Background: Repetitive sub-concussive head
impacts have been associated with changes in brain architecture and
neurological symptoms. In this study, we examined the association between
repetitive sub-concussive impacts, impact burden, and blood brain barrier
(BBB) integrity in university football players.
Methods: 59 university football players were
followed over the 2019 season. Athletes with diagnosed concussion and those
sustaining impacts that alerted a sideline impact monitor (relayed by
ferroelectric helmet sensors) underwent dynamic contrast-enhanced MRI
(DCE-MRI) within one week of injury/alert, and 4 weeks following initial
incident. Results: Helmets recorded 2648 impacts over
48 cumulative hours. 8 concussions occurred during the 2019 season (2.82 per
1000 activity hours). On average, athletes with a diagnosed concussion had
55.3 impacts to the front sensor, compared to 14.1 in non-concussed
athletes. Athletes who consented to DCE-MRI (n=5) had 10.78% BBB-D within a
week of concussion/alert, and 6.77% BBB-D at 4-weeks.
Conclusions: We show quantification of BBB
integrity relative to head impact burden for the first time. This
preliminary study highlights the potential of impact-detecting helmets to
provide relevant impact characteristics and offers a foundation for future
work on neurological consequences of repetitive sub-concussive
impacts.