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Sci Adv. 2019 Aug 7;5(8):eaau3460. doi: 10.1126/sciadv.aau3460. eCollection 2019 Aug.

A common neural signature of brain injury in concussion and subconcussion.

Author information

1
Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA.
2
Department of Clinical and Translational Science, University of Rochester Medical Center, Rochester, NY 14642, USA.
3
Center for Visual Sciences, University of Rochester, Rochester, NY 14642, USA.
4
Moss Rehabilitation Research Institute, Elkins Park, PA 19027, USA.
5
Department of Pharmacology and Physiology, University of Rochester Medical Center, Rochester, NY 14642, USA.
6
Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA.
7
Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY 14642, USA.
8
Division of Neurosurgery, San Antonio Military Medical Center, San Antonio, TX 78234, USA.
9
Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA.
10
Department of Neurology, University of Rochester Medical Center, Rochester, NY 14642, USA.
11
Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.
12
Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213, USA.
13
Carnegie Mellon Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA 15213, USA.
14
Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA.

Abstract

The midbrain is biomechanically susceptible to force loading from repetitive subconcussive head impacts (RSHI), is a site of tauopathy in chronic traumatic encephalopathy (CTE), and regulates functions (e.g., eye movements) often disrupted in concussion. In a prospective longitudinal design, we demonstrate there are reductions in midbrain white matter integrity due to a single season of collegiate football, and that the amount of reduction in midbrain white matter integrity is related to the amount of rotational acceleration to which players' brains are exposed. We then replicate the observation of reduced midbrain white matter integrity in a retrospective cohort of individuals with frank concussion, and further show that variance in white matter integrity is correlated with levels of serum-based tau, a marker of blood-brain barrier disruption. These findings mean that noninvasive structural MRI of the midbrain is a succinct index of both clinically silent white matter injury as well as frank concussion.

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