Poster No:
1670
Submission Type:
Abstract Submission
Authors:
Anna Kwiatkowski1, Ute Habel1,2, Charlotte Huppertz1, Carmen Weidler1
Institutions:
1Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany, 2Institute of Neuroscience and Medicine 10, Research Centre Jülich, Jülich, Germany
First Author:
Anna Kwiatkowski
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University
Aachen, Germany
Co-Author(s):
Ute Habel
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University|Institute of Neuroscience and Medicine 10, Research Centre Jülich
Aachen, Germany|Jülich, Germany
Charlotte Huppertz
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University
Aachen, Germany
Carmen Weidler
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University
Aachen, Germany
Introduction:
Repetitive subconcussive head impacts (RSHI) are prevalent in contact and collision sports athletes (Broglio et al., 2011; Lipton et al., 2013) and are associated with cumulative tearing and shearing injuries in the brain (Bailes et al., 2013; Schneider et al., 2019). Specific concerns have been raised for soccer players, as headers are a unique form of intentional, unprotected head impacts (Peek et al., 2024), and players show an increased mortality rate for neurodegenerative diseases (Mackay et al., 2019). While microstructural changes in brain white matter in this sample and in relation to heading frequency have been shown (Koerte et al., 2012; Myer et al., 2019), studies on RSHI effects and functional connectivity (FC) using resting-state fMRI in soccer players are scarce and limited to a few regions of interest. This study examines the effects of prolonged RSHI exposure on FC across eight large-scale resting-state networks in professional and semiprofessional soccer players. Additionally, it explores the potential protective role of neck strength in mitigating these effects.
Methods:
This cross-sectional study included 27 male soccer players and 28 male control athletes from non-contact and non-collision sports (field hockey, volleyball) with a mean age of 24.71 (SD = 4.09) years and without a history of head injury involving loss of consciousness. Participants underwent a comprehensive assessment, including a heading questionnaire capturing header frequency over the past 12 months, (functional) MRI measurements, balance and neck strength measurements, and neuropsychological testing. Resting-state fMRI data underwent visual and automated quality assurance steps according to Morfini and colleagues (2023) and were pre-processed and analyzed using group-level independent component analysis (Group-ICA) with the CONN toolbox (Whitfield-Gabrieli & Nieto-Castanon, 2012). From 20 estimated components, 8 resting-state networks were identified based on the highest correlation between each group spatial map and CONN default network files. Group differences and soccer-specific analyses, examining the effects of heading frequency and the moderating role of neck strength, were controlled for age and the number of previous symptomatic head impacts. Results were thresholded with a voxel-level p < 0.001 and a cluster-size p-FDR < 0.05.
Results:
Soccer players showed hypoconnectivity compared to control athletes in one cluster of the sensory-motor network (58 voxels, p-FDR = 0.039). In soccer players, higher heading frequency was related to decreased FC in four clusters of the language network (44-104 voxels, p-FDR = <0.001-0.020) and one cluster of the sensory-motor network (72 voxels, p-FDR = 0.005). In the latter analysis, a moderation effect of neck strength was found in the cerebellar network (55 voxels, p-FDR = 0.026) and in two clusters of the language network (51/50 voxels, p-FDR = 0.024).
Conclusions:
This study provides evidence of altered resting-state functional connectivity in soccer players with prolonged exposure to RSHI, particularly in the sensory-motor and language networks. The findings also suggest that neck strength may serve as a potential protective factor, moderating the impact of heading frequency on FC. These results highlight the need for further investigation into the adaptive or maladaptive nature of these changes, relating them to clinical measures. Follow-up analyses will also include resting-state informed voxel-based morphometry (VBM) to explore underlying structural changes associated with prolonged head impact exposure.
Lifespan Development:
Lifespan Development Other
Modeling and Analysis Methods:
fMRI Connectivity and Network Modeling
Task-Independent and Resting-State Analysis 1
Neuroanatomy, Physiology, Metabolism and Neurotransmission:
Normal Development 2
Novel Imaging Acquisition Methods:
BOLD fMRI
Keywords:
ADULTS
Cortex
Data analysis
Degenerative Disease
Development
FUNCTIONAL MRI
Neurological
NORMAL HUMAN
Trauma
Other - sport-reated mTBI, repetitive subconcussive head impacts
1|2Indicates the priority used for review
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Please indicate below if your study was a "resting state" or "task-activation” study.
Resting state
Healthy subjects only or patients (note that patient studies may also involve healthy subjects):
Healthy subjects
Was this research conducted in the United States?
No
Were any human subjects research approved by the relevant Institutional Review Board or ethics panel?
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Were any animal research approved by the relevant IACUC or other animal research panel?
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Please indicate which methods were used in your research:
Functional MRI
Structural MRI
Behavior
Neuropsychological testing
For human MRI, what field strength scanner do you use?
3.0T
Which processing packages did you use for your study?
SPM
Provide references using APA citation style.
Bailes, J. E. (2013). Role of subconcussion in repetitive mild traumatic brain injury. Journal of Neurosurgery, 119(5), 1235–1245. https://doi.org/10.3171/2013.7.JNS121822
Broglio, S. P. (2011). Cumulative head impact burden in high school football. Journal of Neurotrauma, 28(10), 2069–2078. https://doi.org/10.1089/neu.2011.1825
Koerte, I. K. (2012). White matter integrity in the brains of professional soccer players without a symptomatic concussion. JAMA, 308(18), 1859. https://doi.org/10.1001/jama.2012.13735
Lipton, M. L. (2013). Soccer heading is associated with white matter microstructural and cognitive abnormalities. Radiology, 268(3), 850–857. https://doi.org/10.1148/radiol.13130545
Mackay, D. F. (2019). Neurodegenerative disease mortality among former professional soccer players. New England Journal of Medicine, 381(19), 1801–1808. https://doi.org/10.1056/NEJMoa1908483
Morfini, F. (2023). Functional connectivity MRI quality control procedures in CONN. Frontiers in Neuroscience, 17. https://doi.org/10.3389/fnins.2023.1092125
Myer, G. D. (2019). Altered brain microstructure in association with repetitive subconcussive head impacts and the potential protective effect of jugular vein compression: a longitudinal study of female soccer athletes. British Journal of Sports Medicine, 53(24), 1539–1551. https://doi.org/10.1136/bjsports-2018-099571
Peek, K. (2024). Heading in football: A systematic review of descriptors, definitions, and reporting methods used in heading incidence studies. Science and Medicine in Football, 1–18. https://doi.org/10.1080/24733938.2024.2362191
Schneider, D. K. (2019). Diffusion tensor imaging in athletes sustaining repetitive head impacts: A systematic review of prospective studies. Journal of Neurotrauma, 36(20), 2831–2849. https://doi.org/10.1089/neu.2019.6398
Whitfield-Gabrieli, S. (2012). Conn: A functional connectivity toolbox for correlated and anticorrelated brain networks. Brain Connectivity, 2(3), 125–141. https://doi.org/10.1089/brain.2012.0073
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