Abstract
PurposeTo quantify the effects of an externally worn collar device for mitigating the influence of repetitive head impacts on alterations to diffusion tensor imaging (DTI) metrics of white matter.MethodsFifteen female high-school soccer athletes (age: 14.00–16.98 yrs) completed pre- and post-season DTI over two consecutive years, including measures of diffusivity, changes in which may be associated with brain dysfunction. The collar was worn during year 1 (Yr1) but not during year 2 (Yr2). Athlete exposures (AEs) and head impact exposure were recorded over the competitive seasons.ResultsThere were no significant differences in AEs or head impact exposures between Yr1 and Yr2 (P > 0.05). In Yr2, there was significant pre- to post-season mean diffusivity and/or axial diffusivity reduction in multiple WM regions (corrected P < 0.05). Pre- to post-season mean diffusivity, axial diffusivity, and radial diffusivity decreases were 3.04% ± 2.53%, 2.97% ± 2.19%, and 3.37% ± 3.34%, respectively, significantly greater than pre- to post-season changes in Yr1 (mean diffusivity: − 0.31% ± 1.78%, P = 0.0014; axial diffusivity: − 0.02% ± 2.25%, P = 0.0014; radial diffusivity: − 0.63% ± 2.10%, P = 0.0030).ConclusionsMild bilateral compression to athletes’ internal jugular vein through collar application may have increased intracranial blood volume and spatially redistributed head-impact-derived brain energy absorption. However, future research is needed to elucidate the potential clinical significance of WM changes of various degrees.Clinical trails registrationNCT03014492.
Highlights
Girls’ high school soccer has become increasingly popular over the past 20 years, with participation increasing from 226,636 athletes in the 1996–1997 school year to 388,339 athletes (a 58% increase) in the 2016–2017 school year [23, 24]
No significant differences were found in head impact exposure parameters between year 1 (Yr1) and year 2 (Yr2) (Wilcoxon signed-rank test, all P > 0.05)
No significant pre- to post-season diffusion tensor imaging (DTI) changes were found in any white matter (WM) region during Yr1
Summary
Girls’ high school soccer has become increasingly popular over the past 20 years, with participation increasing from 226,636 athletes in the 1996–1997 school year to 388,339 athletes (a 58% increase) in the 2016–2017 school year [23, 24]. FIFA reports 30 million female players worldwide, with a goal to increase this to 60 million by 2026 [9] This growth is reflected in the overall popularity of the sport, as it consistently remains the 4th most popular high school sport for girls, behind only track and field, volleyball, and basketball [24]. The emergence of neuroimaging techniques has made examining the impacts of these potential injuries more viable to researchers One such method, known as diffusion tensor imaging (DTI), has been used to evaluate the integrity of white matter (WM) tracts following repetitive SCI [3, 27, 33]
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