This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Recent reports have noted that the head trauma that occurs in football games is analogous to medium speed motor vehicle collisions. This corresponds to a high rate of head and neck injuries that occur in players during football games and boxing matches at an amateur and professional level manifested either by concussions or episodes of loss of consciousness. The long-term effects of these multiple episodes of clinical and subclinical head trauma have not been addressed but have grave consequences to the players of the sport. Diffusion tensor imaging using high field clinical magnetic resonance imaging scanners allows a quantitative assessment of the degree of white matter distortion in the brain. Small shearing injuries of the white matter are known to occur with head trauma from vehicular accidents and are also associated with concussions. DTI can provide a global and regional assessment of the white matter to identify tractopathy occurring in football players and boxers. This pilot study seeks to assess the ability of DTI variables to predict the state of white matter damage in football players compared to non-contact sports athletes over similar time periods in their sport. The study will attempt to quantify white matter injury and determine whether a threshold in diffusion anisotropy loss exists above which the athletes begin to have neuropsychological and/or cognitive deficits. To examine this feature we will scan each athlete at baseline and again at a one-year interval. In addition with each acute episode of loss of consciousness during a game or practice, scans will be performed within one week, one month, 4 months, and one year intervals to assess the acute and subacute impact on diffusion anisotropy values after such an episode of head trauma. Other variables that will be studies include the position the athlete plays on the team, the level of the sport played (high school, college, professional), the overall years in the sport (counted from high school play), and the number of episodes of 'concussion' occurring during the study interval. Neuropsychological and cognitive tests will be performed to determine the effect of these variables and their relationship to diffusion anisotropy values. The data derived from this pilot study will be used to apply for a grant, which would allow us to follow a group of athletes longitudinally over a 5-year period. The benefits of funding this project and the subsequent grant will be the possible establishment of guidelines and thresholds which will allow proper counseling of players of contact sports as to the long term consequences of continuing to play their sport. The use of DTI parameters may also ultimately be used to determine the efficacy of sports equipment in protecting the brain from damage. The findings derived from this study of contact sports could also be extrapolated to individuals who are involved in motor vehicle accidents and to athletes engaged in other contact sports including ice hockey, lacrosse, and rugby.
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