Selective head cooling in the acute phase of concussive injury: a neuroimaging study
IntroductionNeurovascular decoupling is a common consequence after brain injuries like sports-related concussion. Failure to appropriately match cerebral blood flow (CBF) with increases in metabolic demands of the brain can lead to alterations in neurological function and symptom presentation. Thera...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1272374/full |
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| author | Alexa E. Walter Alexa E. Walter Xiaoxiao Bai James Wilkes Thomas Neuberger Wayne Sebastianelli Wayne Sebastianelli Semyon M. Slobounov |
| author_facet | Alexa E. Walter Alexa E. Walter Xiaoxiao Bai James Wilkes Thomas Neuberger Wayne Sebastianelli Wayne Sebastianelli Semyon M. Slobounov |
| author_sort | Alexa E. Walter |
| collection | DOAJ |
| description | IntroductionNeurovascular decoupling is a common consequence after brain injuries like sports-related concussion. Failure to appropriately match cerebral blood flow (CBF) with increases in metabolic demands of the brain can lead to alterations in neurological function and symptom presentation. Therapeutic hypothermia has been used in medicine for neuroprotection and has been shown to improve outcome. This study aimed to examine the real time effect of selective head cooling on healthy controls and concussed athletes via magnetic resonance spectroscopy (MRS) and arterial spin labeling (ASL) measures.Methods24 participants (12 controls; 12 concussed) underwent study procedures including the Post-Concussion Symptom Severity (PCSS) Rating Form and an MRI cooling protocol (pre-cooling (T1 MPRAGE, ASL, single volume spectroscopy (SVS)); during cooling (ASL, SVS)).ResultsResults showed general decreases in brain temperature as a function of time for both groups. Repeated measures ANOVA showed a significant main effect of time (F = 7.94, p < 0.001) and group (F = 22.21, p < 0.001) on temperature, but no significant interaction of group and time (F = 1.36, p = 0.237). CBF assessed via ASL was non-significantly lower in concussed individuals at pre-cooling and generalized linear mixed model analyses demonstrated a significant main effect of time for the occipital left ROI (F = 11.29, p = 0.002) and occipital right ROI (F = 13.39, p = 0.001). There was no relationship between any MRI metric and PCSS symptom burden.DiscussionThese findings suggest the feasibility of MRS thermometry to monitor alterations of brain temperature in concussed athletes and that metabolic responses in response to cooling after concussion may differ from controls. |
| first_indexed | 2024-03-11T15:25:08Z |
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| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-11T15:25:08Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-62ffd804ee634976a3ec041cfd6d02c42023-10-27T21:53:12ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-10-011410.3389/fneur.2023.12723741272374Selective head cooling in the acute phase of concussive injury: a neuroimaging studyAlexa E. Walter0Alexa E. Walter1Xiaoxiao Bai2James Wilkes3Thomas Neuberger4Wayne Sebastianelli5Wayne Sebastianelli6Semyon M. Slobounov7Department of Kinesiology, The Pennsylvania State University, University Park, PA, United StatesDepartment of Neurology, University of Pennsylvania, Philadelphia, PA, United StatesSocial, Life, and Engineering Science Imaging Center, The Pennsylvania State University, University Park, PA, United StatesDepartment of Kinesiology, The Pennsylvania State University, University Park, PA, United StatesDepartment of Biomedical Engineering, and Social, Life, and Engineering Science Imaging Center, Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, United StatesDepartment of Athletic Medicine, The Pennsylvania State University, University Park, PA, United StatesDepartment of Orthopaedics, Penn State Health, State College, PA, United StatesDepartment of Kinesiology, The Pennsylvania State University, University Park, PA, United StatesIntroductionNeurovascular decoupling is a common consequence after brain injuries like sports-related concussion. Failure to appropriately match cerebral blood flow (CBF) with increases in metabolic demands of the brain can lead to alterations in neurological function and symptom presentation. Therapeutic hypothermia has been used in medicine for neuroprotection and has been shown to improve outcome. This study aimed to examine the real time effect of selective head cooling on healthy controls and concussed athletes via magnetic resonance spectroscopy (MRS) and arterial spin labeling (ASL) measures.Methods24 participants (12 controls; 12 concussed) underwent study procedures including the Post-Concussion Symptom Severity (PCSS) Rating Form and an MRI cooling protocol (pre-cooling (T1 MPRAGE, ASL, single volume spectroscopy (SVS)); during cooling (ASL, SVS)).ResultsResults showed general decreases in brain temperature as a function of time for both groups. Repeated measures ANOVA showed a significant main effect of time (F = 7.94, p < 0.001) and group (F = 22.21, p < 0.001) on temperature, but no significant interaction of group and time (F = 1.36, p = 0.237). CBF assessed via ASL was non-significantly lower in concussed individuals at pre-cooling and generalized linear mixed model analyses demonstrated a significant main effect of time for the occipital left ROI (F = 11.29, p = 0.002) and occipital right ROI (F = 13.39, p = 0.001). There was no relationship between any MRI metric and PCSS symptom burden.DiscussionThese findings suggest the feasibility of MRS thermometry to monitor alterations of brain temperature in concussed athletes and that metabolic responses in response to cooling after concussion may differ from controls.https://www.frontiersin.org/articles/10.3389/fneur.2023.1272374/fullconcussionathletesselective head coolingmagnetic resonance imagingarterial spin labelingmagnetic resonance spectroscopy |
| spellingShingle | Alexa E. Walter Alexa E. Walter Xiaoxiao Bai James Wilkes Thomas Neuberger Wayne Sebastianelli Wayne Sebastianelli Semyon M. Slobounov Selective head cooling in the acute phase of concussive injury: a neuroimaging study Frontiers in Neurology concussion athletes selective head cooling magnetic resonance imaging arterial spin labeling magnetic resonance spectroscopy |
| title | Selective head cooling in the acute phase of concussive injury: a neuroimaging study |
| title_full | Selective head cooling in the acute phase of concussive injury: a neuroimaging study |
| title_fullStr | Selective head cooling in the acute phase of concussive injury: a neuroimaging study |
| title_full_unstemmed | Selective head cooling in the acute phase of concussive injury: a neuroimaging study |
| title_short | Selective head cooling in the acute phase of concussive injury: a neuroimaging study |
| title_sort | selective head cooling in the acute phase of concussive injury a neuroimaging study |
| topic | concussion athletes selective head cooling magnetic resonance imaging arterial spin labeling magnetic resonance spectroscopy |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1272374/full |
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