Sport-related concussion is associated with acute disturbances in neurometabolic function, with effects that may last weeks to months after injury. However, is presently unknown whether these disturbances resolve at medical clearance to return to play (RTP) or continue to evolve over longer time intervals. Moreover, little is known about how these neurometabolic changes correlate with other measures of brain structure and function. In this study, these gaps were addressed by evaluating ninety-nine (99) university-level athletes, including 33 with sport-related concussion and 66 without recent injury, using multi-parameter magnetic resonance imaging (MRI), which included single-voxel spectroscopy (SVS), diffusion tensor imaging (DTI) and resting-state functional MRI (fMRI). The concussed athletes were scanned at the acute phase of injury (27/33 imaged), medical clearance to RTP (25/33 imaged), one month post-RTP (25/33 imaged) and one year post-RTP (13/33 imaged). We measured longitudinal changes in N-acetyl aspartate (NAA) and myo-inositol (Ins), over the course of concussion recovery. Concussed athletes showed no significant abnormalities or longitudinal change in NAA values, whereas Ins was significantly elevated at RTP and one month later. Interestingly, Ins response was attenuated by a prior history of concussion. Subsequent analyses identified significant associations between Ins values, DTI measures of white matter microstructure and fMRI measures of functional connectivity. These associations varied over the course of concussion recovery, suggesting that elevated Ins values at RTP and beyond reflect distinct changes in brain physiology, compared to acute injury. These findings provide novel information about neurometabolic recovery after a sport-related concussion, with disturbances that persist beyond medical clearance to RTP.

中文翻译：

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神经代谢物和与运动有关的脑震荡：从急性损伤到医疗许可后的一年。

与运动有关的脑震荡与神经代谢功能的急性紊乱有关，其影响可能持续至受伤后数周至数月。但是，目前尚不清楚这些干扰是否会在医疗许可后解决以恢复比赛（RTP）或在更长的时间间隔内继续发展。此外，关于这些神经代谢变化如何与大脑结构和功能的其他指标相关的了解甚少。在这项研究中，这些差距通过使用多参数磁共振成像（MRI）评估，评估了九十九（99）名大学水平的运动员，其中包括33名与运动相关的脑震荡和66名近期没有受伤的运动员，其中包括单体素光谱学（SVS），扩散张量成像（DTI）和静止状态功能MRI（fMRI）。在受伤的急性期（图像为27/33），RTP的医疗许可（图像为25/33），RTP术后1个月（图像为25/33）和RTP一年之后（13/33）扫描了受冲击的运动员。图片）。我们测量了脑震荡恢复过程中N-乙酰天门冬氨酸（NAA）和肌醇（Ins）的纵向变化。脑震荡的运动员显示NAA值无明显异常或纵向变化，而在RTP和一个月后，Ins显着升高。有趣的是，先前的脑震荡病史减弱了Ins的反应。随后的分析确定了Ins值，白质微结构的DTI度量和功能连通性的fMRI度量之间的显着关联。这些关联在脑震荡恢复过程中各不相同，这表明与急性损伤相比，RTP及更高水平的Ins值反映了大脑生理的明显变化。这些发现提供了与运动相关的脑震荡后神经代谢恢复的新信息，这些疾病的持续存在超出了RTP的医疗范围。