Featured Research

from universities, journals, and other organizations

Using susceptibility-weighted imaging to study concussion in college ice hockey players

Date:
February 4, 2014
Source:
Journal of Neurosurgery Publishing Group
Summary:
Using susceptibility-weighted imaging (SWI), researchers have identified microstructural changes in the brains of male and female college-level ice hockey players that could be due to concussive or subconcussive trauma. This is the first time SWI has been used to detect signs of concussion (or mild traumatic brain injury), and the first time it has been used to detect changes in the brain prospectively over an entire sports season in athletes of both sexes.

Using susceptibility-weighted imaging (SWI), researchers have identified microstructural changes in the brains of male and female college-level ice hockey players that could be due to concussive or subconcussive trauma. Until now, SWI has been used to detect signs of more severe cases of traumatic brain injury (TBI). This is the first time SWI has been used to detect signs of concussion (or mild TBI), and the first time it has been used to detect changes in the brain prospectively over an entire sports season in athletes of both sexes.

The researchers, hailing from several institutions, describe and discuss their findings in "Hockey Concussion Education Project, Part 1. Susceptibility-weighted imaging study in male and female ice hockey players over a single season. Clinical article," by Karl G. Helmer and colleagues, published online today, ahead of print, in the Journal of Neurosurgery. Two additional papers from the Hockey Concussion Education Project (HCEP) on imaging techniques used to detect and follow concussion's effects are also being published today.

Susceptibility-weighted imaging (SWI) is a high-resolution three-dimensional gradient-echo magnetic resonance imaging (MRI) technique that is particularly sensitive to the presence of blood and blood-breakdown products. SWI can be used to detect cerebral microbleeds, which are small hemorrhages that appear hypointense (contrasting to the appearance of other parts of the brain) on T2-weighted magnetic resonance images. These microbleeds are often the result of traumatic brain injuries (TBIs). Until now SWI has been used to detect microbleeds larger than 5 millimeters -- often a sign of severe TBI. In this study, Helmer and colleagues used SWI to detect clusters of much smaller cerebral microbleeds -- ones that are too small to be seen with the naked eye but could represent acute and chronic injuries to the brain due to concussion or subconcussive events.

The authors report findings in college-level ice hockey players (25 men and 20 women) who initially agreed to participate in the study. These results document the innovative SWI analysis of the participating athletes prospectively during the hockey season, including pre- and post-season testing. Some of these athletes reported a history of concussion prior to the study period and some reported receiving no such injuries. During the season, 5 male and 6 female athletes sustained concussions that were identified and diagnosed by independent (study) medical specialists that attended each game. These athletes underwent additional SWI at 72 hours, 2 weeks, and 2 months after their injuries as well as serial clinical and neuropsychological evaluations. The researchers identified small clusters of hypointensity, which can be related to concussion (mild TBI), on SWIs obtained at time points in all participants. To compare the extent of these hypointense regions within and between individual athletes and groups of athletes, the researchers calculated a hypointensity burden (HIB) metric for each athlete at each SWI time point.

Helmer and colleagues report no significant change in the HIB value between the beginning and end of the hockey season in either male or female athletes who did not sustain a concussion. When the researchers compared HIB values in nonconcussed athletes according to sex, however, they did identify significant differences both at the beginning and end of the season, with male athletes having significantly higher mean HIB values than female athletes at both time points.

Among the athletes who did sustain a concussion during the season, the researchers report a statistically significant difference between the HIB value determined at the beginning of the season and that determined 2 weeks after concussive injury in male athletes and a similar -- albeit not significant -- difference in the HIB value during the same period in female athletes. These changes in HIB values point toward damage sustained at the time of impact as well and may indicate later effects of concussion. It is not unusual for a TBI to produce a two-pronged effect: immediate damage from the impact and secondary damage from injury-induced metabolic changes in the brain. In concussed athletes, the researchers also identified a difference in HIB values between the sexes, with male athletes having higher mean HIB values than female athletes at all SWI time points throughout the season.

The authors note that not all clusters of hypointensity seen on susceptibility-weighted images may represent small microbleeds; some may prove to be false-positive findings. However, given changes in the HIB metric following concussion, the researchers believe that SWI may be a useful diagnostic tool in detecting the effects of concussive impacts over time.

As to the differences in the HIB metric between the sexes, the researchers hypothesize various reasons why this occurred, including the possibility that the male athletes may have accumulated more extensive injuries from pre-study concussive and subconcussive impacts. Additional studies in a greater number of participants are called for, because these may lead to a clearer description of why the HIB metric differed between the sexes in this study.

In summarizing the value of SWI for detecting injuries due to concussion in athletes participating in contact sports, the researchers state: "Data acquired using this method could be used for the monitoring of players throughout their careers and could lead to improved diagnoses and return-to-play guidelines."

When asked to comment on the importance of this study, Dr. Paul Echlin, senior co-author and primary HCEP investigator in this study, stated, "This study contributes to converging objective evidence concerning the acute and chronic effects of repetitive brain injury in the sports. Although future studies are warranted to further validate these initial findings (as well those found in the two accompanying HCEP studies), a cultural shift must be considered toward both the permitted violence that underlies many of the sport-related brain injuries and the high incidence of head impacts that occur in the games which our children play."


Story Source:

The above story is based on materials provided by Journal of Neurosurgery Publishing Group. Note: Materials may be edited for content and length.


Journal References:

  1. Ofer Pasternak, Inga K. Koerte, Sylvain Bouix, Eli Fredman, Takeshi Sasaki, Michael Mayinger, Karl G. Helmer, Andrew M. Johnson, Jeffrey D. Holmes, Lorie A. Forwell, Elaine N. Skopelja, Martha E. Shenton, Paul S. Echlin. Hockey Concussion Education Project, Part 2. Microstructural white matter alterations in acutely concussed ice hockey players: a longitudinal free-water MRI study. Journal of Neurosurgery, 2014; 1 DOI: 10.3171/2013.12.JNS132090
  2. Takeshi Sasaki, Ofer Pasternak, Michael Mayinger, Marc Muehlmann, Peter Savadjiev, Sylvain Bouix, Marek Kubicki, Eli Fredman, Brian Dahlben, Karl G. Helmer, Andrew M. Johnson, Jeffrey D. Holmes, Lorie A. Forwell, Elaine N. Skopelja, Martha E. Shenton, Paul S. Echlin, Inga K. Koerte. Hockey Concussion Education Project, Part 3. White matter microstructure in ice hockey players with a history of concussion: a diffusion tensor imaging study. Journal of Neurosurgery, 2014; 1 DOI: 10.3171/2013.12.JNS132092
  3. Karl G. Helmer, Ofer Pasternak, Eli Fredman, Ronny I. Preciado, Inga K. Koerte, Takeshi Sasaki, Michael Mayinger, Andrew M. Johnson, Jeffrey D. Holmes, Lorie A. Forwell, Elaine N. Skopelja, Martha E. Shenton, Paul S. Echlin. Hockey Concussion Education Project, Part 1. Susceptibility-weighted imaging study in male and female ice hockey players over a single season. Journal of Neurosurgery, 2014; 1 DOI: 10.3171/2013.12.JNS132093

Cite This Page:

Journal of Neurosurgery Publishing Group. "Using susceptibility-weighted imaging to study concussion in college ice hockey players." ScienceDaily. ScienceDaily, 4 February 2014. <www.sciencedaily.com/releases/2014/02/140204074215.htm>.
Journal of Neurosurgery Publishing Group. (2014, February 4). Using susceptibility-weighted imaging to study concussion in college ice hockey players. ScienceDaily. Retrieved September 21, 2014 from www.sciencedaily.com/releases/2014/02/140204074215.htm
Journal of Neurosurgery Publishing Group. "Using susceptibility-weighted imaging to study concussion in college ice hockey players." ScienceDaily. www.sciencedaily.com/releases/2014/02/140204074215.htm (accessed September 21, 2014).

Share This



More Science & Society News

Sunday, September 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Climate Change Rally Held in India Ahead of UN Summit

Climate Change Rally Held in India Ahead of UN Summit

AFP (Sep. 20, 2014) Some 125 world leaders are expected to commit to action on climate change at a UN summit Tuesday called to inject momentum in struggling efforts to tackle global warming. Duration: 00:41 Video provided by AFP
Powered by NewsLook.com
Sierra Leone's Nationwide Ebola Curfew Underway

Sierra Leone's Nationwide Ebola Curfew Underway

Newsy (Sep. 20, 2014) Sierra Leone is locked down as aid workers and volunteers look for new cases of Ebola. Video provided by Newsy
Powered by NewsLook.com
The Cost of Ebola

The Cost of Ebola

Reuters - Business Video Online (Sep. 18, 2014) As Sierra Leone prepares for a three-day "lockdown" in its latest bid to stem the spread of Ebola, Ciara Lee looks at the financial implications of fighting the largest ever outbreak of the disease. Video provided by Reuters
Powered by NewsLook.com
U.S. Food Makers Surpass Calorie-Cutting Pledge

U.S. Food Makers Surpass Calorie-Cutting Pledge

Newsy (Sep. 18, 2014) Sixteen large food and beverage companies in the United States that committed to cut calories in their products far surpassed their target. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins