Long-Term Neuroimaging Findings in American Football Players: Systematic Review

World Neurosurgery
Andrew D LegarretaScott L Zuckerman

Abstract

Lasting neuroimaging changes after participation in American football are an increasing public health concern. The clinical relevance of imaging findings remains unknown. A systematic review was performed with the following inclusion criteria: football players, brain imaging ≥2 years from previous concussion or retirement, and sample size ≥5. Studies were assessed for 1) methodology (control selection, type I error, and recall bias), 2) imaging outcomes, and 3) number of significant statistical comparisons. Sixteen studies (all cross-sectional studies) met the inclusion criteria. Highest level of play included high school (n = 1), college (n = 3), and professional (n = 12). Thirteen of the 16 studies made a total 456 comparisons of brain activity, of which 171 were statistically significant (38%). Nine of 16 studies (56%) had appropriate controls, and 5 of 16 studies (31%) appropriately accounted for type I error. To obtain player concussion history, all studies (16/16) had recall bias or unclear methodology. Imaging outcome measures included structural magnetic resonance imaging (MRI) (29.2%), diffusion tensor imaging (25%), radioactive tracer uptake on positron emission tomography (16.7%), patterns of connectivity on function...Continue Reading

Citations

Mar 20, 2019·Medical Sciences : Open Access Journal·Lydia McKeithanScott L Zuckerman

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