Breaking Studies on Radiology’s Role in High School Sports

By Melinda Taschetta-Millane

Radiology and high school/collegiate sports have been making headlines this past year, and press conferences held this morning at RSNA discussed clinical data on research being done on this noteworthy topic.

A number of reports have emerged in recent years about the potential effects playing youth sports may have on developing brains. However, most of these studies have looked at brain changes as a result of concussion. Christopher T. Whitlow, M.D., Ph.D., MHA, and his colleagues set out to determine if head impacts acquired over a season of high school football produce white matter changes in the brain in the absence of clinically diagnosed concussion.

The researchers studied 24 high school football players between the ages of 16 and 18. For all games and practices, players were monitored with Head Impact Telemetry System (HITs) helmet-mounted accelerometers, which are used in youth and collegiate football to assess the frequency and severity of helmet impacts. Risk-weighted cumulative exposure was computed from the HITs data, representing the risk of concussion over the course of the season. This data, along with total impacts, were used to categorize the players into one of two groups: heavy hitters or light hitters. There were nine heavy hitters and 15 light hitters. None of the players experienced concussion during the season.

"Our study found that players experiencing greater levels of head impacts have more fractional anisotropy (FA) loss compared to players with lower impact exposure," Whitlow said. "Similar brain MRI changes have been previously associated with mild traumatic brain injury. However, it is unclear whether or not these effects will be associated with any negative long-term consequences."

In addition, a second study presented today discussed how students who participate in contact sports display subtle abnormalities in a part of the brain associated with memory.

Michael Zeineh, M.D., Ph.D., and colleagues used volumetric imaging with MRI and automatic data processing to look for differences in the brains of contact and non-contact sports athletes. They focused on the hippocampus, a horseshoe-shaped, paired structure in the brain that is important to forming new memories. Previous research has shown that the hippocampus gets smaller as Alzheimer's disease progresses, but less is known about the possible effects on the hippocampus from participation in contact sports.

The study group included 47 contact and 21 non-contact collegiate athletes. Players enrolled in the first year received an MRI at baseline with a six- and 12-month follow-up, while those enrolled in the second year only had a baseline scan. Unlike prior research, this study examined changes to the microscopic structure of the hippocampus over time.

"The hippocampus is very important in memory, and the left hippocampus is particularly important because that is the side of the brain that is so often critical for language function," Zeineh said. "It is a significant thing to see that it is a little smaller in contact sport athletes compared with those in non-contact sports. I wouldn't say that we're finding CTE in these contact sports athletes, but we do know that patients with CTE have had involvement of the hippocampus."

The findings show that MRI could play a useful role in the noninvasive assessment of the memory components of sports-related cumulative mild traumatic brain injury, possibly even detecting hippocampal changes before any long-term damage is done.

Study findings and other news that breaks from RSNA during the coming week will be posted at itnonline.com. Also visit the RSNA FastPass microsite, www.itnonline.com/rsna-fastpass, with information about hundreds of products on display in the RSNA exhibit halls. Several of them are highlighted below. Enjoy the meeting!