neurophysiology, [17][18][19] white matter integrity, 20,21 functional connectivity, 11 metabolic functioning, 22 and neurocognitive functioning [23][24][25] among young football players. Yet others report minimal, if any, short-term effects of head impact exposure on white matter integrity, 26 neurophysiology, 27 neurocognitive outcomes, [27][28][29][30][31] postural stability [31][32][33] or oculomotor performance. 31,33 Given these inconsistencies, it remains critically important to better understand the influence of repetitive head impacts in young athletes, particularly as adolescence is a critical period of neurodevelopment.…”

Section: Introductionmentioning

confidence: 99%

Effect of Subconcussive Head Impact Exposure and Jugular Vein Compression on Behavioral and Cognitive Outcomes after a Single Season of High-School Football: A Prospective Longitudinal Trial

Narad

Epstein

Peugh

et al. 2022

Journal of Neurotrauma

View full text Add to dashboard Cite

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 following 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 non-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 andCued 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 non-collar group (p=.026, d=.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 sequalae of head impact exposure and the role of cumulative head impact exposure behavioral/cognitive outcomes is required.

show abstract

“…To date, an unbiased brain atlas targeting adolescent collision-sport athletes does not exist, to the best of our knowledge. DTI literature of sports-related mTBI and repetitive head impacts in adolescents either manually defined their own regions of interest (ROIs) 29 – 31 , or more often did not employ a population-specific template to spatially normalize each individual brain image 32 – 44 . This may confound statistical analyses and contribute to varied DTI findings that make it difficult to interpret axonal pathology 45 .…”

Section: Introductionmentioning

confidence: 99%

Development of brain atlases for early-to-middle adolescent collision-sport athletes

Zou

Zhu

Yang

et al. 2021

Sci Rep

View full text Add to dashboard Cite

Human brains develop across the life span and largely vary in morphology. Adolescent collision-sport athletes undergo repetitive head impacts over years of practices and competitions, and therefore may exhibit a neuroanatomical trajectory different from healthy adolescents in general. However, an unbiased brain atlas targeting these individuals does not exist. Although standardized brain atlases facilitate spatial normalization and voxel-wise analysis at the group level, when the underlying neuroanatomy does not represent the study population, greater biases and errors can be introduced during spatial normalization, confounding subsequent voxel-wise analysis and statistical findings. In this work, targeting early-to-middle adolescent (EMA, ages 13–19) collision-sport athletes, we developed population-specific brain atlases that include templates (T1-weighted and diffusion tensor magnetic resonance imaging) and semantic labels (cortical and white matter parcellations). Compared to standardized adult or age-appropriate templates, our templates better characterized the neuroanatomy of the EMA collision-sport athletes, reduced biases introduced during spatial normalization, and exhibited higher sensitivity in diffusion tensor imaging analysis. In summary, these results suggest the population-specific brain atlases are more appropriate towards reproducible and meaningful statistical results, which better clarify mechanisms of traumatic brain injury and monitor brain health for EMA collision-sport athletes.

show abstract

Repetitive Head Impacts in Youth Football: Description and Relationship to White Matter Structure

Cited by 7 publications

References 29 publications

Subconcussive changes in youth football players: objective evidence using brain vital signs and instrumented accelerometers

Subconcussive changes in youth football players: objective evidence using brain vital signs and instrumented accelerometers

Effect of Subconcussive Head Impact Exposure and Jugular Vein Compression on Behavioral and Cognitive Outcomes after a Single Season of High-School Football: A Prospective Longitudinal Trial

Development of brain atlases for early-to-middle adolescent collision-sport athletes

Contact Info

Product

Resources

About