Use of functional near-infrared spectroscopy to quantify neurophysiological deficits after repetitive head impacts in adolescent athletes

ABSTRACT

There is concern that repetitive head impact exposure (RHIE) may lead to neurophysiological deficits in adolescents. Twelve high school varsity soccer players (5 female) completed the King-Devick (K-D) and complex tandem gait (CTG) assessments pre- and post-season while wearing a functional near-infrared spectroscopy (fNIRS) sensor. The average head impact load (AHIL) for each athlete-season was determined via a standardised protocol of video-verification of headband-based head impact sensor data. Linear mixed effect models were used to determine the effects of AHIL and task condition (3 K-D cards or 4 CTG conditions) on the change in mean prefrontal cortical activation measured by fNIRS, and performance on K-D and CTG, from pre- to post-season. Although there was no difference in the pre- to post-season change in K-D or CTG performance, greater AHIL was associated with greater cortical activation at post-season in comparison to pre-season during the most challenging conditions of K-D (p = 0.003) and CTG (p = 0.02), suggesting that greater RHIE necessitates increased cortical activation to complete the more challenging aspects of these assessments at the same level of performance. These results describe the effect of RHIE on neurofunction and suggest the need for further study of the time course of these effects.

KEYWORDS:

• Functional near-infrared spectroscopy
• adolescents
• soccer
• repetitive head impacts
• concussion

Acknowledgments

We thank Ronni S. Kessler, MEd, Fairuz Mohammed, MS, MPH, Alexis Brzuchalski, MPH, Daniele Fedonni, MPH, Melissa Pfieffer, MPH, Anne Mozel, MS, Ari Fish, BS, Julia Vanni, BS, Taylor Valerio, BA, and Shelly Sharma, BA, of Children’s Hospital of Philadelphia for their contributions to this study. In addition, we thank the students and parents from the Shipley School for their participation. We appreciate the support from the Shipley School administration, faculty and athletic department: Steve Piltch, MEd, EdD, Mark Duncan, MEd, Katelyn Taylor, BS, Dakota Carroll, MS, Kimberly Shaud, BS, Kayleigh Jenkins, BS, and Michael Turner, MEd, without whose support this research would not have been possible.

Disclosure statement

fNIR Devices, LLC manufactures the optical brain imaging instrument and licenced IP and know-how from Drexel University. Dr. Ayaz was involved in the technology development and thus offered a minor share in the startup firm fNIR Devices, LLC. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14763141.2023.2229790

Additional information

Funding

This work was supported in part by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health [R01NS0975NIH] and the Pennsylvania Department of Health [SAP4100077078].