Sex differences in white matter alterations following repetitive subconcussive head impacts in collegiate ice hockey players
Objective: Repetitive subconcussive head impacts (RSHI) may lead to structural, functional, and metabolic alterations of the brain. While differences between males and females have already been suggested following a concussion, whether there are sex differences following exposure to RSHI remains unk...
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| Format: | Article |
| Language: | English |
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Elsevier
2018-01-01
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| Series: | NeuroImage: Clinical |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213158217303005 |
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doaj-206d38546d7648f7b61e5ef9d385bb6d |
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Article |
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DOAJ |
| language |
English |
| format |
Article |
| sources |
DOAJ |
| author |
Nico Sollmann Paul S. Echlin Vivian Schultz Petra V. Viher Amanda E. Lyall Yorghos Tripodis David Kaufmann Elisabeth Hartl Philipp Kinzel Lorie A. Forwell Andrew M. Johnson Elaine N. Skopelja Christian Lepage Sylvain Bouix Ofer Pasternak Alexander P. Lin Martha E. Shenton Inga K. Koerte |
| spellingShingle |
Nico Sollmann Paul S. Echlin Vivian Schultz Petra V. Viher Amanda E. Lyall Yorghos Tripodis David Kaufmann Elisabeth Hartl Philipp Kinzel Lorie A. Forwell Andrew M. Johnson Elaine N. Skopelja Christian Lepage Sylvain Bouix Ofer Pasternak Alexander P. Lin Martha E. Shenton Inga K. Koerte Sex differences in white matter alterations following repetitive subconcussive head impacts in collegiate ice hockey players NeuroImage: Clinical |
| author_facet |
Nico Sollmann Paul S. Echlin Vivian Schultz Petra V. Viher Amanda E. Lyall Yorghos Tripodis David Kaufmann Elisabeth Hartl Philipp Kinzel Lorie A. Forwell Andrew M. Johnson Elaine N. Skopelja Christian Lepage Sylvain Bouix Ofer Pasternak Alexander P. Lin Martha E. Shenton Inga K. Koerte |
| author_sort |
Nico Sollmann |
| title |
Sex differences in white matter alterations following repetitive subconcussive head impacts in collegiate ice hockey players |
| title_short |
Sex differences in white matter alterations following repetitive subconcussive head impacts in collegiate ice hockey players |
| title_full |
Sex differences in white matter alterations following repetitive subconcussive head impacts in collegiate ice hockey players |
| title_fullStr |
Sex differences in white matter alterations following repetitive subconcussive head impacts in collegiate ice hockey players |
| title_full_unstemmed |
Sex differences in white matter alterations following repetitive subconcussive head impacts in collegiate ice hockey players |
| title_sort |
sex differences in white matter alterations following repetitive subconcussive head impacts in collegiate ice hockey players |
| publisher |
Elsevier |
| series |
NeuroImage: Clinical |
| issn |
2213-1582 |
| publishDate |
2018-01-01 |
| description |
Objective: Repetitive subconcussive head impacts (RSHI) may lead to structural, functional, and metabolic alterations of the brain. While differences between males and females have already been suggested following a concussion, whether there are sex differences following exposure to RSHI remains unknown. The aim of this study was to identify and to characterize sex differences following exposure to RSHI. Methods: Twenty-five collegiate ice hockey players (14 males and 11 females, 20.6±2.0years), all part of the Hockey Concussion Education Project (HCEP), underwent diffusion-weighted magnetic resonance imaging (dMRI) before and after the Canadian Interuniversity Sports (CIS) ice hockey season 2011–2012 and did not experience a concussion during the season. Whole-brain tract-based spatial statistics (TBSS) were used to compare pre- and postseason imaging in both sexes for fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). Pre- and postseason neurocognitive performance were assessed by the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). Results: Significant differences between the sexes were primarily located within the superior longitudinal fasciculus (SLF), the internal capsule (IC), and the corona radiata (CR) of the right hemisphere (RH). In significant voxel clusters (p<0.05), decreases in FA (absolute difference pre- vs. postseason: 0.0268) and increases in MD (0.0002), AD (0.00008), and RD (0.00005) were observed in females whereas males showed no significant changes. There was no significant correlation between the change in diffusion scalar measures over the course of the season and neurocognitive performance as evidenced from postseason ImPACT scores. Conclusions: The results of this study suggest sex differences in structural alterations following exposure to RSHI. Future studies need to investigate further the underlying mechanisms and association with exposure and clinical outcomes. Keywords: Diffusion tensor imaging, Ice hockey, Repetitive subconcussive head impacts, Sex difference, Traumatic brain injury, White matter |
| url |
http://www.sciencedirect.com/science/article/pii/S2213158217303005 |
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doaj-206d38546d7648f7b61e5ef9d385bb6d2020-11-25T02:14:18ZengElsevierNeuroImage: Clinical2213-15822018-01-0117642649Sex differences in white matter alterations following repetitive subconcussive head impacts in collegiate ice hockey playersNico Sollmann0Paul S. Echlin1Vivian Schultz2Petra V. Viher3Amanda E. Lyall4Yorghos Tripodis5David Kaufmann6Elisabeth Hartl7Philipp Kinzel8Lorie A. Forwell9Andrew M. Johnson10Elaine N. Skopelja11Christian Lepage12Sylvain Bouix13Ofer Pasternak14Alexander P. Lin15Martha E. Shenton16Inga K. Koerte17Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, GermanyElliott Sports Medicine Clinic, Burlington, ON, CanadaPsychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, GermanyPsychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Translational Research Center, University Hospital of Psychiatry, Bern, SwitzerlandPsychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USADepartment of Biostatistics, Boston University School of Public Health, Boston, MA, USA; Boston University Alzheimer's Disease and CTE Center, Boston University School of Medicine, Boston, MA, USAPsychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany; Department of Radiology, Charité Universitätsmedizin, Berlin, GermanyPsychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology, Epilepsy Center, Ludwig-Maximilians-Universität, Munich, GermanyPsychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany3M Centre, The University of Western Ontario, London, ON, CanadaSchool of Health Studies, The University of Western Ontario, London, ON, CanadaRuth Lilly Medical Library, Indiana University, Indianapolis, IN, USAPsychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; School of Psychology, University of Ottawa, Ottawa, ON, CanadaPsychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USAPsychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USAPsychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USAPsychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; VA Boston Healthcare System, Brockton Division, Brockton, MA, USAPsychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Corresponding author at: Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, 1249 Boylston St., Boston, MA 02215, USA.Objective: Repetitive subconcussive head impacts (RSHI) may lead to structural, functional, and metabolic alterations of the brain. While differences between males and females have already been suggested following a concussion, whether there are sex differences following exposure to RSHI remains unknown. The aim of this study was to identify and to characterize sex differences following exposure to RSHI. Methods: Twenty-five collegiate ice hockey players (14 males and 11 females, 20.6±2.0years), all part of the Hockey Concussion Education Project (HCEP), underwent diffusion-weighted magnetic resonance imaging (dMRI) before and after the Canadian Interuniversity Sports (CIS) ice hockey season 2011–2012 and did not experience a concussion during the season. Whole-brain tract-based spatial statistics (TBSS) were used to compare pre- and postseason imaging in both sexes for fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). Pre- and postseason neurocognitive performance were assessed by the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). Results: Significant differences between the sexes were primarily located within the superior longitudinal fasciculus (SLF), the internal capsule (IC), and the corona radiata (CR) of the right hemisphere (RH). In significant voxel clusters (p<0.05), decreases in FA (absolute difference pre- vs. postseason: 0.0268) and increases in MD (0.0002), AD (0.00008), and RD (0.00005) were observed in females whereas males showed no significant changes. There was no significant correlation between the change in diffusion scalar measures over the course of the season and neurocognitive performance as evidenced from postseason ImPACT scores. Conclusions: The results of this study suggest sex differences in structural alterations following exposure to RSHI. Future studies need to investigate further the underlying mechanisms and association with exposure and clinical outcomes. Keywords: Diffusion tensor imaging, Ice hockey, Repetitive subconcussive head impacts, Sex difference, Traumatic brain injury, White matterhttp://www.sciencedirect.com/science/article/pii/S2213158217303005 |