• Gregory D Myer, Weihong Yuan, Kim D Barber Foss, Staci Thomas, David Smith, James Leach, Adam W Kiefer, Chris Dicesare, Janet Adams, Paul J Gubanich, Katie Kitchen, Daniel K Schneider, Daniel Braswell, Darcy Krueger, and Mekibib Altaye.
• Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Division of Sports Medicine, The SPORT Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA Department of Orthopaedics, University of Pennsylvania, Philadelphia, Pennsylvania, USA The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, USA.
• Br J Sports Med. 2016 Oct 1; 50 (20): 1276-1285.

BackgroundHistorical approaches to protect the brain from outside the skull (eg, helmets and mouthpieces) have been ineffective in reducing internal injury to the brain that arises from energy absorption during sports-related collisions. We aimed to evaluate the effects of a neck collar, which applies gentle bilateral jugular vein compression, resulting in cerebral venous engorgement to reduce head impact energy absorption during collision. Specifically, we investigated the effect of collar wearing during head impact exposure on brain microstructure integrity following a competitive high school American football season.MethodsA prospective longitudinal controlled trial was employed to evaluate the effects of collar wearing (n=32) relative to controls (CTRL; n=30) during one competitive football season (age: 17.04±0.67 years). Impact exposure was collected using helmet sensors and white matter (WM) integrity was quantified based on diffusion tensor imaging (DTI) serving as the primary outcome.ResultsWith similar overall g-forces and total head impact exposure experienced in the two study groups during the season (p>0.05), significant preseason to postseason changes in mean diffusivity, axial diffusivity and radial diffusivity in the WM integrity were noted in the CTRL group (corrected p<0.05) but not in the collar group (p>0.05). The CTRL group demonstrated significantly larger preseason to postseason DTI change in multiple WM regions compared with the collar group (corrected p<0.05).DiscussionReduced WM diffusivity alteration was noted in participants wearing a neck collar after a season of competitive football. Collar wearing may have provided a protective effect against brain microstructural changes after repetitive head impacts.Trial Registration NumberNCT02696200.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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