Concussions and head injuries are a common occurrence in every level of contact sports. It has been estimated that 1.6 to 3.8 million people sustain a sports-related traumatic brain injury. The long-term sequelae of repetitive head impacts (RHI) such as chronic traumatic encephalopathy (CTE) have become a major concern.  MRS provides a non-invasive and quantitative assay that is highly sensitive to even subconcussive injuries.  Furthermore, the alternation of brain metabolites provides insight into the underlying pathophysiological changes that may be occurring with sports-related RHI.  

15 symptomatic retired NFL athletes with exposure to concussive RHI were compared to 11 age-matched former professional soccer players with exposure to subconcussive RHI and 14 athletes in non-contact competitive sports with no history of RHI.  All athletes underwent single voxel point-resolved spectroscopy in the posterior cingulate gyrus on 3T MRI (Siemens) using the same acquisition parameters.  All data was post-processed using LCmodel to determine metabolite concentrations and ratios.

Choline was found to be significantly increased in both football and soccer players (p<0.05) but myoinositol levels were increased (p<0.005) in soccer players.  Glutamate was normal in soccer players when compared to controls but significantly decreased in football players (p<0.0005).  Surprisingly NAA levels were decreased in athletes but found to be somewhat increased with football players reaching significance (p<0.05).