PATHOPHYSIOLOGICAL MODELING OF THE NORMALIZED BRAIN TISSUE-LEVEL VOLUMETRIC EVALUATIONS OF YOUTH ATHLETES PARTICIPATING IN COLLISION SPORTS

Recent observations of short-term changes in the neural health of youth athletes participating in collision sports such as football (boys) and soccer (girls) have incited a need to explore structural alterations in their brain tissue volumes. Studies have shown biochemical, vascular, functional connectivity, and white matter diffusivity changes in the brain physiology of these athletes that are strongly correlated with repetitive head acceleration exposure from on-field collisions. Here, research is presented that highlights regional anatomical volumetric measures that change longitudinally with accrued repetitive head impacts. A novel pipeline is introduced that provides simplified data analysis on a standard-space template to quantify group-level longitudinal volumetric changes within these populations. For both sports, results highlight incremental relative regional volumetric changes in the sub-cortical cerebrospinal fluid that are strongly correlated with head exposure events greater than a 50G threshold at the short-term post-season assessment. Moreover, longitudinal regional gray matter volumes are observed to decrease with time, only returning to baseline/pre-participation levels after sufficient (5-6 months) rest from collision-based exposure. These temporal structural volumetric alterations are significantly different from normal aging observed in gender and age-matched controls participating in non-collision sports. Future work involves modeling safe repetitive head exposure thresholds with multimodal image analysis and understanding their underlying physiological functioning. A possible pathophysiological pathway is presented highlighting the probable metabolic regulatory mechanisms. The interdisciplinary nature of this work is crucial to understand this pathology accurately and aid healthcare, sport professionals in the future. It is evident that continual participation in collision- based activities may represent a risk wherein recovery cannot occur. Even when present, the degree of the eventual recovery remains to be explored but has strong implications for the well-being of collision-sport participants.