{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T22:50:04Z","timestamp":1792709404708,"version":"4.5.0"},"reference-count":46,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T00:00:00Z","timestamp":1687564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100011975","name":"American Society of Neuroradiology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011975","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005625","name":"RSNA Research and Education Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005625","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Repetitive head trauma is common in high\u2010contact sports. Cerebral blood flow (CBF) can measure changes in brain perfusion that could indicate injury. Longitudinal studies with a control group are necessary to account for interindividual and developmental effects. We investigated whether exposure to head impacts causes longitudinal CBF changes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We prospectively studied 63 American football (high\u2010contact cohort) and 34 volleyball (low\u2010contact controls) male collegiate athletes, tracking CBF using 3D pseudocontinuous arterial spin labeling magnetic resonance imaging for up to 4\u2009years. Regional relative CBF (rCBF, normalized to cerebellar CBF) was computed after co\u2010registering to T1\u2010weighted images. A linear mixed effects model assessed the relationship of rCBF to sport, time, and their interaction. Within football players, we modeled rCBF against position\u2010based head impact risk and baseline Standardized Concussion Assessment Tool score. Additionally, we evaluated early (1\u20135\u2009days) and delayed (3\u20136\u2009months) post\u2010concussion rCBF changes (in\u2010study concussion).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Supratentorial gray matter rCBF declined in football compared with volleyball (sport\u2010time interaction <jats:italic>p<\/jats:italic>\u2009=\u20090.012), with a strong effect in the parietal lobe (<jats:italic>p<\/jats:italic>\u2009=\u20090.002). Football players with higher position\u2010based impact\u2010risk had lower occipital rCBF over time (interaction <jats:italic>p<\/jats:italic>\u2009=\u20090.005), whereas players with lower baseline Standardized Concussion Assessment Tool score (worse performance) had relatively decreased rCBF in the cingulate\u2010insula over time (interaction effect <jats:italic>p<\/jats:italic>\u2009=\u20090.007). Both cohorts showed a left\u2013right rCBF asymmetry that decreased over time. Football players with an in\u2010study concussion showed an early increase in occipital lobe rCBF (<jats:italic>p<\/jats:italic>\u2009=\u20090.0166).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>These results suggest head impacts may result in an early increase in rCBF, but cumulatively a long\u2010term decrease in rCBF. ANN NEUROL 2023;94:457\u2013469<\/jats:p><\/jats:sec>","DOI":"10.1002\/ana.26718","type":"journal-article","created":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T13:39:25Z","timestamp":1686577165000},"page":"457-469","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Longitudinal Alterations of Cerebral Blood Flow in High\u2010Contact Sports"],"prefix":"10.1002","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8025-6230","authenticated-orcid":false,"given":"Mahta","family":"Karimpoor","sequence":"first","affiliation":[{"name":"Department of Radiology Stanford University  Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marios","family":"Georgiadis","sequence":"additional","affiliation":[{"name":"Department of Radiology Stanford University  Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moss 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