Brain injury due to soccer heading and opportunities for its mitigation

足球头球造成的脑损伤及其缓解方法

• 批准号: 8926006
• 负责人: Michael Lawrence Lipton
• 金额: $ 5万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-02-01 至 2018-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8926006
• 关键词: Address; Anisotropy; Apolipoprotein E; Brain; Brain Concussion; Brain Injuries; Cognition; Cognitive; Craniocerebral Trauma; Cross-Sectional Studies; Data; Development; Devices; Diffusion; Enrollment; Etiology; Exposure to; Foundations; Frequencies; Genes; Genotype; Guidelines; Hand; Head; Health; Individual Differences; Injury; Longitudinal Studies; Magnetic Resonance Imaging; Manufactured Baseball; Measurement; Measures; Minor; Multiple Head Injuries; Outcome; Pathologic; Performance; Play; Post-Concussion Syndrome; Predictive Value; Prospective Studies; Public Health; Questionnaires; Recording of previous events; Recovery; Research Design; Risk; Sampling; Soccer; Sports; Structure; Subgroup; Tablet Computer; Tablets; Time; Trauma; Traumatic Brain Injury; Upper Extremity; Variant; Vulnerable Populations; Work; adverse outcome; apolipoprotein E-4; base; cognitive function; design; follow-up; in vivo; response; white matter

DESCRIPTION (provided by applicant): Traumatic brain injury (TBI) in athletes is a major and increasingly recognized public health problem. The presumed pathologic basis of the injury is multifocal microstructural traumatic axonal injury (TAI), which can be detected in vivo using diffusion tensor MRI (DTI). These structural changes have both short-term and long-term cognitive consequences. Our preliminary studies show that amateur soccer players do head the ball frequently, up to > 5,000 per year, and those who head more than 1,000- 1,500 times per year are at increased risk for structural (TAI) and functional (poorer cognitive performance) changes. Heading exposes the brain to repeated low-level ("subconcussive") trauma. It is known that multiple head injuries in close succession are associated with worse outcomes. Additional work is needed to define exposure-response relationships for soccer heading, the time course for the onset and recovery from these structural and functional effects and particularly vulnerable populations. Herein, we use 3 integrated study designs to determine the influence of heading on brain structure and function. In a cross-sectional study (Aim 1), we assess the relationship of heading over the previous year to structural (TAI) and functional (cognition and post-concussion symptoms (PCS)) measures in a large sample (n=400) of amateur soccer players. To assess causality, we propose a longitudinal study to investigate the incremental effects of heading on changes in TAI, cognition and PCS over 2 years of follow-up (Aim 2). To assess the short-term relationship between heading and day-to-day variability in cognitive function and PCS as well as the predictive value of intensive measurement, we will assess heading, cognition and PCS on a daily basis for 14 days every 3 months using a hand-held device in a substudy of 100 players. We will also assess a number of potential modifiers of the association between heading and brain structure and function (e.g., Apolipoprotein E4 genotype). Specific Aims: Aim I (Cross-sectional): Determine the relationship of heading exposure to MRI evidence of traumatic axonal injury (TAI), cognitive function and post concussion symptoms (PCS). Aim II (Longitudinal): Determine the longitudinal relationships between heading and incremental changes in TAI, cognitive function, and PCS in a prospective study. Aim III (Intensive measurement): Determine the short-term effects on and variability in day-to-day cognitive function and PCS using an intensive measurement design.

描述（由申请人提供）：运动员中的创伤性脑损伤（TBI）是一个重大且越来越认可的公共卫生问题。损伤的假定病理基础是多灶微结构创伤性轴突损伤（TAI），可以使用扩散张量MRI（DTI）在体内检测到。这些结构性变化既有短期和长期认知后果。我们的初步研究表明，业余足球运动员每年经常领先超过5,000，而每年超过1,000-1,500次的人的结构性（TAI）和功能性（较差的认知表现）变化的风险增加。标题使大脑暴露于重复的低级（“亚语”）创伤。众所周知，紧密连续的多次头部受伤与结果差有关。需要其他工作来定义足球标题的暴露响应关系，从这些结构和功能效应中恢复的时间过程，尤其是脆弱的人群。本文中，我们使用3种综合研究设计来确定标题对大脑结构和功能的影响。在一项横断面研究（AIM 1）中，我们评估了前一年与结构（TAI）和功能性（认知和脑力后症状（PCS））测量的关系，这是业余足球运动员的大样本（n = 400）。为了评估因果关系，我们提出了一项纵向研究，以研究趋势对TAI，认知和PC的变化的增量影响（AIM 2）。为了评估认知功能和PC的标题与日常变异性之间的短期关系以及密集度量的预测价值，我们将每天使用100个播放器中的手持设备每3天评估每天14天的标题，认知和PC。我们还将评估标题与大脑结构和功能之间关联的许多潜在修饰符（例如，载脂蛋白E4基因型）。具体目的：目标I（横截面）：确定标题暴露与创伤性轴突损伤（TAI），认知功能和脑震荡后症状（PC）的关系。 AIM II（纵向）：确定前瞻性研究中TAI，认知功能和PC的标题变化与渐进变化之间的纵向关系。 AIM III（密集度量）：使用密集的测量设计确定日常认知功能和PC的短期影响和可变性。