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Int J Sports Med 2024; 45(12): 871-883
DOI: 10.1055/a-2342-3604
Review

Repetitive Subconcussive Head Impacts in Sports and Their Impact on Brain Anatomy and Function: A Systematic Review

Lukas Hack 
1   Department of Motor Behavior in Sports, German Sport University Cologne, Koln, Germany
2   Department of Human Movement Science, University of Hamburg, Hamburg, Germany
,
Bhagyashree Singh
1   Department of Motor Behavior in Sports, German Sport University Cologne, Koln, Germany
,
Ferdinand Binkofski
3   Clinical Cognitive Sciences, University Hospital RWTH Aachen, Aachen , Germany
,
Ingo Helmich
1   Department of Motor Behavior in Sports, German Sport University Cologne, Koln, Germany
4   Department of Exercise and Sport Studies, Smith College, Northampton, United States
5   Department of Neurology, Psychosomatic Medicine and Psychiatry, German Sport University Cologne, Koln, Germany
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Abstract

Repetitive subconcussive head impacts occur regularly in sports. However, the exact relationship between their biomechanical properties and their consequences on brain structure and function has not been clarified yet. We therefore reviewed prospective cohort studies that objectively reported the biomechanical characteristics of repetitive subconcussive head impacts and their impact on brain anatomy and function. Only studies with a pre- to post-measurement design were included. Twenty-four studies met the inclusion criteria. Structural white matter alterations, such as reduced fractional anisotropy and an increase in mean diffusivity values, seem to be evident in athletes exposed to repetitive subconcussive head impacts exceeding 10 g. Such changes are observable after only one season of play. Furthermore, a dose-response relationship exists between white matter abnormalities and the total number of subconcussive head impacts. However, functional changes after repetitive subconcussive head impacts remain inconclusive. We therefore conclude that repetitive subconcussive head impacts induce structural changes, but thus far without overt functional changes.

Keywords

neurodegeneration - repetitive head impacts - brain injury - concussion - contact sports


Publication History

Received: 24 January 2024

Accepted: 06 June 2024

Accepted Manuscript online:
10 June 2024

Article published online:
19 July 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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