Repetitive subconcussion results in disrupted neural activity independent of concussion history.

IF 4.1 Q1 CLINICAL NEUROLOGY
Brain communications Pub Date : 2024-10-08 eCollection Date: 2024-01-01 DOI:10.1093/braincomms/fcae348
Kevin Grant Solar, Matthew Ventresca, Rouzbeh Zamyadi, Jing Zhang, Rakesh Jetly, Oshin Vartanian, Shawn G Rhind, Benjamin T Dunkley
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引用次数: 0

Abstract

Concussion is a public health crisis that results in a complex cascade of neurochemical changes that can have life-changing consequences. Subconcussions are generally considered less serious, but we now realize repetitive subconcussions can lead to serious neurological deficits. Subconcussions are common in contact sports and the military where certain personnel are exposed to repetitive occupational blast overpressure. Post-mortem studies show subconcussion is a better predictor than concussion for chronic traumatic encephalopathy-a progressive and fatal neurodegenerative tauopathy, only diagnosable post-mortem-thus, an in vivo biomarker would be transformative. Magnetoencephalography captures the dynamics of neuronal electrochemical action, and functional MRI shows that functional connectivity is associated with tauopathy patterns. Therefore, both imaging modalities could provide surrogate markers of tauopathy. In this cross-sectional study, we examined the effects of repetitive subconcussion on neuronal activity and functional connectivity using magnetoencephalography and functional MRI, and on neurological symptoms and mental health in a military sample. For magnetoencephalography and outcome analyses, 81 participants were split into 'high' and 'low' blast exposure groups using the generalized blast exposure value: n = 41 high blast (26.4-65.7 years; 4 females) and n = 40 low blast (28.0-63.3 years; 8 females). For functional MRI, two high blast male participants without data were excluded: n = 39 (29.6-65.7 years). Magnetoencephalography revealed disrupted neuronal activity in participants with a greater history of repetitive subconcussions, including neural slowing (higher delta activity) in right fronto-temporal lobes and subcortical regions (hippocampus, amygdala, caudate, pallidum and thalamus), and functional dysconnectivity in the posterior default mode network (lower connectivity at low and high gamma). These abnormalities were independent of concussion or traumatic stress history, and magnetoencephalography showed functional dysconnectivity not detected in functional MRI. Besides magnetoencephalography changes, those with higher blast exposure had poorer somatic and cognitive outcomes, with no blast-related differences in mental health or associations between neurological symptoms and neuronal activity. This study suggests that repetitive subconcussions have deleterious effects on brain function and that magnetoencephalography provides an avenue for both treatment targets by identifying affected brain regions and in prevention by identifying those at risk of cumulative subconcussive neurotrauma.

重复性亚脑震荡会导致神经活动紊乱,与脑震荡史无关。
脑震荡是一种公共卫生危机,它导致一连串复杂的神经化学变化,可造成改变生活的后果。亚脑震荡一般被认为不太严重,但我们现在认识到,反复的亚脑震荡可导致严重的神经功能缺损。亚撞击常见于接触性运动和军事领域,因为某些人员会暴露于重复的职业性爆炸超压中。死后研究表明,亚脑震荡比脑震荡更能预测慢性创伤性脑病--一种进行性和致命的神经退行性牛磺酸病,只能在死后诊断,因此,体内生物标志物将是一种变革。脑磁图可以捕捉神经元电化学作用的动态,而功能性核磁共振成像则显示功能连接性与牛磺酸脑病的模式有关。因此,这两种成像模式都可以提供tauopathy的替代标记物。在这项横断面研究中,我们使用脑磁图和功能磁共振成像检查了重复性脑震荡对神经元活动和功能连通性的影响,以及对军队样本中神经症状和心理健康的影响。在脑磁图和结果分析中,81 名参与者被分成了 "高 "和 "低 "爆炸暴露组,使用通用爆炸暴露值:n = 41 高爆炸暴露组(26.4-65.7 岁;4 名女性)和 n = 40 低爆炸暴露组(28.0-63.3 岁;8 名女性)。在功能磁共振成像中,排除了两名没有数据的高爆炸值男性参与者:n = 39(29.6-65.7 岁)。脑磁图显示,重复亚脑震荡史较多的参与者的神经元活动紊乱,包括右侧额颞叶和皮层下区域(海马、杏仁核、尾状核、苍白球和丘脑)的神经减速(较高的δ活动),以及后部默认模式网络的功能性连接失调(低γ和高γ连接性较低)。这些异常与脑震荡或创伤应激史无关,脑磁图显示了功能磁共振成像未检测到的功能性连接失调。除了脑磁图变化外,爆炸暴露程度较高的人的躯体和认知结果也较差,而精神健康方面的差异或神经症状与神经元活动之间的关联则与爆炸无关。这项研究表明,重复性次撞击会对大脑功能产生有害影响,而脑磁图通过识别受影响的大脑区域,为治疗目标提供了一种途径,同时也通过识别累积性次撞击神经创伤的高危人群,为预防提供了一种途径。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
7.00
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