2025-09-18 コロンビア大学
<関連情報>
- https://www.cuimc.columbia.edu/news/soccer-heading-does-most-damage-brain-area-critical-cognition#
- https://www.neurology.org/doi/10.1212/WNL.0000000000214034
- https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2839068
サッカーのヘディング曝露による成人アマチュア選手の脳溝深部の微細構造損傷 Soccer Heading Exposure–Dependent Microstructural Injury at Depths of Sulci in Adult Amateur Players
Bluyé DeMessie, Walter F. Stewart, Richard B. Lipton, Mimi Kim, Kenny Ye, Molly E. Zimmerman, Thomas W. Kaminski, Roman Fleysher, and Michael L. Lipton
Neurology Published:September 17, 2025
DOI:https://doi.org/10.1212/WNL.0000000000214034
Abstract
Background and Objectives
Repetitive head impacts (RHIs) in sports are associated with adverse clinical and neuropathologic outcomes, but there is limited evidence from in vivo human imaging studies to inform risk assessment, exposure standards, and interventions. We tested the association of RHI with in vivo microstructural disruption at the depths of cerebral sulci, a region vulnerable to trauma.
Methods
We examined the relationship between soccer-related RHI exposure over 12 months and imaging measures. Participants included amateur soccer players and noncollision sport athletes aged 18–55 years from the Greater New York City area. We analyzed diffusion MRI measures specifically within the juxtacortical white matter at the depths of cortical sulci and crests of gyri, as well as within deep white matter. Cognitive function was assessed using components of the CogState computerized battery, focusing on verbal learning and memory performance.
Results
A total of 352 soccer players (mean [SD] age, 25.6 [7.5] years; 245 men [70%]) and 77 controls (22.8 [5.1] years; 30 men [39%]) were included. In multivariable regression, greater RHI was associated with lower fractional anisotropy (FA) (standardized β = -0.234; p < 0.001) and higher orientation dispersion index (ODI) (β = 0.156; p = 0.008), averaged over depths of cerebral sulci, in an RHI exposure-dependent manner. Worse cognitive performance on verbal learning and memory tests was associated with lower FA (Pearson r = 0.16 to 0.24, p < 0.001) and higher ODI (r = -0.25 to -0.17, p < 0.001) at depths of sulci in the orbitofrontal region. Diffusion measures from deep white matter were not associated with RHI or cognitive measures. Mediation analyses revealed that orbitofrontal depths of sulci microstructural disruption (lower FA and higher ODI) partially mediated the relationship between RHI exposure and poorer performance on verbal learning (indirect effects = -0.26 to -0.25, p < 0.001), weighted verbal learning (-0.51 to -0.48, p < 0.001), and verbal memory (-0.05 to -0.04, p = 0.04).
Discussion
Higher RHI exposure was associated with MRI measures of microstructural disruption at the depths of sulci in an exposure-dependent manner. By contrast, deep white matter regions were relatively insensitive to RHI effects. Diffusion MRI at the depths of sulci may serve as a more specific marker of RHI-related brain injury.
眼窩前頭灰白質境界面損傷とサッカーのヘディングと言語学習の関連性 Orbitofrontal Gray-White Interface Injury and the Association of Soccer Heading With Verbal Learning
Joan Y. Song, MS; Roman Fleysher, PhD; Kenny Ye, PhD;et al
JAMA Network Open Published:September 18, 2025
DOI:10.1001/jamanetworkopen.2025.32461
Key Points
Question Is the orbitofrontal gray matter–white matter interface (GWI) a locus of injury due to repetitive head impacts (RHIs) among soccer players, and does it mediate RHI associations with poorer verbal learning?
Findings In this cross-sectional study of RHI in 352 adult amateur soccer players, greater RHI exposure was associated with attenuation of orbitofrontal GWI fractional anisotropy slope sharpness, and orbitofrontal fractional anisotropy slope mediated the association between RHI and International Shopping List Task score.
Meaning These findings suggest that soccer RHI-related consequences are specific to orbitofrontal GWI, where disruption plays a mediating role in the adverse association of RHI with cognitive performance.
Abstract
Importance Sport-related repetitive head impacts (RHIs) are linked to structural and functional brain changes and may be associated with risk for neurodegenerative disease. However, the locus of RHI-associated pathology that leads to adverse cognitive performance has yet to be characterized in vivo.
Objective To examine whether orbitofrontal gray matter–white matter interface (GWI) microstructure is associated with soccer RHI and whether it mediates the association of RHI with cognitive performance.
Design, Setting, and Participants This cross-sectional study, performed at Albert Einstein College of Medicine and Columbia University Irving Medical Center, included a population-based sample from the greater New York City area of amateur soccer players aged 18 to 55 years who played for at least 5 years, currently played at least 6 months per year, and were fluent in English. Exclusion criteria consisted of schizophrenia, bipolar disorder, current substance use disorder, any drug use within 30 days, and any contraindication to magnetic resonance imaging. Data were collected from November 11, 2013, to December 28, 2015, and analyses were performed from April 1 through December 4, 2024.
Exposure Soccer RHI exposure in the prior 12 months quantified via the HeadCount 12-month survey.
Main Outcome and Measures Slope of diffusion magnetic resonance imaging metrics (fractional anisotropy [FA], axial diffusivity, orientation dispersion index, and intracellular volume fraction) across the GWI was computed for each of 6 cerebral regions (cingulate, orbitofrontal, frontal, temporal, parietal, and occipital). The GWI slope association with RHI and with International Shopping List (ISL) immediate recall task performance, which is associated with RHI, were examined. Mediation analyses tested for the mechanistic role of GWI slope in the RHI and ISL association.
Results In 352 adult amateur soccer players aged 18 to 53 years (243 [69.0%] male; mean [SD] age, 25.6 [7.5] years), greater RHI exposure was associated with a less steep FA slope across the orbitofrontal GWI (estimate, 0.000001; P < .001). The orbitofrontal FA slope measure mediated the association of RHI with ISL performance (indirect effect estimate, -0.000064; P = .006).
Conclusions and Relevance In this cross-sectional study of soccer RHI, the orbitofrontal GWI emerged as a specific site of soccer RHI-related consequences, with FA slope suggesting that GWI microstructural disruption plays a mediating role in the association of greater RHI exposure with poorer verbal learning task performance.
