Imaging biomarkers of impairing brain injuries identified in athletes

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Combining structural MRI, diffusion-weighted MRI and multivariate analysis, researchers at Cleveland Clinic’s Lou Ruvo Center for Brain Health in Las Vegas have identified seven biomarkers of early brain damage related to cognitive decline in athletes who’ve taken a lot of blows to the head.   

RSNA’s Radiology published the study online July 25.

The biomarkers—changes in brain-matter volume, thickness and organization—showed up in the forceps major, left inferior longitudinal fasciculus, left cerebellum, right cortex, left thalamus, right pallidum and right rostral anterior cingulate cortex.

The study subjects were professional boxers and mixed martial artists participating in the Ruvo organization’s ongoing Professional Fighters Brain Health Study.

Virendra Mishra, PhD, and colleagues included 91 neuropsychologically impaired fighters, 182 nonimpaired fighters and 20 control participants who never competed in contact sports in their main baseline analysis.

In a follow-up analysis, they looked at 17 impaired fighters, 39 nonimpaired fighters and six controls.

Along with the seven biomarkers, the researchers found significant associations between imaging signatures of damage and years of fighting, psychomotor speed and number of fights.

In their discussion, Mishra et al note that, unlike authors of previous studies, they identified structures associated with cognition without any regional a priori bias.

“Post hoc analysis of these features at baseline not only showed significant group differences but also showed a differential association with clinical scores and exposure to fighting at an individual level, suggesting that these features are characteristic of an imaging biomarker,” they write. “Moreover, the imaging biomarkers allowed successful differentiation of cognitively impaired fighters from nonimpaired fighters at follow-up, which suggests that the combination of these imaging biomarkers may provide quantifiable and objective information about the progression of cognitive decline due to repeated head trauma.”

RSNA has posted the study in full for free.