{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T14:37:34Z","timestamp":1783521454826,"version":"3.55.0"},"reference-count":44,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi231583-4\"><jats:title>Importance<\/jats:title><jats:p>Recurring exposure to head impacts in American football has garnered public and scientific attention, yet neurobiological associations in adolescent football players remain unclear.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi231583-5\"><jats:title>Objective<\/jats:title><jats:p>To examine cortical structure and neurophysiological characteristics in adolescent football players.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi231583-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This cohort study included adolescent football players and control athletes (swimming, cross country, and tennis) from 5 high school athletic programs, who were matched with age, sex (male), and school. Neuroimaging assessments were conducted May to July of the 2021 and 2022 seasons. Data were analyzed from February to November 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi231583-7\"><jats:title>Exposure<\/jats:title><jats:p>Playing tackle football or noncontact sports.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi231583-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Structural magnetic resonance imaging (MRI) data were analyzed for cortical thickness, sulcal depth, and gyrification, and cortical surface-based resting state (RS)\u2013functional MRI analyses examined the amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), and RS-functional connectivity (RS-FC).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi231583-9\"><jats:title>Results<\/jats:title><jats:p>Two-hundred seventy-five male participants (205 football players; mean [SD] age, 15.8 [1.2] years; 5 Asian [2.4%], 8 Black or African American [3.9%], and 189 White [92.2%]; 70 control participants; mean [SD] age 15.8 [1.2] years, 4 Asian [5.7], 1 Black or African American [1.4%], and 64 White [91.5%]) were included in this study. Relative to the control group, the football group showed significant cortical thinning, especially in fronto-occipital regions (eg, right precentral gyrus: <jats:italic>t<\/jats:italic>\u2009=\u2009\u22122.24; <jats:italic>P<\/jats:italic>\u2009=\u2009.01; left superior frontal gyrus: \u22122.42; <jats:italic>P<\/jats:italic>\u2009=\u2009.002). Elevated cortical thickness in football players was observed in the anterior and posterior cingulate cortex (eg, left posterior cingulate cortex: <jats:italic>t<\/jats:italic>\u2009=\u20092.28; <jats:italic>P<\/jats:italic>\u2009=\u2009.01; right caudal anterior cingulate cortex 3.01; <jats:italic>P<\/jats:italic>\u2009=\u2009.001). The football group had greater and deeper sulcal depth than the control groups in the cingulate cortex, precuneus, and precentral gyrus (eg, right inferior parietal lobule: <jats:italic>t<\/jats:italic>\u2009=\u20092.20; <jats:italic>P<\/jats:italic>\u2009=\u2009.004; right caudal anterior cingulate cortex: 4.30; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). Significantly lower ALFF was detected in the frontal lobe and cingulate cortex of the football group (<jats:italic>t<\/jats:italic>\u2009=\u2009\u22123.66 to \u22124.92; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.01), whereas elevated ALFF was observed in the occipital regions (calcarine and lingual gyrus, <jats:italic>t<\/jats:italic>\u2009=\u20093.20; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.01). Similar to ALFF, football players exhibited lower ReHo in the precentral gyrus and medial aspects of the brain, such as precuneus, insula, and cingulum, whereas elevated ReHo was clustered in the occipitotemporal regions (<jats:italic>t<\/jats:italic>\u2009=\u20093.17; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001; to 4.32; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.01). There was no group difference in RS-FC measures.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi231583-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this study of adolescent athletes, there was evidence of discernible structural and physiological differences in the brains of adolescent football players compared with their noncontact controls. Many of the affected brain regions were associated with mental health well-being.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.54235","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T16:32:28Z","timestamp":1706805148000},"page":"e2354235","source":"Crossref","is-referenced-by-count":18,"title":["Cerebral Cortical Surface Structure and Neural Activation Pattern Among Adolescent Football Players"],"prefix":"10.1001","volume":"7","author":[{"given":"Taylor R.","family":"Zuidema","sequence":"first","affiliation":[{"name":"Department of Kinesiology, Indiana University School of Public Health, Bloomington"},{"name":"Program in Neuroscience, The College of Arts and Sciences, Indiana University, Bloomington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiancheng","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Indiana University School of Public Health, Bloomington"},{"name":"Research Center for Cross-Straits Cultural Development, Fujian Normal University, Fuzhou, Fujian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle A.","family":"Kercher","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Indiana University School of Public Health, Bloomington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace O.","family":"Recht","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Indiana University School of Public Health, Bloomington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sage H.","family":"Sweeney","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Indiana University School of Public Health, Bloomington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishant","family":"Chenchaiah","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Indiana University School of Public Health, Bloomington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hu","family":"Cheng","sequence":"additional","affiliation":[{"name":"Program in Neuroscience, The College of Arts and Sciences, Indiana University, Bloomington"},{"name":"Department of Psychological and Brain Sciences, College of Arts and Sciences, Indiana University, Bloomington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse A.","family":"Steinfeldt","sequence":"additional","affiliation":[{"name":"Department of Counseling and Educational Psychology, School of Education, Indiana University, Bloomington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Kawata","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Indiana University School of Public Health, Bloomington"},{"name":"Program in Neuroscience, The College of Arts and Sciences, Indiana University, Bloomington"},{"name":"Department of Pediatrics, Indiana University School of Medicine, Indianapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,2,1]]},"reference":[{"issue":"2","key":"zoi231583r2","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1007\/s11682-012-9164-5","article-title":"Chronic traumatic encephalopathy: neurodegeneration following repetitive concussive and subconcussive brain trauma.","volume":"6","author":"Baugh","year":"2012","journal-title":"Brain Imaging Behav"},{"issue":"10","key":"zoi231583r3","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1001\/jamaneurol.2023.2907","article-title":"Neuropathologic and clinical findings in young contact sport athletes exposed to repetitive head impacts.","volume":"80","author":"McKee","year":"2023","journal-title":"JAMA Neurol"},{"issue":"4","key":"zoi231583r4","doi-asserted-by":"publisher","first-page":"1911","DOI":"10.1007\/s00429-015-1012-0","article-title":"Frontotemporal correlates of impulsivity and machine learning in retired professional athletes with a history of multiple concussions.","volume":"221","author":"Goswami","year":"2016","journal-title":"Brain Struct Funct"},{"issue":"5","key":"zoi231583r5","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1093\/cercor\/bhs102","article-title":"Sports concussions and aging: a neuroimaging investigation.","volume":"23","author":"Tremblay","year":"2013","journal-title":"Cereb Cortex"},{"issue":"3","key":"zoi231583r6","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1007\/s11682-015-9442-0","article-title":"Cortical thinning in former professional soccer players.","volume":"10","author":"Koerte","year":"2016","journal-title":"Brain Imaging Behav"},{"issue":"7","key":"zoi231583r7","doi-asserted-by":"publisher","first-page":"e728","DOI":"10.1212\/WNL.0000000000207508","article-title":"Longitudinal gray matter trajectories in pediatric mild traumatic brain injury.","volume":"101","author":"Ware","year":"2023","journal-title":"Neurology"},{"issue":"11","key":"zoi231583r8","doi-asserted-by":"publisher","first-page":"1608","DOI":"10.1007\/s10439-022-03023-x","article-title":"Helmet technology, head impact exposure, and cortical thinning following a season of high school football.","volume":"50","author":"Dudley","year":"2022","journal-title":"Ann Biomed Eng"},{"key":"zoi231583r9","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2020.116864","article-title":"Longitudinal alteration of cortical thickness and volume in high-impact sports.","volume":"217","author":"Mills","year":"2020","journal-title":"Neuroimage"},{"issue":"23","key":"zoi231583r10","doi-asserted-by":"publisher","first-page":"1907","DOI":"10.1089\/neu.2014.3415","article-title":"Effects of subconcussive head trauma on the default mode network of the brain.","volume":"31","author":"Johnson","year":"2014","journal-title":"J Neurotrauma"},{"issue":"8","key":"zoi231583r11","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1017\/S1355617718000413","article-title":"Longitudinal changes in resting state connectivity and white matter integrity in adolescents with sports-related concussion.","volume":"24","author":"Murdaugh","year":"2018","journal-title":"J Int Neuropsychol Soc"},{"issue":"2","key":"zoi231583r12","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1089\/brain.2014.0279","article-title":"Alteration of default mode network in high school football athletes due to repetitive subconcussive mild traumatic brain injury: a resting-state functional magnetic resonance imaging study.","volume":"5","author":"Abbas","year":"2015","journal-title":"Brain Connect"},{"key":"zoi231583r13","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1016\/j.nicl.2017.03.006","article-title":"The effect of repetitive subconcussive collisions on brain integrity in collegiate football players over a single football season: a multi-modal neuroimaging study.","volume":"14","author":"Slobounov","year":"2017","journal-title":"Neuroimage Clin"},{"issue":"9","key":"zoi231583r14","doi-asserted-by":"publisher","first-page":"4624","DOI":"10.1093\/cercor\/bhx182","article-title":"What can cortical development in attention-deficit\/hyperactivity disorder teach us about the early developmental mechanisms involved?","volume":"27","author":"Ambrosino","year":"2017","journal-title":"Cereb Cortex"},{"issue":"20","key":"zoi231583r15","doi-asserted-by":"publisher","first-page":"e1900","DOI":"10.1212\/WNL.0000000000008478","article-title":"Regionally decreased gyrification in middle-aged adults with autism spectrum disorders.","volume":"93","author":"Kohli","year":"2019","journal-title":"Neurology"},{"key":"zoi231583r16","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1016\/j.neuroimage.2012.09.050","article-title":"Cortical thickness and central surface estimation.","volume":"65","author":"Dahnke","year":"2013","journal-title":"Neuroimage"},{"issue":"24","key":"zoi231583r17","doi-asserted-by":"publisher","first-page":"2453","DOI":"10.1016\/j.scib.2021.09.016","article-title":"DPABISurf: data processing and analysis for brain imaging on surface.","volume":"66","author":"Yan","year":"2021","journal-title":"Sci Bull (Beijing)"},{"issue":"8","key":"zoi231583r18","doi-asserted-by":"publisher","first-page":"1390","DOI":"10.3174\/ajnr.A5527","article-title":"Resting-state functional MRI: everything that nonexperts have always wanted to know.","volume":"39","author":"Lv","year":"2018","journal-title":"AJNR Am J Neuroradiol"},{"issue":"4","key":"zoi231583r19","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1089\/neu.2010.1512","article-title":"Functionally-detected cognitive impairment in high school football players without clinically-diagnosed concussion.","volume":"31","author":"Talavage","year":"2014","journal-title":"J Neurotrauma"},{"key":"zoi231583r20","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2021.118018","article-title":"Surface-based single-subject morphological brain networks: effects of morphological index, brain parcellation and similarity measure, sample size-varying stability and test-retest reliability.","volume":"235","author":"Li","year":"2021","journal-title":"Neuroimage"},{"issue":"7","key":"zoi231583r21","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1002\/hbm.v32.7","article-title":"Topological correction of brain surface meshes using spherical harmonics.","volume":"32","author":"Yotter","year":"2011","journal-title":"Hum Brain Mapp"},{"issue":"4","key":"zoi231583r22","doi-asserted-by":"publisher","first-page":"1224","DOI":"10.1016\/j.neuroimage.2005.08.049","article-title":"A curvature-based approach to estimate local gyrification on the cortical surface.","volume":"29","author":"Luders","year":"2006","journal-title":"Neuroimage"},{"issue":"7","key":"zoi231583r23","doi-asserted-by":"publisher","first-page":"951","DOI":"10.3390\/jcm8070951","article-title":"Differing spontaneous brain activity in healthy adults with two different body constitutions: a resting-state functional magnetic resonance imaging study.","volume":"8","author":"Liu","year":"2019","journal-title":"J Clin Med"},{"issue":"1","key":"zoi231583r24","doi-asserted-by":"publisher","DOI":"10.1136\/bmjno-2021-000229","article-title":"Damage to the dorsolateral prefrontal cortex is associated with repetitive compulsive behaviors in patients with penetrating brain injury.","volume":"4","author":"Fremont","year":"2022","journal-title":"BMJ Neurol Open"},{"issue":"20","key":"zoi231583r25","doi-asserted-by":"publisher","first-page":"2831","DOI":"10.1089\/neu.2019.6398","article-title":"Diffusion tensor imaging in athletes sustaining repetitive head impacts: a systematic review of prospective studies.","volume":"36","author":"Schneider","year":"2019","journal-title":"J Neurotrauma"},{"issue":"1","key":"zoi231583r26","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1007\/s11065-022-09566-z","article-title":"Diffusion imaging of sport-related repetitive head impacts: a systematic review.","volume":"33","author":"Koerte","year":"2023","journal-title":"Neuropsychol Rev"},{"key":"zoi231583r27","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.nicl.2018.01.005","article-title":"Cortical thickness and subcortical brain volumes in professional rugby league players.","volume":"18","author":"Wojtowicz","year":"2018","journal-title":"Neuroimage Clin"},{"issue":"8","key":"zoi231583r28","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0235609","article-title":"Soccer heading and concussion are not associated with reduced brain volume or cortical thickness.","volume":"15","author":"Oliveira","year":"2020","journal-title":"PLoS One"},{"issue":"4","key":"zoi231583r29","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1038\/s41386-019-0563-9","article-title":"Meta-analysis of cortical thickness abnormalities in medication-free patients with major depressive disorder.","volume":"45","author":"Li","year":"2020","journal-title":"Neuropsychopharmacology"},{"key":"zoi231583r30","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1016\/j.neubiorev.2017.08.023","article-title":"Psychiatric phenotypes in chronic traumatic encephalopathy.","volume":"83","author":"Mahar","year":"2017","journal-title":"Neurosci Biobehav Rev"},{"issue":"3","key":"zoi231583r31","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1002\/hbm.v26:3","article-title":"Age-related morphology trends of cortical sulci.","volume":"26","author":"Kochunov","year":"2005","journal-title":"Hum Brain Mapp"},{"issue":"1","key":"zoi231583r32","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.neuroimage.2008.07.016","article-title":"Sulcal morphology changes and their relationship with cortical thickness and gyral white matter volume in mild cognitive impairment and Alzheimer\u2019s disease.","volume":"43","author":"Im","year":"2008","journal-title":"Neuroimage"},{"issue":"5","key":"zoi231583r33","doi-asserted-by":"publisher","first-page":"353","DOI":"10.5607\/en22031","article-title":"Reduced sulcal depth in central sulcus of major depressive disorder.","volume":"31","author":"Shin","year":"2022","journal-title":"Exp Neurobiol"},{"issue":"1","key":"zoi231583r34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11682-015-9499-9","article-title":"Occipital cortical gyrification reductions associate with decreased functional connectivity in amyotrophic lateral sclerosis.","volume":"11","author":"Zhang","year":"2017","journal-title":"Brain Imaging Behav"},{"issue":"2","key":"zoi231583r35","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0031083","article-title":"Cortical gyrification and sulcal spans in early stage Alzheimer\u2019s disease.","volume":"7","author":"Liu","year":"2012","journal-title":"PLoS One"},{"key":"zoi231583r36","doi-asserted-by":"publisher","first-page":"998","DOI":"10.3389\/fneur.2020.00998","article-title":"Simulation of the strain amplification in sulci due to blunt impact to the head.","volume":"11","author":"Fagan","year":"2020","journal-title":"Front Neurol"},{"issue":"4","key":"zoi231583r37","doi-asserted-by":"publisher","first-page":"640","DOI":"10.9758\/cpn.2021.19.4.640","article-title":"Decreased cortical thickness and local gyrification in individuals with subjective cognitive impairment.","volume":"19","author":"Youn","year":"2021","journal-title":"Clin Psychopharmacol Neurosci"},{"issue":"1","key":"zoi231583r38","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1089\/neu.2019.6698","article-title":"Developmental alterations in cortical organization and socialization in adolescents who sustained a traumatic brain injury in early childhood.","volume":"38","author":"Wilde","year":"2021","journal-title":"J Neurotrauma"},{"issue":"7","key":"zoi231583r39","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1007\/s00234-016-1675-0","article-title":"Brain functional connectivity and cognition in mild traumatic brain injury.","volume":"58","author":"Xiong","year":"2016","journal-title":"Neuroradiology"},{"issue":"6","key":"zoi231583r40","doi-asserted-by":"publisher","first-page":"1860","DOI":"10.1523\/JNEUROSCI.5062-08.2009","article-title":"Cortical hubs revealed by intrinsic functional connectivity: mapping, assessment of stability, and relation to Alzheimer\u2019s disease.","volume":"29","author":"Buckner","year":"2009","journal-title":"J Neurosci"},{"key":"zoi231583r41","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2022.118923","article-title":"Hemodynamic and metabolic correspondence of resting-state voxel-based physiological metrics in healthy adults.","volume":"250","author":"Deng","year":"2022","journal-title":"Neuroimage"},{"issue":"1","key":"zoi231583r42","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1089\/neu.2019.6471","article-title":"Resting-state fMRI metrics in acute sport-related concussion and their association with clinical recovery: a study from the NCAA-DOD CARE consortium.","volume":"37","author":"Meier","year":"2020","journal-title":"J Neurotrauma"},{"key":"zoi231583r43","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2021.768485","article-title":"Resting-state functional MRI metrics in patients with chronic mild traumatic brain injury and their association with clinical cognitive performance.","volume":"15","author":"Vedaei","year":"2021","journal-title":"Front Hum Neurosci"},{"issue":"3-4","key":"zoi231583r44","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1007\/s11682-010-9102-3","article-title":"Decreased prefrontal cortex activity in mild traumatic brain injury during performance of an auditory oddball task.","volume":"4","author":"Witt","year":"2010","journal-title":"Brain Imaging Behav"},{"key":"zoi231583r1","unstructured":"National Federation of State High School Associations. NFHS Releases first high school sports participation survey in three years. 2022. Accessed March 24, 2023. https:\/\/www.nfhs.org\/articles\/nfhs-releases-first-high-school-sports-participation-survey-in-three-years\/"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2814507\/zuidema_2024_oi_231583_1706171029.61402.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T16:32:31Z","timestamp":1706805151000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2814507"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,1]]},"references-count":44,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2,5]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.54235","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,1]]}}}