Browsing by Author "Kercher, Kyle A."

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    Association Between Head Impact Exposure, Psychological Needs, and Indicators of Mental Health Among U.S. High School Tackle Football Players
    (Elsevier, 2023) Kercher, Kyle A.; Steinfeldt, Jesse A.; Rettke, Devin J.; Zuidema, Taylor R.; Walker, Miata J.; (Martinez) Kercher, Vanessa M.; Silveyra, Patricia; Seo, Dong-Chul; Macy, Jonathan T.; Hulvershorn, Leslie A.; Kawata, Keisuke; Psychiatry, School of Medicine
    Purpose: Age of first exposure to tackle football and head impact kinematics have been used to examine the effect of head impacts on mental health outcomes. These measures coupled with retrospective and cross-sectional designs have contributed to conflicting results. The purpose of this study was to identify the effect of one season of head impact exposure, age of first exposure to football, and psychological need satisfaction on acute mental health outcomes in adolescent football players. Methods: This prospective single-season cohort study used sensor-installed mouthguards to collect head impact exposure along with surveys to assess age of first exposure to football, psychological satisfaction, depressive symptoms, anxiety symptoms, and thriving from football players at four high schools (n = 91). Linear regression was used to test the association of head impact exposure, age of first exposure, and psychological satisfaction with acute mental health outcomes. Results: A total of 9,428 impacts were recorded with a mean of 102 ± 113 impacts/player. Cumulative head impact exposure and age of first exposure were not associated with acute mental health outcomes at postseason or change scores from preseason to postseason. Greater psychological satisfaction was associated with fewer depressive symptoms (β = -0.035, SE = 0.008, p = < .001), fewer anxiety symptoms (β = -0.021, SE = 0.008, p = .010), and greater thriving scores (β = 0.278, SE = 0.040, p = < .001) at postseason. Discussion: This study does not support the premise that greater single-season head impact exposure or earlier age of first exposure to tackle football is associated with worse acute mental health indicators over the course of a single season in adolescent football players.
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    Association of Auditory Interference and Ocular-Motor Response with Subconcussive Head Impacts in Adolescent Football Players
    (Mary Ann Liebert, 2024-05-31) Bellini, Zachary S.; Recht, Grace O.; Zuidema, Taylor R.; Kercher, Kyle A.; Sweeney, Sage H.; Steinfeldt, Jesse A.; Kawata, Keisuke; Pediatrics, School of Medicine
    The aim of this study was to examine whether neuro-ophthalmological function, as assessed by the King-Devick test (KDT), alters during a high school football season and to explore the role of auditory interference on the sensitivity of KDT. During the 2021 and 2022 high school football seasons, football players' neuro-ophthalmological function was assessed at five time points (preseason, three in-season, postseason), whereas control athletes were assessed at preseason and postseason. Two-hundred ten football players and 80 control athletes participated in the study. The year 1 cohort (n = 94 football, n = 10 control) was tested with a conventional KDT, whereas the year 2 cohort (n = 116 football, n = 70 control) was tested with KDT while listening to loud traffic sounds to induce auditory interference. There were improvements in KDT during a season among football players, regardless of conventional KDT (preseason 53.4 ± 9.3 vs. postseason 46.4 ± 8.5 sec; β = -1.7, SE = 0.12, p < 0.01) or KDT with auditory interference (preseason 52.3 ± 11.5 vs. postseason 45.1 ± 9.5 sec; β = -1.7, SE = 0.11, p < 0.001). The degree of improvement was similar between the tests, with no significant group-by-time interaction (β = -0.08, SE = 0.17, p = 0.65). The control athletes also improved KDT performance at a similar degree as the football cohorts in both KDT conditions. Our data suggest that KDT performance improves during a season, regardless of auditory interference or head impact exposure. KDT performance was not impacted by a noisy environment, supporting its sideline utility for screening more severe forms of injury.
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    Cerebral Cortical Surface Structure and Neural Activation Pattern Among Adolescent Football Players
    (American Medical Association, 2024-02-05) Zuidema, Taylor R.; Hou, Jiancheng; Kercher, Kyle A.; Recht, Grace O.; Sweeney, Sage H.; Chenchaiah, Nishant; Cheng, Hu; Steinfeldt, Jesse A.; Kawata, Keisuke; Pediatrics, School of Medicine
    Importance: Recurring exposure to head impacts in American football has garnered public and scientific attention, yet neurobiological associations in adolescent football players remain unclear. Objective: To examine cortical structure and neurophysiological characteristics in adolescent football players. Design, setting, and participants: This cohort study included adolescent football players and control athletes (swimming, cross country, and tennis) from 5 high school athletic programs, who were matched with age, sex (male), and school. Neuroimaging assessments were conducted May to July of the 2021 and 2022 seasons. Data were analyzed from February to November 2023. Exposure: Playing tackle football or noncontact sports. Main outcomes and measures: Structural magnetic resonance imaging (MRI) data were analyzed for cortical thickness, sulcal depth, and gyrification, and cortical surface-based resting state (RS)-functional MRI analyses examined the amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), and RS-functional connectivity (RS-FC). Results: Two-hundred seventy-five male participants (205 football players; mean [SD] age, 15.8 [1.2] years; 5 Asian [2.4%], 8 Black or African American [3.9%], and 189 White [92.2%]; 70 control participants; mean [SD] age 15.8 [1.2] years, 4 Asian [5.7], 1 Black or African American [1.4%], and 64 White [91.5%]) were included in this study. Relative to the control group, the football group showed significant cortical thinning, especially in fronto-occipital regions (eg, right precentral gyrus: t = -2.24; P = .01; left superior frontal gyrus: -2.42; P = .002). Elevated cortical thickness in football players was observed in the anterior and posterior cingulate cortex (eg, left posterior cingulate cortex: t = 2.28; P = .01; right caudal anterior cingulate cortex 3.01; P = .001). The football group had greater and deeper sulcal depth than the control groups in the cingulate cortex, precuneus, and precentral gyrus (eg, right inferior parietal lobule: t = 2.20; P = .004; right caudal anterior cingulate cortex: 4.30; P < .001). Significantly lower ALFF was detected in the frontal lobe and cingulate cortex of the football group (t = -3.66 to -4.92; P < .01), whereas elevated ALFF was observed in the occipital regions (calcarine and lingual gyrus, t = 3.20; P < .01). Similar to ALFF, football players exhibited lower ReHo in the precentral gyrus and medial aspects of the brain, such as precuneus, insula, and cingulum, whereas elevated ReHo was clustered in the occipitotemporal regions (t = 3.17; P < .001; to 4.32; P < .01). There was no group difference in RS-FC measures. Conclusions and relevance: In this study of adolescent athletes, there was evidence of discernible structural and physiological differences in the brains of adolescent football players compared with their noncontact controls. Many of the affected brain regions were associated with mental health well-being.