The ENIGMA sports injury working group - an international collaboration to further our understanding of sport-related brain injury

Sport-related brain injury is very common, and the potential long-term effects include a wide range of neurological and psychiatric symptoms, and potentially neurodegeneration. Around the globe, researchers are conducting neuroimaging studies on primarily homogenous samples of athletes. However, neuroimaging studies are expensive and time consuming, and thus current findings from studies of sport-related brain injury are often limited by small sample sizes. Further, current studies apply a variety of neuroimaging techniques and analysis tools which limit comparability among studies. The ENIGMA Sports Injury working group aims to provide a platform for data sharing and collaborative data analysis thereby leveraging existing data and expertise. By harmonizing data from a large number of studies from around the globe, we will work towards reproducibility of previously published findings and towards addressing important research questions with regard to diagnosis, prognosis, and efficacy of treatment for sport-related brain injury. Moreover, the ENIGMA Sports Injury working group is committed to providing recommendations for future prospective data acquisition to enhance data quality and scientific rigor

Physiological Correlates of Volunteering

We review research on physiological correlates of volunteering, a neglected but promising research field. Some of these correlates seem to be causal factors influencing volunteering. Volunteers tend to have better physical health, both self-reported and expert-assessed, better mental health, and perform better on cognitive tasks. Research thus far has rarely examined neurological, neurochemical, hormonal, and genetic correlates of volunteering to any significant extent, especially controlling for other factors as potential confounds. Evolutionary theory and behavioral genetic research suggest the importance of such physiological factors in humans. Basically, many aspects of social relationships and social activities have effects on health (e.g., Newman and Roberts 2013; Uchino 2004), as the widely used biopsychosocial (BPS) model suggests (Institute of Medicine 2001). Studies of formal volunteering (FV), charitable giving, and altruistic behavior suggest that physiological characteristics are related to volunteering, including specific genes (such as oxytocin receptor [OXTR] genes, Arginine vasopressin receptor [AVPR] genes, dopamine D4 receptor [DRD4] genes, and 5-HTTLPR). We recommend that future research on physiological factors be extended to non-Western populations, focusing specifically on volunteering, and differentiating between different forms and types of volunteering and civic participation

Amygdala volume and functional connectivity predict individual differences in human social networks and social cognition

Thesis (Ph.D.)--Boston University PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at [email protected]. Thank you.Comparative neuroanatomists hypothesize that the amygdala is one brain region that might be important for handling the demands of complex social life. In this dissertation, four studies were conducted to examine relationships between individual differences in amygdala volume and functional connectivity, social network size, and social cognitive functions . Using structural MRI, Study 1 demonstrated the first evidence that amygdala volume uniquely predicts the size and complexity of social networks in healthy adults. Using resting-state functional connectivity analysis, Study 2 demonstrated that healthy adults who have larger and more complex social networks not only have larger amygdala volumes but also amygdalae with stronger functional connectivity. Study 3 and 4 used structural MRI and a newly developed and validated clinician-based rating scale to assess relationships between atrophy in large-scale brain networks anchored in the amygdala and social cognitive impairments in a sample of frontotemporal dementia (FTD) patients. Results demonstrated that patients with the greatest atrophy in a mesolimbic-social affiliation network exhibited the most severe socioemotional detachment, whereas patients with the greatest atrophy in an interoception-social aversion network exhibited the most severe lack of social apprehension, and patients with the greatest atrophy in a sensory association-social perception network exhibited the most severe lack of awareness or understanding of others' social and emotional behavior. All findings were anatomically specific to the amygdala or amygdalar networks in that individual differences in social network characteristics and social cognitive impairment could not be explained by the volume, strength of functional connectivity, or degree of atrophy in other, control, brain regions and networks. Taken together with previous human neuroimaging and neuropsychology work, findings from this dissetiation suggest that the amygdala patiicipates in large-scale brain networks to conduct aspects of social cognition that are needed to forge and maintain social relationships

Amygdala volume and social network size in humans

nature neuroscience advance online publication B r i e f c o m m u n i c at i o n s For many species, but particularly for primates, living in groups is a major adaptive advantage 1 . But living in a social group also presents its own challenges. To get along while getting ahead, it is necessary to learn who is who, who is friend and who is foe. It might be productive to form an alliance with certain group members in one context, but to outmaneuver them in another. The 'social brain hypothesis' suggests that, evolutionarily, living in larger, more complex social groups selected for larger brain regions with a greater capacity for performing relevant computations 2 . On the basis of its central functional role Comparative neuroanatomical studies in nonhuman primates strongly support a link between amygdala volume and social network size 7 and social behavior 8 . Species characterized by larger social groups have a larger corticobasolateral complex within the amygdala. The corticobasolateral complex conjointly expanded with evolutionarily newer cortex and the lateral geniculate nucleus, particularly the layers of the lateral geniculate nucleus that project to the ventral stream visual system 7 . Taken together, these comparative findings suggest that a larger amygdala provides for the increased processing demands required by a complex social life. In this study we examined whether amygdala volume varies with individual variation in the size and complexity of social groupings within a single primate species, humans. In 58 healthy adults (22 females; mean age M = 52.6, s.d. = 21.2, range = 19-83 years) with confirmed absence of DSM-IV Axis I diagnoses and normal performance on cognitive testing, we examined social network size and complexity with two subscales of the Social Network Index (SNI 9 ). One SNI subscale (Number of People in Social Network) measures the total number of regular contacts that a person maintains, reflecting overall network size. A second subscale (Number of Embedded Networks) measured the number of different groups these contacts belong to, reflecting network complexity. Despite the fact that the two social network variables were strongly correlated within the present sample (r = 0.86, P < 0.001), we opted to consider their separate relation to amygdala and hippocampal volumes. (For more details, see Supplementary Results.) To assess amygdala (and, as a control region, hippocampal) volume, we performed quantitative morphometric analysis of T1-weighted MRI data using an automated segmentation and probabilistic regionof-interest (ROI) labeling technique (FreeSurfer, http://surfer.nmr. mgh.harvard.edu/). For methodological details, see Supplementary Methods. To adjust for differences in head size, amygdala and hippocampal volumes were divided by total intracranial volume, as performed previously Linear regression analyses revealed that individuals with larger and more complex social networks had larger amygdala volumes To assess discriminant validity, we performed a linear regression using right and left hippocampal volumes (corrected for total intracranial volume) as independent variables and social network size and complexity as dependent variables while controlling for age (because hippocampal volume typically diminishes with age). For the whole group, these analyses showed no significant relationship Amygdala volume and social network size in humans We found that amygdala volume correlates with the size and complexity of social networks in adult humans. An exploratory analysis of subcortical structures did not find strong evidence for similar relationships with any other structure, but there were associations between social network variables and cortical thickness in three cortical areas, two of them with amygdala connectivity. These findings indicate that the amygdala is important in social behavior

Cardiorespiratory Functioning in Youth with Persistent Post-Concussion Symptoms: A Pilot Study

Dysregulation of the autonomic nervous system (ANS) may play an important role in the development and maintenance of persistent post-concussive symptoms (PPCS). Post-injury breathing dysfunction, which is influenced by the ANS, has not been well-studied in youth. This study evaluated cardiorespiratory functioning at baseline in youth patients with PPCS and examined the relationship of cardiorespiratory variables with neurobehavioral outcomes. Participants were between the ages of 13-25 in two groups: (1) Patients with PPCS (concussion within the past 2-16 months; n = 13) and (2) non-injured controls (n = 12). Capnometry was used to obtain end-tidal CO2 (EtCO2), oxygen saturation (SaO2), respiration rate (RR), and pulse rate (PR) at seated rest. PPCS participants exhibited a reduced mean value of EtCO2 in exhaled breath (M = 36.3 mmHg, SD = 2.86 mmHg) and an altered inter-correlation between EtCO2 and RR compared to controls. Neurobehavioral outcomes including depression, severity of self-reported concussion symptoms, cognitive catastrophizing, and psychomotor processing speed were correlated with cardiorespiratory variables when the groups were combined. Overall, results from this study suggest that breathing dynamics may be altered in youth with PPCS and that cardiorespiratory outcomes could be related to a dimension of neurobehavioral outcomes associated with poorer recovery from concussion

Frontoamygdala hyperconnectivity predicts affective dysregulation in adolescent moderate-severe TBI.

In survivors of moderate to severe traumatic brain injury (msTBI), affective disruptions often remain underdetected and undertreated, in part due to poor understanding of the underlying neural mechanisms. We hypothesized that limbic circuits are integral to affective dysregulation in msTBI. To test this, we studied 19 adolescents with msTBI 17 months post-injury (TBI: M age 15.6, 5 females) as well as 44 matched healthy controls (HC: M age 16.4, 21 females). We leveraged two previously identified, large-scale resting-state (rsfMRI) networks of the amygdala to determine whether connectivity strength correlated with affective problems in the adolescents with msTBI. We found that distinct amygdala networks differentially predicted externalizing and internalizing behavioral problems in patients with msTBI. Specifically, patients with the highest medial amygdala connectivity were rated by parents as having greater externalizing behavioral problems measured on the BRIEF and CBCL, but not cognitive problems. The most correlated voxels in that network localize to the rostral anterior cingulate (rACC) and posterior cingulate (PCC) cortices, predicting 48% of the variance in externalizing problems. Alternatively, patients with the highest ventrolateral amygdala connectivity were rated by parents as having greater internalizing behavioral problems measured on the CBCL, but not cognitive problems. The most correlated voxels in that network localize to the ventromedial prefrontal cortex (vmPFC), predicting 57% of the variance in internalizing problems. Both findings were independent of potential confounds including ratings of TBI severity, time since injury, lesion burden based on acute imaging, demographic variables, and other non-amygdalar rsfMRI metrics (e.g., rACC to PCC connectivity), as well as macro- and microstructural measures of limbic circuitry (e.g., amygdala volume and uncinate fasciculus fractional anisotropy). Supporting the clinical significance of these findings, patients with msTBI had significantly greater externalizing problem ratings than healthy control participants and all the brain-behavior findings were specific to the msTBI group in that no similar correlations were found in the healthy control participants. Taken together, frontoamygdala pathways may underlie chronic dysregulation of behavior and mood in patients with msTBI. Future work will focus on neuromodulation techniques to directly affect frontoamygdala pathways with the aim to mitigate such dysregulation problems

Flying After Concussion and Symptom Recovery in College Athletes and Military Cadets

Importance: Concussions are a common occurrence in young athletes. Hypobaric hypoxemia, such as that experienced during airplane travel, can potentially cause alterations to cerebral blood flow and increased neuroinflammatory response. It remains unknown whether flying early after a concussion may influence the clinical course of injury. Objective: To determine whether there is an association between concussion recovery and airplane travel in collegiate athletes and military cadets. Design, Setting, and Participants: This cohort study was conducted by the National Collegiate Athletic Association and US Department of Defense Concussion Assessment, Research, and Education Consortium from August 3, 2014, to September 13, 2018. Participant groups were categorized by those who flew within 72 hours of injury and those who did not fly. All participants included in the final analyses had complete data of interest and only 1 injury during the study. Data analysis was performed from September 2018 to March 2020. Main Outcomes and Measures: Recovery outcome measures were defined as time (in days) from injury to return to activity, school, and baseline symptoms. Symptom and headache severity scores were derived from the Sports Concussion Assessment Tool-Third Edition. Scores for both groups were taken at baseline and a median of 2 days after injury. Results: A total of 92 participants who flew (mean [SD] age, 19.1 [1.2] years; 55 male [59.8%]) and 1383 participants who did not fly (mean [SD] age, 18.9 [1.3] years; 809 male [58.5%]) were included in the analysis of symptom recovery outcomes (analysis 1). Similarly, 100 participants who flew (mean [SD] age, 19.2 [1.2] years; 63 male [63.0%]) and 1577 participants who did not fly (mean [SD] age, 18.9 [1.3] years; 916 male [58.1%]) were included in the analysis of symptom severity outcomes (analysis 2). No significant group differences were found regarding recovery outcome measures. Likewise, there were no group differences in symptom (estimated mean difference, 0.029; 95% CI, -0.083 to 0.144; P = .67) or headache (estimated mean difference, -0.007; 95% CI, -0.094 to 0.081; P = .91) severity scores. Conclusions and Relevance: Airplane travel early after concussion was not associated with recovery or severity of concussion symptoms. These findings may help guide future recommendations on flight travel after concussion in athletes