Cerebrovascular reactivity changes in asymptomatic female athletes attributable to high school soccer participation
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As participation in women’s soccer continues to grow and the longevity of female athletes’ careers continues to increase, prevention and care for mTBI in women’s soccer has become a major concern for female athletes since the long-term risks associated with a history of mTBI are well documented. Among women’s sports, soccer exhibits among the highest concussion rates, on par with those of men’s football at the collegiate level. Head impact monitoring technology has revealed that “concussive hits” occurring directly before symptomatic injury are not predictive of mTBI, suggesting that the cumulative effect of repetitive head impacts experienced by collision sport athletes should be assessed. Neuroimaging biomarkers have proven to be valuable in detecting brain changes that occur before neurocognitive symptoms in collision sport athletes. Quantifying the relationship between changes in these biomarkers and head impacts experienced by female soccer athletes may prove valuable to developing preventative measures for mTBI. This study paired functional magnetic resonance imaging with head impact monitoring to track cerebrovascular reactivity changes throughout a season and to test whether the observed changes could be attributed to mechanical loading experienced by female athletes participating in high school soccer. Marked cerebrovascular reactivity changes were observed in female soccer athletes, relative both to non-collision sport control measures and pre-season measures and were localized to fronto-temporal aspects of the brain. These changes persisted 4–5 months after the season ended and recovered by 8 months after the season. Segregation of the total soccer cohort into cumulative loading groups revealed that population-level changes were driven by athletes experiencing high cumulative loads, although athletes experiencing lower cumulative loads still contributed to group changes. The results of this study imply a non-linear relationship between cumulative loading and cerebrovascular changes with a threshold, above which the risk, of injury likely increases significantly.
KeywordsMild traumatic brain injury Collision sports Head impacts Cerebrovascular reactivity Soccer
Compliance with ethical standards
All procedures performed in studies involving human participants were approved by the Purdue IRB and were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
This study was funded by BrainScope Company, Inc., and General Electric Healthcare.
Conflict of interest
Author Diana Otero Svaldi declares that she has no conflict of interest. Author Emily McCuen declares that she has no conflict of interest. Author Chetas Joshi declares that he has no conflict of interest. Author Yeseul Nho declares that she has no conflict of interest. Author Meghan Robinson declares that she has no conflict of interest. Author Robert Hanneman declares that he has no conflict of interest. Author Larry Leverenz declares that he has no conflict of interest. Author Eric Nauman declares that he has no conflict of interest. Author Thomas Talavage declares that he has no conflict of interest.
Informed parent consent and subject assent was obtained for all subjects under the age of 18. Informed consent was obtained for all subjects 18 or older.
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