Abnormalities in Diffusional Kurtosis Metrics Related to Head Impact Exposure in a Season of High School Varsity Football
| Autor: | Jens H. Jensen, Jillian E. Urban, Daryl A. Rosenbaum, Elizabeth M. Davenport, Kalyna Apkarian, Youngkyoo Jung, Alexander K. Powers, Christopher T. Whitlow, Eliza Szuch, Joseph A. Maldjian, Joel D. Stitzel, Gerard A. Gioia, Mark A. Espeland |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Adolescent Football computer.software_genre 03 medical and health sciences 0302 clinical medicine Voxel Linear regression Concussion Covariate Statistics medicine Humans Diffusion Kurtosis Imaging Brain Concussion Schools business.industry 68–95–99.7 rule 030229 sport sciences Original Articles medicine.disease White Matter Diffusion Magnetic Resonance Imaging Athletes Kurtosis Neurology (clinical) Seasons business computer 030217 neurology & neurosurgery |
| Zdroj: | Journal of neurotrauma. 33(23) |
| ISSN: | 1557-9042 |
| Popis: | The purpose of this study was to determine whether the effects of cumulative head impacts during a season of high school football produce changes in diffusional kurtosis imaging (DKI) metrics in the absence of clinically diagnosed concussion. Subjects were recruited from a high school football team and were outfitted with the Head Impact Telemetry System (HITS) during all practices and games. Biomechanical head impact exposure metrics were calculated, including: total impacts, summed acceleration, and Risk Weighted Cumulative Exposure (RWE). Twenty-four players completed pre- and post-season magnetic resonance imaging, including DKI; players who experienced clinical concussion were excluded. Fourteen subjects completed pre- and post-season Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). DKI-derived metrics included mean kurtosis (MK), axial kurtosis (K axial), and radial kurtosis (K radial), and white matter modeling (WMM) parameters included axonal water fraction, tortuosity of the extra-axonal space, extra-axonal diffusivity (De axial and radial), and intra-axonal diffusivity (Da). These metrics were used to determine the total number of abnormal voxels, defined as 2 standard deviations above or below the group mean. Linear regression analysis revealed a statistically significant relationship between RWE combined probability (RWECP) and MK. Secondary analysis of other DKI-derived and WMM metrics demonstrated statistically significant linear relationships with RWECP after covariate adjustment. These results were compared with the results of DTI-derived metrics from the same imaging sessions in this exact same cohort. Several of the DKI-derived scalars (Da, MK, K axial, and K radial) explained more variance, compared with RWECP, suggesting that DKI may be more sensitive to subconcussive head impacts. No significant relationships between DKI-derived metrics and ImPACT measures were found. It is important to note that the pathological implications of these metrics are not well understood. In summary, we demonstrate a single season of high school football can produce DKI measurable changes in the absence of clinically diagnosed concussion. |
| Databáze: | OpenAIRE |
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