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      An Acute Bout of Soccer Heading Subtly Alters Neurovascular Coupling Metrics

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          Abstract

          Objective: The current investigation examined how a bout of soccer heading may impact brain function.

          Design: Semi-randomized crossover cohort.

          Setting: Controlled soccer heading.

          Participants: Seven male soccer players (24.1 ± 1.5 years).

          Intervention: 40 successful soccer headers were performed in 20 min (25 m, launch velocity ~80 km/h). X2 xPatch recorded linear and rotational head accelerations during each impact. A contact control “ sham” condition – ball made body contact, but not by the head; and a no activity time “ control” condition were also completed.

          Main Outcome Measures: Posterior and middle cerebral artery (PCA and MCA, respectively), cerebral blood velocity (CBV) was recorded during a visual task (neurovascular coupling: NVC) alongside SCAT3 symptoms scores pre/post a controlled bout of soccer heading.

          Results: Cumulative linear and rotational accelerations were 1,574 ± 97.9 g and 313,761 ± 23,966 rads/s 2, respectively, during heading and changes in SCAT3 symptom number (pre: 2.6 ± 3.0; post: 6.7 ± 6.2, p = 0.13) and severity (pre: 3.7 ± 3.6, post: 9.4 ± 7.6, p = 0.11) were unchanged. In the PCA, no NVC differences were observed, including: relative CBV increase (28.0 ± 7.6% , p = 0.71) and total activation (188.7 ± 68.1 cm, p = 0.93). However, MCA-derived NVC metrics were blunted following heading, demonstrating decreased relative CBV increase (7.8 ± 3.1%, p = 0.03) and decreased total activation (26.7 ± 45.3 cm, p = 0.04).

          Conclusion: Although an acute bout of soccer heading did not result in an increase of concussion-like symptoms, there were alterations in NVC responses within the MCA during a visual task. This suggests an acute bout of repetitive soccer heading can alter CBV regulation within the region of the brain associated with the header impacts.

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          Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries.

          In this report the authors describe a noninvasive transcranial method of determining the flow velocities in the basal cerebral arteries. Placement of the probe of a range-gated ultrasound Doppler instrument in the temporal area just above the zygomatic arch allowed the velocities in the middle cerebral artery (MCA) to be determined from the Doppler signals. The flow velocities in the proximal anterior (ACA) and posterior (PCA) cerebral arteries were also recorded at steady state and during test compression of the common carotid arteries. An investigation of 50 healthy subjects by this transcranial Doppler method revealed that the velocity in the MCA, ACA, and PCA was 62 +/- 12, 51 +/0 12, and 44 +/- 11 cm/sec, respectively. This method is of particular value for the detection of vasospasm following subarachnoid hemorrhage and for evaluating the cerebral circulation in occlusive disease of the carotid and vertebral arteries.
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            Integrative regulation of human brain blood flow.

            Herein, we review mechanisms regulating cerebral blood flow (CBF), with specific focus on humans. We revisit important concepts from the older literature and describe the interaction of various mechanisms of cerebrovascular control. We amalgamate this broad scope of information into a brief review, rather than detailing any one mechanism or area of research. The relationship between regulatory mechanisms is emphasized, but the following three broad categories of control are explicated: (1) the effect of blood gases and neuronal metabolism on CBF; (2) buffering of CBF with changes in blood pressure, termed cerebral autoregulation; and (3) the role of the autonomic nervous system in CBF regulation. With respect to these control mechanisms, we provide evidence against several canonized paradigms of CBF control. Specifically, we corroborate the following four key theses: (1) that cerebral autoregulation does not maintain constant perfusion through a mean arterial pressure range of 60-150 mmHg; (2) that there is important stimulatory synergism and regulatory interdependence of arterial blood gases and blood pressure on CBF regulation; (3) that cerebral autoregulation and cerebrovascular sensitivity to changes in arterial blood gases are not modulated solely at the pial arterioles; and (4) that neurogenic control of the cerebral vasculature is an important player in autoregulatory function and, crucially, acts to buffer surges in perfusion pressure. Finally, we summarize the state of our knowledge with respect to these areas, outline important gaps in the literature and suggest avenues for future research.
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              Utility of transcranial Doppler ultrasound for the integrative assessment of cerebrovascular function.

              There is considerable utility in the use of transcranial Doppler ultrasound (TCD) to assess cerebrovascular function. The brain is unique in its high energy and oxygen demand but limited capacity for energy storage that necessitates an effective means of regional blood delivery. The relative low cost, ease-of-use, non-invasiveness, and excellent temporal resolution of TCD make it an ideal tool for the examination of cerebrovascular function in both research and clinical settings. TCD is an efficient tool to access blood velocities within the cerebral vessels, cerebral autoregulation, cerebrovascular reactivity to CO(2), and neurovascular coupling, in both physiological states and in pathological conditions such as stroke and head trauma. In this review, we provide: (1) an overview of TCD methodology with respect to other techniques; (2) a methodological synopsis of the cerebrovascular exam using TCD; (3) an overview of the physiological mechanisms involved in regulation of the cerebral blood flow; (4) the utility of TCD for assessment of cerebrovascular pathology; and (5) recommendations for the assessment of four critical and complimentary aspects of cerebrovascular function: intra-cranial blood flow velocity, cerebral autoregulation, cerebral reactivity, and neurovascular coupling. The integration of these regulatory mechanisms from an integrated systems perspective is discussed, and future research directions are explored. Copyright © 2011 Elsevier B.V. All rights reserved.
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                Author and article information

                Contributors
                Journal
                Front Neurol
                Front Neurol
                Front. Neurol.
                Frontiers in Neurology
                Frontiers Media S.A.
                1664-2295
                24 July 2020
                2020
                : 11
                : 738
                Affiliations
                [1] 1Concussion Research Laboratory, University of British Columbia , Kelowna, BC, Canada
                [2] 2Faculty of Kinesiology, University of Calgary , Calgary, AB, Canada
                [3] 3Sport Injury Prevention Research Centre, University of Calgary , Calgary, AB, Canada
                [4] 4Human Performance Laboratory, University of Calgary , Calgary, AB, Canada
                [5] 5Hotchkiss Brain Institute, University of Calgary , Calgary, AB, Canada
                [6] 6Integrated Concussion Research Program, University of Calgary , Calgary, AB, Canada
                [7] 7Alberta Children's Hospital Research Institute, University of Calgary , Calgary, AB, Canada
                [8] 8Libin Cardiovascular Institute, University of Calgary , Calgary, AB, Canada
                [9] 9Southern Medical Program, University of British Columbia , Kelowna, BC, Canada
                [10] 10MD/PhD Program, University of British Columbia , Vancouver, BC, Canada
                [11] 11Experimental Medicine, University of British Columbia , Vancouver, BC, Canada
                [12] 12Faculty of Health, School of Physiotherapy, Dalhousie University , Halifax, NS, Canada
                Author notes

                Edited by: Damir Janigro, Case Western Reserve University, United States

                Reviewed by: Frank M. Webbe, Florida Institute of Technology, United States; David Warren Newell, Seattle Neuroscience Institute, United States

                *Correspondence: Jonathan D. Smirl jonathan.smirl@ 123456ucalgary.ca

                This article was submitted to Neurotrauma, a section of the journal Frontiers in Neurology

                †These authors share first authorship

                Article
                10.3389/fneur.2020.00738
                7396491
                32849205
                ad89ee99-44e6-49b1-b23e-8d104920f10b
                Copyright © 2020 Smirl, Peacock, Wright, Bouliane, Dierijck, Burma, Kennefick, Wallace and van Donkelaar.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 23 December 2019
                : 16 June 2020
                Page count
                Figures: 4, Tables: 2, Equations: 0, References: 57, Pages: 9, Words: 6644
                Funding
                Funded by: Mitacs 10.13039/501100004489
                Categories
                Neurology
                Original Research

                Neurology
                repetitive football/soccer heading,sub-concussive impacts,cerebral blood flow,sport concussion assessment tool 3,scat3

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