以擴散張量成像視角探討退役運動員腦震盪與腦白質結構之關聯：系統性文獻回顧

Effect of sport relation concussion on white matter in retired athletes from diffusion tensor imaging approach: A systematic review

運動員在競技運動場域中發生腦震盪之機會頻繁，這使後續產生許多慢性神經系統症狀與臨床症狀。目前已有研究以神經影像學視角，評估競技運動相關腦震盪（sport relation concussion, SRC）在腦白質上之影響。本文目的是以系統性回顧方式，探討擴散張量成像（diffusion tensor imaging, DTI）視角來探討SRC退役運動員在腦白質之變化情況。本文從PubMed資料庫進行系統性搜尋，並針對該些文章進行品質評估。文獻回顧結果共納入11篇研究，其中有10項研究指出DTI白質產生變化之情形，顯示SRC退役運動員組與對照組在特定腦區的擴散參數產生明顯差異，其中又以皮質脊髓束及丘腦前輻射區最為明顯，說明這些區域的白質完整性會受到SRC之負面影響，可能預示退役後患神經性退性疾病之高風險。最後，建議未來研究應以大樣本、縱貫式研究、軟體算法分析以及結合腦灰質和腦網路研究一起進行後續探討，以利該議題之相關知識更加完整。

Athletes have frequent concussions on the competitive sports field, which causes many chronic neurological and clinical symptoms in the aftermath, and studies have used neuroimaging to assess the impact of sports-related concussions (SRC) on the white matter of the brain. The purpose of this article is to investigate the changes in the brain white matter of retired SRC athletes from the perspective of diffusion tensor imaging (DTI) in a systematic review. This article searches two databases, MEDLINE and PubMed, and evaluates the quality of these articles. A total of 11 studies were included in the literature review, 10 of which reported DTI white matter changes. In particular, these studies’ information showed that the SRC retired athlete’s group and the control group were DTI targeted in specific brain regions. In particular, the corticospinal tract, and the prethalamic radiation area, have shown significant differences in diffusion parameters, which means that SRC retired athletes have poor white matter integrity, which may indicate a high risk for neurodegenerative diseases after retirement. Finally, this article suggests that future research should use large samples, longitudinal studies and follow-up discussions in conjunction with studies of brain gray matter and brain networks, so that the relevant knowledge of this topic may be made more complete.