Exploring Differences in Functional Connectivity in Australian Rules Football Players : A Resting-State fMRI Study on the Default Mode Network

The effects of non-concussive impacts in contact-sports such as in Australian rules football (ARF) are still largely unexplored. These impacts are often but not always lower in intensity, but occur more frequently than actual concussions. Since non-concussive impacts are often asymptomatic, their significance may be underestimated. Acute or subacute measurement of non-concussive injury is challenging as the pathological response and injury is poorly described. There is therefore a need for a greater understanding of the pathological consequences of exposure. Growing evidence indicates that resting-state functional connectivity (rs-fMRI) changes in the Default Mode Network (DMN) may be an important biomarker that is sensitive to characterize these impacts. In this work, we examined functional connectivity changes within the DMN of ARF players to evaluate its potential as an early biomarker for non-concussive impacts. Based on rs-fMRI, we compare the DMN of 47 sub-elite ARF players (mean age 21.5{+/-}2.7 years [SD], males 57%) and 42 age-matched healthy controls (mean age 23.2{+/-}2.3 years [SD], males 48%) using Independent Component Analysis (ICA) and Dual Regression. This approach permits an unbiased decomposition of brain activity into networks with principled handling of statistical error. An 83% increase in DMN connectivity (as measured by the Strictly Standardized Mean Difference on values derived from Dual Regression) was observed in ARF players in the left retrosplenial cingulate cortex compared to healthy controls (FDR-corrected p-value from dual regression = 0.03, 95% CI computed via bootstrapping was 58% to 116%). The AUC for distinguishing ARF players from controls was 0.80 (95% CI; [0.71, 0.89]), equating to a PPV of 78% and a NPV of 74%. These results are preliminary; future work could investigate robustness to different random initializations of ICA and validate the findings on an independent testing set, as well as investigate longitudinal changes in ARF players over the course of a playing season.