MRI Markers May Signal Brain Changes from Repeated Head Impacts
Antemortem white matter hyperintensities linked to white matter pathologies seen at autopsy among athletes exposed to repetitive head injury
MONDAY, Nov. 29, 2021 (HealthDay News) -- Antemortem white matter hyperintensities (WMH) are associated with neuropathological changes among athletes exposed to repetitive head injury, according to a study published online Nov. 24 in Neurology.
Madeline Uretsky, from the Boston University Alzheimer's Disease Research Center, and colleagues examined the neuropathologic correlates of antemortem WMH in brain donors exposed to repetitive head impacts. The sample included 75 symptomatic deceased men exposed to repetitive head impacts: 67 football players and eight non-football contact sport athletes and/or military veterans who had antemortem fluid attenuated inversion recovery magnetic resonance imaging (MRI) scans. Log-transformed values for total lesion volume (TLV) were used to quantify WMH.
The researchers found that the most common MRI indication was dementia (64 percent). At autopsy, 70.7 percent had chronic traumatic encephalopathy (CTE). There were associations seen for log-TLV with white matter rarefaction, arteriolosclerosis, CTE stage, and dorsolateral frontal p-tau severity (odds ratios, 2.32, 2.38, 2.58, and 3.03, respectively); no association was seen with amyloid-ß. There was an association noted for more years of football play with log-TLV (b = 0.04). Greater log-TLV also correlated with higher Functional Activities Questionnaire and Cognitive Difficulties Scale scores (unstandardized beta = 4.94 and 15.35, respectively).
"White matter hyperintensities might capture long-term harm to the brain in people who have a history of repetitive head impacts," a coauthor said in a statement. "White matter hyperintensities on MRI may indeed be an effective tool to study the effects of repetitive head impacts on the brain's white matter while the athlete is still alive."
Several authors disclosed financial ties to industry.