Characterizing the Effects of Sub-Concussive Head Impacts on Brain Biomarkers: a Multi-Modal Approach Toward Developing Safer Practices on the Football Field
Growing literature has raised concerns that repeated sub-concussive impacts to the head may induce changes in both structural and functional brain biomarkers. Despite these findings however, evidence from neuroimaging using the blood oxygenation level dependent (BOLD) contrast has limited our understanding for the effects of repetitive head impacts on physiological parameters such as cerebral blood flow (CBF), cerebrovascular reactivity (CVR) and cerebral metabolic rate of oxygen consumption (CMRO2). In this project, we combined novel calibrated magnetic resonance imaging methods with helmet accelerometers to gather insight about the effects of sub-concussive collisions on brain hemodynamics and explore the relationship between head impacts and changes in brain biomarkers. Dual-echo BOLD and arterial spin labelling (ASL) contrasts modulated via precise gas breathing manipulations (i.e., hypercapnia and hyperoxia) were used to study changes in the brain of collegiate football players, while accounting for time-varying fluctuations in cerebrovascular physiology. Increases in default-mode network functional connectivity, as well as changes in resting CBF and CMRO2, were all documented following exposure to head impacts, suggesting that brain physiological parameters may be sensitive to repeated mechanical loading from sub-concussive events during the season. Using these findings as a basis for actions toward reducing head impacts in football, we leveraged TEDx Montréal as a social platform to introduce the NeuroProtection Project - a novel approach designed to re-focus coaching practices toward improving how athletes are thought to engage in contact on the football field. Finally, the effectiveness of the NeuroProtection project was tested in high- school football players using a combination of video analyses, helmet accelerometers and customized training paradigms. Significant improvements in blocking and tackling techniques were observed following introduction of the data-informed intervention, as well as a ~30% decrease in the frequency of head impacts sustained during practice. These findings suggest that targeted behavioral interventions may be used to improve coaching practices and promote safer play. Altogether, it is hoped that these findings will motivate the integration of multi-modal imaging designs to deepen our knowledge for the effects of sub-concussive impacts, while inspiring the expansion of community-based initiatives like the NeuroProtection project to prioritize safety in contact sports.
URI for this recordhttp://hdl.handle.net/1974/26361
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