title: Cerebrovascular reactivity changes in asymptomatic female athletes attributable to high school soccer participation.
abstract: As participation in women's soccer continues to grow and the longevity of female athletes' careers continues to increase, prevention and care for mTBI in women's soccer has become a major concern for female athletes since the long-term risks associated with a history of mTBI are well documented. Among women's sports, soccer exhibits among the highest concussion rates, on par with those of men's football at the collegiate level. Head impact monitoring technology has revealed that "concussive hits" occurring directly before symptomatic injury are not predictive of mTBI, suggesting that the cumulative effect of repetitive head impacts experienced by collision sport athletes should be assessed. Neuroimaging biomarkers have proven to be valuable in detecting brain changes that occur before neurocognitive symptoms in collision sport athletes. Quantifying the relationship between changes in these biomarkers and head impacts experienced by female soccer athletes may prove valuable to developing preventative measures for mTBI. This study paired functional magnetic resonance imaging with head impact monitoring to track cerebrovascular reactivity changes throughout a season and to test whether the observed changes could be attributed to mechanical loading experienced by female athletes participating in high school soccer. Marked cerebrovascular reactivity changes were observed in female soccer athletes, relative both to non-collision sport control measures and pre-season measures and were localized to fronto-temporal aspects of the brain. These changes persisted 4-5 months after the season ended and recovered by 8 months after the season. Segregation of the total soccer cohort into cumulative loading groups revealed that population-level changes were driven by athletes experiencing high cumulative loads, although athletes experiencing lower cumulative loads still contributed to group changes. The results of this study imply a non-linear relationship between cumulative loading and cerebrovascular changes with a threshold, above which the risk, of injury likely increases significantly.
authors.affiliation: Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 4907, USA. dianaotero7@gmail.com.
authors.forename: Diana O
authors.identifier: 0000-0001-6265-1931
authors.initials: DO
authors.lastname: Svaldi
authors.affiliation: Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 4907, USA.
authors.forename: Emily C
authors.initials: EC
authors.lastname: McCuen
authors.affiliation: School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, 47907, USA.
authors.forename: Chetas
authors.initials: C
authors.lastname: Joshi
authors.affiliation: School of Chemical Engineering, Purdue University, West Lafayette, IN, 47907, USA.
authors.forename: Meghan E
authors.initials: ME
authors.lastname: Robinson
authors.affiliation: Department of Psychology, University of California, Berkeley, CA, 94729, USA.
authors.forename: Yeseul
authors.initials: Y
authors.lastname: Nho
authors.affiliation: Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 4907, USA.|Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, 02130, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Hannemann
authors.affiliation: Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 4907, USA.|School of Mechanical Engineering, Purdue University, West Lafayette, IN, 47907, USA.|Concussion Neuroimaging Consortium, Purdue University, West Lafayette, IN, 47907, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Nauman
authors.affiliation: Department of Health and Kinesiology, Purdue University, West Lafayette, IN, 47907, USA.|Concussion Neuroimaging Consortium, Purdue University, West Lafayette, IN, 47907, USA.
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Leverenz
authors.affiliation: Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 4907, USA.|School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, 47907, USA.|Concussion Neuroimaging Consortium, Purdue University, West Lafayette, IN, 47907, USA.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Talavage
mesh_terms: D000293:Adolescent; D056352:Athletes; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D000070642:Brain Injuries, Traumatic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D012916:Soccer / Q000293:injuries*; D013334:Students; D013997:Time Factors
keywords: Cerebrovascular reactivity; Collision sports; Head impacts; Mild traumatic brain injury; Soccer