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White matter abnormalities in active elite adult rugby players
- Source :
- Brain Communications
- Publication Year :
- 2021
- Publisher :
- Oxford University Press (OUP), 2021.
-
Abstract
- The recognition, diagnosis and management of mild traumatic brain injuries are difficult and confusing. It is unclear how the severity and number of injuries sustained relate to brain injuries, such as diffuse axonal injury, diffuse vascular injury and progressive neurodegeneration. Advances in neuroimaging techniques enable the investigation of neuropathologies associated with acute and long-term effects of injury. Head injuries are the most commonly reported injury seen during professional rugby. There is increased vigilance for the immediate effects of these injuries in matches, but there has been surprisingly little research investigating the longer-term effects of rugby participation. Here, we present a longitudinal observational study investigating the relationship of exposure to rugby participation and sub-acute head injuries in professional adult male and female rugby union and league players using advanced MRI. Diffusion tensor imaging and susceptibility weighted imaging was used to assess white matter structure and evidence of axonal and diffuse vascular injury. We also studied changes in brain structure over time using Jacobian Determinant statistics extracted from serial volumetric imaging. We tested 41 male and 3 female adult elite rugby players, of whom 21 attended study visits after a head injury, alongside 32 non-sporting controls, 15 non-collision-sport athletic controls and 16 longitudinally assessed controls. Eighteen rugby players participated in the longitudinal arm of the study, with a second visit at least 6 months after their first scan. Neuroimaging evidence of either axonal injury or diffuse vascular injury was present in 23% (10/44) of players. In the non-acutely injured group of rugby players, abnormalities of fractional anisotropy and other diffusion measures were seen. In contrast, non-collision-sport athletic controls were not classified as showing abnormalities. A group level contrast also showed evidence of sub-acute injury using diffusion tensor imaging in rugby players. Examination of longitudinal imaging revealed unexpected reductions in white matter volume in the elite rugby players studied. These changes were not related to self-reported head injury history or neuropsychological test scores and might indicate excess neurodegeneration in white matter tracts affected by injury. Taken together, our findings suggest an association of participation in elite adult rugby with changes in brain structure. Further well-designed large-scale studies are needed to understand the impact of both repeated sports-related head impacts and head injuries on brain structure, and to clarify whether the abnormalities we have observed are related to an increased risk of neurodegenerative disease and impaired neurocognitive function following elite rugby participation.<br />Using advanced neuroimaging techniques to study a group of professional rugby players, Zimmerman et al. report evidence of both cross-sectional and longitudinal imaging abnormalities in the white matter. Their findings suggest an association of participation in elite adult rugby with changes in brain structure.<br />Graphical Abstract Graphical Abstract
- Subjects :
- medicine.medical_specialty
White matter
03 medical and health sciences
0302 clinical medicine
Physical medicine and rehabilitation
mTBI
Neuroimaging
TBI
Fractional anisotropy
Concussion
medicine
Humans
Qualitative Research
030304 developmental biology
0303 health sciences
medicine.diagnostic_test
AcademicSubjects/SCI01870
business.industry
Head injury
Diffuse axonal injury
General Engineering
imaging
Neuropsychological test
medicine.disease
medicine.anatomical_structure
DTI
Susceptibility weighted imaging
concussion
Women's Health
Original Article
AcademicSubjects/MED00310
Female
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 26321297
- Volume :
- 3
- Database :
- OpenAIRE
- Journal :
- Brain Communications
- Accession number :
- edsair.doi.dedup.....479b1e5a4efcaa9033b010099bca19d0