{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T07:46:23Z","timestamp":1773128783615,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T00:00:00Z","timestamp":1724371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>While changes in brain metabolites after injury have been reported, relationships between metabolite changes and head impacts are less characterized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate alterations in neurochemistry in high school athletes as a function of head impacts, concussion, and the use of a jugular vein compression (JVC) collar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Prospective controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects<\/jats:title><jats:p>A total of 284 male American football players, divided into JVC collar and noncollar groups; 215 included in final analysis (age = 15.9 \u00b1 1.0 years; 114 in collar group).<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>3 Tesla\/T<jats:sub>1<\/jats:sub>\u2010weighted gradient echo, <jats:sup>1<\/jats:sup>H point resolved spectroscopy, acquired between August and November 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>Head impacts were quantified using accelerometers. Concussion was diagnosed by medical professionals for each team. Pre\u2010 to postseason differences in total <jats:italic>N<\/jats:italic>\u2010acetylaspartate (tNAA), total choline (tCho), myo\u2010inositol (myoI), and glutamate + glutamine (Glx), in primary motor cortex (M1) and anterior cingulate cortex (ACC), relative to total creatine (tCr), were determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Group\u2010wise comparisons were performed using Wilcoxon signed\u2010rank, Friedman's, and Mann\u2013Whitney <jats:italic>U<\/jats:italic> tests. Relationships between \u2206metabolite\/tCr and mean <jats:italic>g<\/jats:italic>\u2010force were analyzed using linear regressions accounting for concussion and JVC collar. Significance was set at <jats:italic>P<\/jats:italic> \u2264 0.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In participants without concussion, a significant decrease in tCho\/tCr (0.233 \u00b1 1.40 \u00d7 10<jats:sup>\u22123<\/jats:sup> to 0.227 \u00b1 1.47 \u00d7 10<jats:sup>\u22127<\/jats:sup>) and increase in Glx\/tCr (1.60 \u00b1 8.75 \u00d7 10<jats:sup>\u22123<\/jats:sup> to 1.63 \u00b1 1.08 \u00d7 10<jats:sup>\u22122<\/jats:sup>) in ACC were observed pre\u2010 to postseason. The relationship between \u2206tCho\/tCr in M1 and ACC and mean <jats:italic>g<\/jats:italic>\u2010force from &gt;80 <jats:italic>g<\/jats:italic> to &gt;140 <jats:italic>g<\/jats:italic> differed significantly between participants with and without concussion (M1 <jats:italic>\u03b2<\/jats:italic> ranged from 3.9 \u00d7 10<jats:sup>\u22123<\/jats:sup> to 2.1 \u00d7 10<jats:sup>\u22123<\/jats:sup>; ACC <jats:italic>\u03b2<\/jats:italic> ranged from 2.7 \u00d7 10<jats:sup>\u22123<\/jats:sup> to 2.1 \u00d7 10<jats:sup>\u22123<\/jats:sup>). Posthoc analyses revealed increased tCho\/tCr in M1 was positively associated with mean <jats:italic>g\u2010<\/jats:italic>force &gt;100 <jats:italic>g<\/jats:italic> (<jats:italic>\u03b2<\/jats:italic> = 3.6 \u00d7 10<jats:sup>\u22123<\/jats:sup>) and &gt;110 <jats:italic>g<\/jats:italic> (<jats:italic>\u03b2<\/jats:italic> = 2.9 \u00d7 10<jats:sup>\u22123<\/jats:sup>) in participants with concussion. Significant associations between  in ACC and mean <jats:italic>g<\/jats:italic>\u2010force &gt;110 <jats:italic>g<\/jats:italic> (<jats:italic>\u03b2<\/jats:italic> = \u22121.1 \u00d7 10<jats:sup>\u22123<\/jats:sup>) and &gt;120 <jats:italic>g<\/jats:italic> (<jats:italic>\u03b2<\/jats:italic> = \u22121.1 \u00d7 10<jats:sup>\u22123<\/jats:sup>) were observed in the collar group only.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>Diagnosed concussion and the use of a JVC collar result in distinct neurochemical trends after repeated head impacts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy<\/jats:title><jats:p>Stage 3<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.29581","type":"journal-article","created":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T12:07:04Z","timestamp":1724414824000},"page":"1738-1750","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Associations Between Brain Metabolites Measured With <scp>MR<\/scp> Spectroscopy and Head Impacts in High School American Football Athletes"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7463-1612","authenticated-orcid":false,"given":"Zexuan","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering Georgia Institute of Technology and Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan A.","family":"Dudley","sequence":"additional","affiliation":[{"name":"Imaging Research Center, Department of Radiology Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jed A.","family":"Diekfuss","sequence":"additional","affiliation":[{"name":"Emory Sports Performance and Research Center (SPARC)  Flowery Branch Georgia USA"},{"name":"Emory Sports Medicine Center  Atlanta Georgia USA"},{"name":"Department of Orthopaedics Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadine","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Georgia Institute of Technology  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex D.","family":"Edmondson","sequence":"additional","affiliation":[{"name":"Imaging Research Center, Department of Radiology Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Department of Radiology University of Cincinnati College of Medicine  Cincinnati Ohio 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