Cerebral Cortical Surface Structure and Neural Activation Pattern Among Adolescent Football Players

• Published in: JAMA network open 2024-02, Vol.7 (2), p.e2354235
• Main Authors: Zuidema, Taylor R, Hou, Jiancheng, Kercher, Kyle A, Recht, Grace O, Sweeney, Sage H, Chenchaiah, Nishant, Cheng, Hu, Steinfeldt, Jesse A, Kawata, Keisuke
• Format: Article
• Language: English
• Subjects: Adolescent; Cerebral Cortex - diagnostic imaging; Cohort Studies; Football; Gyrus Cinguli; Humans; Magnetic resonance imaging; Male
• ISSN: 2574-3805; 2574-3805
• DOI: 10.1001/jamanetworkopen.2023.54235

Recurring exposure to head impacts in American football has garnered public and scientific attention, yet neurobiological associations in adolescent football players remain unclear. To examine cortical structure and neurophysiological characteristics in adolescent football players. This cohort study included adolescent football players and control athletes (swimming, cross country, and tennis) from 5 high school athletic programs, who were matched with age, sex (male), and school. Neuroimaging assessments were conducted May to July of the 2021 and 2022 seasons. Data were analyzed from February to November 2023. Playing tackle football or noncontact sports. Structural magnetic resonance imaging (MRI) data were analyzed for cortical thickness, sulcal depth, and gyrification, and cortical surface-based resting state (RS)-functional MRI analyses examined the amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), and RS-functional connectivity (RS-FC). Two-hundred seventy-five male participants (205 football players; mean [SD] age, 15.8 [1.2] years; 5 Asian [2.4%], 8 Black or African American [3.9%], and 189 White [92.2%]; 70 control participants; mean [SD] age 15.8 [1.2] years, 4 Asian [5.7], 1 Black or African American [1.4%], and 64 White [91.5%]) were included in this study. Relative to the control group, the football group showed significant cortical thinning, especially in fronto-occipital regions (eg, right precentral gyrus: t = -2.24; P = .01; left superior frontal gyrus: -2.42; P = .002). Elevated cortical thickness in football players was observed in the anterior and posterior cingulate cortex (eg, left posterior cingulate cortex: t = 2.28; P = .01; right caudal anterior cingulate cortex 3.01; P = .001). The football group had greater and deeper sulcal depth than the control groups in the cingulate cortex, precuneus, and precentral gyrus (eg, right inferior parietal lobule: t = 2.20; P = .004; right caudal anterior cingulate cortex: 4.30; P