High school football players show neurophysiological changes linked to head impact exposure.

PurposePrevious research has demonstrated effects of head impact exposure on cortical neurophysiology, which may help with understanding variability in clinical sequelae. In separate lines of research, neurochemical and gene transcription markers of vulnerability to traumatic brain injury (TBI) have been established. The purpose of this study was to examine whether these cortical neurochemical and gene transcription gradients are spatially aligned with neurophysiological effects. Methods and MaterialsMagnetoencephalography (MEG) data was collected at a total of 278 pre- and post-season timepoints from 91 high school football players across up to four seasons of play. Of the 91 football players, 10 experienced a concussion, and of the remaining 81 non-concussed players, 71 met the criteria for complete imaging and kinematic data, with post-season evaluations less than six weeks after the end of the season. Head impacts were tracked over the course of the season with helmet-mounted sensors. MEG data underwent source-imaging, frequency-transformation, spectral parameterization, and linear modeling to examine the effects of concussive and non-concussive head impact exposure on pre-to-post-season changes in rhythmic and arrhythmic neurophysiological activity. To determine clinical effects, parent reported Post-Concussive Symptom Inventory scores related to cognitive symptoms were correlated with cortical neurophysiological changes. Multi-atlas data of neurochemical system densities from neuromaps and gene expression from the Allen Human Brain Atlas were examined for alignment with head impact-related alterations in neurophysiology via nonparametric spin-tests with autocorrelation-preserving null models (5,000 Hungarian spins; pFDR <.05). ResultsConcussion-related reductions in cortical excitability (i.e., aperiodic exponent slowing) were aligned with atlas-based norepinephrine transporter (NET) and alpha-4 beta-2 nicotinic receptor (4{beta}2) densities, and with apolipoprotein E (APOE) and brain-derived neurotrophic factor (BDNF) expression levels. More severe cognitive symptoms associated with concussion-related slowing of aperiodic neurophysiology were also aligned with atlas-based NET and 4{beta}2 receptor densities. Similar changes in cortical excitability related to non-concussive head impact exposure were colocalized with serotonin receptor (5-HT1A) density maps and APOE and BDNF expression. Rhythmic alpha activity was reduced by concussion and colocalized with histamine (H3) and mu-opioid (MOR) receptors, among others, as well as with gene transcription atlases of APOE and C-C chemokine receptor 5 (CCR5). ConclusionsThese findings extend our previous work to show that the effects of head impact exposure on neurophysiology are strongest in cortical areas with specific neurochemical and genetic profiles that are known to signal vulnerability to traumatic brain injury, and that these spatial alignments are also associated with self-reported symptom severity. Clinical Relevance / ApplicationChange in cortical excitability, as measured here by MEG, has potential value as a clinical tool for concussion diagnosis and prognosis. We provide genetic and neurochemical contextualization for these changes that may extend their clinical applications, for example to concussion risk assessment and pharmacotherapies.