A Prospective Transcranial Doppler Ultrasound-Based Evaluation of the Effects of Repetitive Subconcussive Head Trauma on Neurovascular Coupling Dynamics

Clin J Sport Med. 2020 Mar:30 Suppl 1:S53-S60. doi: 10.1097/JSM.0000000000000578.

Abstract

Objective: To determine the effects of repetitive subconcussive head trauma on neurovascular coupling (NVC) responses.

Design: Prospective cohort study collected between September 2013 and December 2016.

Setting: University laboratory.

Participants: One hundred seventy-nine elite, junior-level (age, 19.6 ± 1.5 years) contact sport (ice hockey, American football) athletes recruited for preseason testing. Fifty-two nonconcussed athletes returned for postseason testing. Fifteen noncontact sport athletes (age, 20.4 ± 2.2 years) also completed preseason and postseason testing.

Exposure(s): Subconcussive sport-related head trauma.

Main outcome measures: Dynamics of NVC were estimated during cycles of 20 seconds eyes closed and 40 seconds eyes open to a visual stimulus (reading) by measuring cerebral blood flow (CBF) velocity in the posterior (PCA) and middle (MCA) cerebral arteries via transcranial Doppler ultrasound.

Results: Both athlete groups demonstrated no significant differences in PCA or MCA NVC dynamics between preseason and postseason, despite exposure to a median of 353.5 (range, 295.0-587.3) head impacts (>2g) over the course of the season for contact sport athletes.

Conclusions: Within the context of growing concern over detrimental effects of repetitive subconcussive trauma, the current results encouragingly suggest that the dynamics of NVC responses are not affected by 1 season of participation in junior-level ice hockey or American football. This is an important finding because it indicates an appropriate postseason CBF response to elevated metabolic demand with increases in neural activity.

MeSH terms

  • Analysis of Variance
  • Athletes
  • Athletic Injuries / diagnostic imaging
  • Athletic Injuries / physiopathology
  • Basketball / physiology
  • Brain Concussion / diagnostic imaging
  • Brain Concussion / physiopathology*
  • Craniocerebral Trauma / complications
  • Craniocerebral Trauma / physiopathology
  • Football / injuries*
  • Hockey / injuries*
  • Humans
  • Male
  • Neurovascular Coupling / physiology*
  • Prospective Studies
  • Running / physiology
  • Ultrasonography, Doppler / methods
  • Young Adult