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MRI Brain Changes After Marathon Running: Results of the Berlin Beat of Running Study
Juliane Herm1,2, Karl Georg Haeusler3, Claudia Kunze2
1Department of Neurology, Charité, Universitätsmedizin Berlin, Berlin, Germany.
Abstract:
Several studies report neurological complications such as brain injury induced by ischemia or edema following exhaustive endurance sport. We aimed to detect the frequency of acute brain lesions after a marathon race. In the prospective observational Berlin Beat of Running study, 110 experienced endurance athletes underwent 3-Tesla brain MRI exams 2-3 days prior and within 2 days after a marathon run. MRI results were compared to an age- and sex-matched control group of 68 non-athletes, including the "Age-Related White Matter Changes" (ARWMC) scale to assess white matter lesions (WML) in the brain. 108 athletes (median age 48 years, 24% female, 8% with hypertension; 0% with diabetes) completed the race. No athlete reported neurological deficits, but a single acute ischemic lesion was detected in diffusion-weighted MRI after the race in one athlete. No other acute brain lesions compared to prior MRI were found. An ARWMC score ≥4 was found in 15% of athletes and 12% of non-athletic controls (p=0.7). Chronic ischemic lesions were not found in athletes but in four controls (6%) (p=0.02). In conclusion, acute ischemic brain lesions may be found in endurance runners. Every seventh endurance athlete and every ninth control showed evidence for substantial white matter lesions.
Insights
Exhaustive endurance running may cause acute ischemic brain lesions in athletes. While most runners showed no acute issues, one athlete had a lesion, and many had white matter changes, similar to controls.
Area of Science:
- Neurology
- Radiology
- Sports Medicine
Background:
- Neurological complications, including brain injury from ischemia or edema, are reported after strenuous endurance sports.
- The frequency of acute brain lesions following marathon running requires further investigation.
Purpose of the Study:
- To determine the incidence of acute brain lesions in experienced endurance athletes after a marathon race.
- To compare white matter lesions (WML) in marathon runners versus a non-athletic control group.
Main Methods:
- Prospective observational study (Berlin Beat of Running) involving 110 endurance athletes.
- 3-Tesla brain MRI scans were performed before and after a marathon.
- Comparison with 68 age- and sex-matched non-athletes, utilizing the Age-Related White Matter Changes (ARWMC) scale.
Main Results:
- One athlete (out of 108 finishers) had a single acute ischemic lesion detected on diffusion-weighted MRI post-race.
- No other acute brain lesions were observed in athletes compared to pre-race scans.
- Substantial white matter lesions (ARWMC score ≥4) were found in 15% of athletes and 12% of controls (p=0.7).
- Chronic ischemic lesions were absent in athletes but present in 6% of controls (p=0.02).
Conclusions:
- Acute ischemic brain lesions can occur in endurance runners.
- A significant proportion of endurance athletes and controls exhibit white matter lesions.
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