Contributions de la neuro-imagerie à l'étude des commotions cérébrales reliées au sport

Abstract

Sports-related concussions affect between 1,6 and 3 millions athletes every year in the United States alone and are a major public health concern. This injury is typically characterized as mild and transient, resolving in a few days (10-12 in adults while children and adolescents typically recover in 3-4 weeks). However, recent research demonstrates that sports-related concussions are much more severe than was previously thought and repeated concussions could increase an athlete's vulnerability to a neurodegenerative disease such as mild cognitive impairment (MCI) (a condition that converts at a rate of about 10-20% annually into dementia of Alzheimer's type) and early onset Alzheimer's disease compared to the general population. To compound the difficulty of understanding concussive injuries, conventional neuroimaging such as CT scans and MRI do not reveal any gross structural changes in the vast majority of cases. Given this alarming epidemiologic data, the severity of the sequelae, and the clinical limitations of conventional imaging, research using different advanced neuroimaging techniques to investigate the acute and long-term effects of sports-related concussions has exploded in the last two decades. The goal of these studies has been to better understand the structural and functional alterations that occur as a result of sports-related concussions. As such, the aim of the current article is to review the scientific literature that employed neuroimaging techniques such as electroencephalography (EEG), evoked-response potentials (ERP), functional magnetic resonance imaging (fMRI), magnetic resonance spectroscopy (MRS), transcranial magnetic stimulation (TMS), and diffusion tensor imaging (DTI). Although future studies are still required, these results provide a better understanding of the pathophysiological mechanisms underpinning the symptomatology of sports-related concussions. (PsycINFO Database Record (c) 2015 APA, all rights reserved)(journal abstract)