Samuel Joseph Kuzminski MD, Presenter: Nothing to Disclose

Michael D. Clark, Abstract Co-Author: Nothing to Disclose

Melissa A. Fraser MS, Abstract Co-Author: Nothing to Disclose

Jeffrey William Prescott MD, PhD, Abstract Co-Author: Nothing to Disclose

Chunlei Liu PhD, Abstract Co-Author: Nothing to Disclose

Kevin Guskiewicz, Abstract Co-Author: Nothing to Disclose

Jeffrey Robert Petrella MD, Abstract Co-Author: Advisory Board, Johnson & Johnson Speakers Bureau, Quintiles Inc Advisory Board, Piramal Enterprises Limited

Magnetic resonance diffusion tensor imaging (DTI) has emerged at the forefront of sports-related neurotrauma research. DTI can detect subclinical alterations in the white matter tracts related to contact sport exposure. Structural brain connectivity is a method that investigates white matter tract associations between different regions of the brain utilizing DTI. The primary purpose of this pilot study was to investigate structural connectivity alterations over the course of a high school football season. Our secondary purpose was to correlate these changes to cumulative head impact exposure as measured by helmet accelerometers.

Pre- and postseason MRI scans were obtained on 12 varsity high school football players. Graph theory metrics of cortical organization were subsequently calculated from DTI data. Accelerometer data was collected throughout the season using the Head Impact Telemetry System (HITS). DTI measures were correlated to HITS measures using general linear regression. The pre- to post-season DTI measures were compared using paired samples t-tests. Our a priori α was set at 0.05.  

Significant changes from pre- to post-season measures were observed for global network node strength and local efficiency, with trend-level changes observed for clustering coefficient (Table 1). Changes in DTI measures were not significantly correlated to the helmet accelerometer measures.

The results from our preliminary study show changes in global white-matter structural connectivity across a single season of high school football. These changes are not explained by cumulative measures of head impacts. It is unclear if these alterations are related to brain network reorganization in response to repetitive trauma or expected brain development. Our preliminary analyses are limited by small sample size, lack of a control group, and coarse resolution of our network analyses. A larger cohort with an age-matched non-contact sport control group is needed to verify these findings. Determining the biomechanical correlates of head impacts to neuroanatomical changes may inform equipment design, coaching practices, and rule development to improve the overall safety of youth football.

Repetitive asymptomatic head trauma may lead to structural connectivity changes in high school football players. 

Kuzminski, S, Clark, M, Fraser, M, Prescott, J, Liu, C, Guskiewicz, K, Petrella, J, Changes in Structural Connectivity Across a High School Football Season.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015402.html