title: Alterations in default-mode network connectivity may be influenced by cerebrovascular changes within 1 week of sports related concussion in college varsity athletes: a pilot study.
abstract: The goal of this pilot study is to use complementary MRI strategies to quantify and relate cerebrovascular reactivity, resting cerebral blood flow and functional connectivity alterations in the first week following sports concussion in college varsity athletes. Seven college athletes (3F/4M, age = 19.7 ± 1.2 years) were imaged 3-6 days following a diagnosed sports related concussion and compared to eleven healthy controls with no history of concussion (5M/6F, 18-23 years, 7 athletes). Cerebrovascular reactivity and functional connectivity were measured using functional MRI during a hypercapnia challenge and via resting-state regional partial correlations, respectively. Resting cerebral blood flow was quantified using arterial spin labeling MRI methods. Group comparisons were made within and between 18 regions of interest. Cerebrovascular reactivity was increased after concussion when averaged across all regions of interest (p = 0.04), and within some default-mode network regions, the anterior cingulate and the right thalamus (p < 0.05) independently. The FC was increased in the concussed athletes within the default-mode network including the left and right hippocampus, precuneus and ventromedial prefrontal cortex (p < 0.01), with measures being linearly related to cerebrovascular reactivity in the hippocampus in the concussed athletes. Significant resting cerebral blood flow changes were not detected between the two groups. This study provides evidence for increased cerebrovascular reactivity and functional connectivity in the medial regions of the default-mode network within days of a single sports related concussion in college athletes. Our findings emphasize the utility of complementary cerebrovascular measures in the interpretation of alterations in functional connectivity following concussion.
authors.affiliation: Department of Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Adam R
authors.initials: AR
authors.lastname: Militana
authors.affiliation: Department of Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Manus J
authors.initials: MJ
authors.lastname: Donahue
authors.affiliation: Department of Neurosurgery, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Allen K
authors.initials: AK
authors.lastname: Sills
authors.affiliation: Department of Neurosurgery, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Gary S
authors.initials: GS
authors.lastname: Solomon
authors.affiliation: Department of Orthopedics, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Gregory
authors.affiliation: Department of Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Megan K
authors.initials: MK
authors.lastname: Strother
authors.affiliation: Department of Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA. victoria.morgan@vanderbilt.edu.|Department of Radiology, Vanderbilt University, 1161 21st Ave South, AA1105 MCN, Nashville, TN, 37232, USA. victoria.morgan@vanderbilt.edu.
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Morgan
mesh_terms: D000293:Adolescent; D056352:Athletes; D001265:Athletic Injuries / Q000503:physiopathology; D001921:Brain / Q000503:physiopathology; D001924:Brain Concussion / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods; D002560:Cerebrovascular Circulation / Q000502:physiology*; D063132:Connectome; D005260:Female; D006179:Gyrus Cinguli / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010296:Parietal Lobe / Q000503:physiopathology; D010865:Pilot Projects; D013177:Sports; D013334:Students; D055815:Young Adult
keywords: Cerebral blood flow; Cerebrovascular reactivity; Concussion; Functional MRI; Functional connectivity