MRI may detect mild traumatic brain injury in football players, finds study

Noninvasive structural Magnetic Resonance Imaging (MRI) may detect mild traumatic brain injury in football players, revealed a study published in the Journal, Science Advances.

The researchers tested the hypothesis that Magnetic Resonance Imaging-based measures of midbrain white matter integrity at the level of the CSTs in collegiate football players would be decreased after a season of play compared to preseason measures

Midbrain is most susceptible to mild brain injuries caused by head hits by football players. Head hits can cause acute neurophysiological changes and are thought to be, in the long term, associated with neurodegenerative diseases such as chronic traumatic encephalopathy (CTE).

The study demonstrated that apart from concussions that damage the brains of football players routine hits over the course of a season also causes significant damage to the midbrain which is a part of a larger rigid structure that includes the brain stem and the thalamus. The relative rigidity of the thalamus causes it to absorb forces differently than surrounding softer tissues, making it susceptible to head hit forces.

The authors conducted a prospective longitudinal design including 38 male football players on the University of Rochester football team [National Collegiate Athletic Association (NCAA) Division III], enrolled over the course of three seasons (2011, 2012, and 2013), who had accelerometers in their helmets that measured linear and rotational force for every practice and game.

The accelerometers tracked all contact that produced forces of 10 gs or greater. (Astronauts experience 3 gs during liftoff; race car drivers experience 6 gs, and car crashes can produce forces of more than 100 gs, the group noted.) Each player underwent a brain Magnetic Resonance Imaging scan two weeks before and one week after the football season.

Of the 38 players, only two had concussions during the study timeframe. The authors observed reductions in midbrain white matter integrity due to a single season of collegiate football and that the amount of reduction in midbrain white matter integrity is related to the amount of rotational acceleration to which players’ brains are exposed. They then replicated the observation of reduced midbrain white matter integrity in a retrospective cohort of individuals with a frank concussion, and further show that variance in white matter integrity is correlated with levels of serum-based tau, a marker of blood-brain barrier disruption.

"These findings mean that noninvasive structural magnetic resonance imaging of the midbrain is a succinct index of both clinically silent white matter injury as well as a frank concussion.' concluded the authors.

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DOI: 10.1126/sciadv.aau3460