Association of Cavum Septum Pellucidum and Cavum Vergae With Cognition, Mood, and Brain Volumes in Professional Fighters

Importance

Many studies have investigated the imaging findings showing sequelae of repetitive head trauma, with mixed results.

Objective

To determine whether fighters (boxers and mixed martial arts fighters) with cavum septum pellucidum (CSP) and cavum vergae (CV) have reduced volumes in various brain structures or worse clinical outcomes on cognitive and mood testing.

Design, Setting, and Participants

This cohort study assessed participants from the Professional Fighters Brain Health Study. Data were collected from April 14, 2011, to January 17, 2018, and were analyzed from September 1, 2018, to May 23, 2019. This study involved a referred sample of 476 active and retired professional fighters. Eligible participants were at least 18 years of age and had at least a fourth-grade reading level. Healthy age-matched controls with no history of trauma were also enrolled.

Exposures

Presence of CSP, CV, and their total (additive) length (CSPV length).

Main Outcomes and Measures

Information regarding depression, impulsivity, and sleepiness among study participants was obtained using the Patient Health Questionnaire depression scale, Barrett Impulsiveness Scale, and the Epworth Sleepiness Scale. Cognition was assessed using raw scores from CNS Vital Signs. Volumes of various brain structures were measured via magnetic resonance imaging.

Results

A total of 476 fighters (440 men, 36 women; mean [SD] age, 30.0 [8.2] years [range, 18-72 years]) and 63 control participants (57 men, 6 women; mean [SD] age, 30.8 [9.6] years [range, 18-58 years]) were enrolled in the study. Compared with fighters without CV, fighters with CV had significantly lower mean psychomotor speed (estimated difference, –11.3; 95% CI, –17.4 to –5.2;P = .004) and lower mean volumes in the supratentorium (estimated difference, –31 191 mm³; 95% CI, –61 903 to –479 mm³;P = .05) and other structures. Longer CSPV length was associated with lower processing speed (slope, –0.39; 95% CI, –0.49 to –0.28;P < .001), psychomotor speed (slope, –0.43; 95% CI, –0.53 to –0.32;P < .001), and lower brain volumes in the supratentorium (slope, –1072 mm³for every 1-mm increase in CSPV length; 95% CI, –1655 to –489 mm³;P < .001) and other structures.

Conclusions and Relevance

This study suggests that the presence of CSP and CV is associated with lower regional brain volumes and cognitive performance in a cohort exposed to repetitive head trauma.