{"doi":"10.3174/ajnr.a8294","title":"Cognitive and Salience Network Connectivity Changes following a Single Season of Repetitive Head Impact Exposure in High School Football","abstract":"BACKGROUND AND PURPOSE:
During a season of high school football, adolescents with actively developing brains experience a considerable number of head impacts. Our aim was to determine whether repetitive head impacts in the absence of a clinically diagnosed concussion during a season of high school football produce changes in cognitive performance or functional connectivity of the salience network and its central hub, the dorsal anterior cingulate cortex. MATERIALS AND METHODS:
Football players were instrumented with the Head Impact Telemetry System during all practices and games, and the helmet sensor data were used to compute a risk-weighted exposure metric (RWEcp), accounting for the cumulative risk during the season. Participants underwent MRI and a cognitive battery (ImPACT) before and shortly after the football season. A control group of noncontact/limited-contact-sport athletes was formed from 2 cohorts: one from the same school and protocol and another from a separate, nearly identical study. RESULTS:
Sixty-three football players and 34 control athletes were included in the cognitive performance analysis. Preseason, the control group scored significantly higher on the ImPACT Visual Motor (P = .04) and Reaction Time composites (P = .006). These differences increased postseason (P = .003, P < .001, respectively). Additionally, the control group had significantly higher postseason scores on the Visual Memory composite (P = .001). Compared with controls, football players showed significantly less improvement in the Verbal (P = .04) and Visual Memory composites (P = .01). A significantly greater percentage of contact athletes had lower-than-expected scores on the Verbal Memory (27% versus 6%), Visual Motor (21% versus 3%), and Reaction Time composites (24% versus 6%). Among football players, a higher RWEcp was significantly associated with greater increments in ImPACT Reaction Time (P = .03) and Total Symptom Scores postseason (P = .006). Fifty-seven football players and 13 control athletes were included in the imaging analyses. Postseason, football players showed significant decreases in interhemispheric connectivity of the dorsal anterior cingulate cortex (P = .026) and within-network connectivity of the salience network (P = .018). These decreases in dorsal anterior cingulate cortex interhemispheric connectivity and within-network connectivity of the salience network were significantly correlated with deteriorating ImPACT Total Symptom (P = .03) and Verbal Memory scores (P = .04). CONCLUSIONS:
Head impact exposure during a single season of high school football is negatively associated with cognitive performance and brain network connectivity. Future studies should further characterize these short-term effects and examine their relationship with long-term sequelae.","journal":"American Journal of Neuroradiology","year":2024,"id":458070,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9638,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1283991,"name":"Kyle M. Atcheson","orcid":"0000-0002-6150-8671","position":1,"is_corresponding":false},{"id":929273,"name":"William C. Flood","orcid":null,"position":2,"is_corresponding":false},{"id":1283992,"name":"Christopher Sheridan","orcid":"0000-0002-9410-274X","position":3,"is_corresponding":false},{"id":505132,"name":"Richard A. Barcus","orcid":"0000-0002-3584-8242","position":4,"is_corresponding":false},{"id":450265,"name":"Laura A. Flashman","orcid":null,"position":5,"is_corresponding":false},{"id":264449,"name":"Thomas W. McAllister","orcid":"0000-0003-0267-3076","position":6,"is_corresponding":false},{"id":661473,"name":"Megan E. Lipford","orcid":"0000-0003-1357-2131","position":7,"is_corresponding":false},{"id":505130,"name":"Jeongchul Kim","orcid":"0000-0002-2369-4653","position":8,"is_corresponding":false},{"id":471050,"name":"Jillian E. Urban","orcid":"0000-0002-7348-9244","position":9,"is_corresponding":false},{"id":392013,"name":"Elizabeth M. Davenport","orcid":"0000-0002-8765-6584","position":10,"is_corresponding":false},{"id":424004,"name":"Christopher G. Vaughan","orcid":"0009-0001-0440-6177","position":11,"is_corresponding":false},{"id":406160,"name":"Kiran Kumar Solingapuram Sai","orcid":"0000-0002-6442-5169","position":12,"is_corresponding":false},{"id":471052,"name":"Joel D. Stitzel","orcid":"0000-0001-9762-3033","position":13,"is_corresponding":false},{"id":392012,"name":"Joseph A. Maldjian","orcid":"0000-0002-6384-1072","position":14,"is_corresponding":false},{"id":406157,"name":"Christopher T. Whitlow","orcid":"0000-0003-2392-8293","position":15,"is_corresponding":false},{"id":1283990,"name":"Mohammad Kawas","orcid":"0000-0003-0248-8989","position":0,"is_corresponding":true}],"reference_count":36,"raw_metadata":null,"created_at":"2026-07-19T02:03:46.117860Z","pmid":"39054293","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}