Faculty Collaboration Database

Longitudinal white-matter abnormalities in sports-related concussion: A diffusion MRI study. Neurology 2020 Aug 18;95(7):e781-e792

Date

07/10/2020

Pubmed ID

32641518

Pubmed Central ID

PMC7605507

DOI

10.1212/WNL.0000000000009930

Scopus ID

2-s2.0-85089787382 (requires institutional sign-in at Scopus site)   40 Citations

Abstract

OBJECTIVE: To study longitudinal recovery trajectories of white matter after sports-related concussion (SRC) by performing diffusion tensor imaging (DTI) on collegiate athletes who sustained SRC.

METHODS: Collegiate athletes (n = 219, 82 concussed athletes, 68 contact-sport controls, and 69 non-contact-sport controls) were included from the Concussion Assessment, Research and Education Consortium. The participants completed clinical assessments and DTI at 4 time points: 24 to 48 hours after injury, asymptomatic state, 7 days after return-to-play, and 6 months after injury. Tract-based spatial statistics was used to investigate group differences in DTI metrics and to identify white-matter areas with persistent abnormalities. Generalized linear mixed models were used to study longitudinal changes and associations between outcome measures and DTI metrics. Cox proportional hazards model was used to study effects of white-matter abnormalities on recovery time.

RESULTS: In the white matter of concussed athletes, DTI-derived mean diffusivity was significantly higher than in the controls at 24 to 48 hours after injury and beyond the point when the concussed athletes became asymptomatic. While the extent of affected white matter decreased over time, part of the corpus callosum had persistent group differences across all the time points. Furthermore, greater elevation of mean diffusivity at acute concussion was associated with worse clinical outcome measures (i.e., Brief Symptom Inventory scores and symptom severity scores) and prolonged recovery time. No significant differences in DTI metrics were observed between the contact-sport and non-contact-sport controls.

CONCLUSIONS: Changes in white matter were evident after SRC at 6 months after injury but were not observed in contact-sport exposure. Furthermore, the persistent white-matter abnormalities were associated with clinical outcomes and delayed recovery time.

Author List

Wu YC, Harezlak J, Elsaid NMH, Lin Z, Wen Q, Mustafi SM, Riggen LD, Koch KM, Nencka AS, Meier TB, Mayer AR, Wang Y, Giza CC, DiFiori JP, Guskiewicz KM, Mihalik JP, LaConte SM, Duma SM, Broglio SP, Saykin AJ, McCrea MA, McAllister TW

Authors

Kevin M. Koch PhD Center Director, Professor in the Radiology department at Medical College of Wisconsin
Michael McCrea PhD Professor in the Neurosurgery department at Medical College of Wisconsin
Timothy B. Meier PhD Associate Professor in the Neurosurgery department at Medical College of Wisconsin
Andrew S. Nencka PhD Director, Associate Professor in the Radiology department at Medical College of Wisconsin
Yang Wang MD Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Athletes
Athletic Injuries
Brain Concussion
Corpus Callosum
Diffusion Magnetic Resonance Imaging
Diffusion Tensor Imaging
Female
Football
Humans
Male
White Matter
Young Adult