HJNO Jul/Aug 2024

26 JUL / AUG 2024 I  HEALTHCARE JOURNAL OF NEW ORLEANS control group, including lingual, inferior and middle occipital gyri, calcarine sulcus, and middle and inferior temporal gyrus ( t =3.17 to 4.32; P  <.01). Significantly lower ReHo was observed in the bilateral precentral gyri, as well as medial brain regions, including bilat- eral middle and posterior cingulate cortex, insula and putamen ( t =−3.65 to t =−7.16) (Figure 2C, 2D). Detailed information for each brain region is listed in Table 3. Group Difference in RS-FC RS-FC was also assessed on the cortical surface, and the DLPFC was our seed region due to its role as a network hub and one of the regions vulnerable to brain trauma. Our analysis revealed that there were no signifi- cant differences in functional connectivity ( t  <2.0, P  >.05). DISCUSSION The current study revealed distinctive neuroanatomical and physiological attri- butes associated with high school football players, delineating 4 key findings. First, these players displayed cortical thinning in numerous localized areas of the fron- tal and occipital regions, alongside corti- cal thickening in the cingulate cortex. Sec- ond, an increase in sulcal depth and greater gyrification manifested across various brain regions in football players. Third, an intrigu- ing pattern of local neural activity (ALFF) emerged, revealing decreased ALFF in the frontal region and increased ALFF in the occipital region among football players. Lastly, coherence of neural signals (ReHo) was similar with the ALFF findings, sug- gesting decreased ReHo in the frontal and medial regions (eg, cingulate, insula) and increased ReHo in the occipitotemporal regions. These data collectively suggest the presence of discernible structural and phys- iological differences in the brains of adoles- cent football players compared with their noncontact control counterparts. The associations between repetitive head impacts and changes in axonal microstruc- tural integrity have been documented in contact sports athletes, 25,26 but changes in brain structure at a macro level are thought to require years of exposure to head impacts. Indeed, studies have reported cor- tical thinning in retired football and soccer players, specifically in the frontal, tempo- ral, and parietal lobes. 4-6 Yet, several stud- ies argue that such a morphological change is absent in young adult soccer and rugby players aged 20 to 39 years. 27,28 In contrast, our data showed significant cortical thin- ning in the fronto-occipital regions of ado- lescent football players’ brains, accompa- nied by cortical thickening in the cingulate cortex. TBI and repetitive exposure to head impacts can emerge as potential accelera- tors of age-related cortical thinning in these identified regions. Additionally, our observa- tions align with a meta-analysis suggesting increased cortical thickness in the anterior/ posterior cingulate cortex among medica- tion-free patients withmajor depressive dis- order. 29 While group differences in PHQ-9 and GAD-7 were not significant in our sam- ples, the cortical thickening observed in the