Accumulation of high magnitude acceleration events predicts cerebrovascular reactivity changes in female high school soccer athletes

Mitigating the effects of repetitive exposure to head trauma has become a major concern for the general population, given the growing body of evidence that even asymptomatic exposure to head accelerations is linked with increased risk for negative life outcomes and that risk increases as exposure is prolonged over many years. Among women's sports, soccer currently exhibits the highest growth in participation and reports the largest number of mild traumatic brain injuries annually, making female soccer athletes a relevant population in assessing the effects of repetitive exposure to head trauma. Cerebrovascular biomarkers may be useful in assessing the effects of repetitive head trauma, as these are thought to contribute directly to neurocognitive symptoms associated with mild traumatic brain injury. Here we use fMRI paired with a hypercapnic breath hold task along with monitoring of head acceleration events, to assess the relationship between cerebrovascular brain changes and exposure to repetitive head trauma over a season of play in female high school soccer athletes. We identified longitudinal changes in cerebrovascular reactivity that were significantly associated with prolonged accumulation to high magnitude (> 75th percentile) head acceleration events. Findings argue for active monitoring of athletes during periods of exposure to head acceleration events, illustrate the importance of collecting baseline (i.e., pre-exposure) measurements, and suggest modeling as a means of guiding policy to mitigate the effects of repetitive head trauma

Measurement, characterization, and effects of head impacts in women\u27s soccer

The potential for long term neurological deficits resulting from repetitive head trauma is a major concern for collision sport athletes. Research conducted on football played has found neurophysiologic changes in the absence of concussion in athletes as early as high school age. Given that female soccer players show the highest rate of concussion for female athletes and a higher rate of concussion than their male counterparts, it is important to characterize the types of impacts female soccer athletes receive and assess female soccer athletes for neurophysiologic changes due to these impacts. This work paired head impact sensors with functional MRI to assess the effects of head impacts experienced by female soccer players at both the high school and collegiate level. A total of 29 high school female soccer athletes were studied from two different high schools (HS1: n=12, HS2: n=17) and 14 collegiate Division I female soccer athletes from one university. Collegiate athletes sustained significantly higher cumulative loads in terms of peak translational and peak angular accelerations than high school athletes (p\u3c.001). However, a subset of high school athletes sustained cumulative loading on par with collegiate athletes despite their season being 2-4 weeks shorter than the collegiate season. High school athletes experiencing high cumulative loads through a 10-12 week season exhibited a significant decline in cerebrovascular reactivity. Overall, the results indicate that the female soccer athletes sustain significant mechanical loading to the head throughout a season, capable of causing neurophyisiologic changes in the brain. These results indicate that soccer athletes may also be at risk for chronic neurologic damage even in the absence of concussion