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Acute White-Matter Abnormalities in Sports-Related Concussion: A Diffusion Tensor Imaging Study from the NCAA-DoD CARE Consortium. J Neurotrauma 2018 Nov 15;35(22):2653-2664

Date

10/27/2017

Pubmed ID

29065805

Pubmed Central ID

PMC6238613

DOI

10.1089/neu.2017.5158

Scopus ID

2-s2.0-85053645863 (requires institutional sign-in at Scopus site)   59 Citations

Abstract

Sports-related concussion (SRC) is an important public health issue. Although standardized assessment tools are useful in the clinical management of acute concussion, the underlying pathophysiology of SRC and the time course of physiological recovery after injury remain unclear. In this study, we used diffusion tensor imaging (DTI) to detect white matter alterations in football players within 48 h after SRC. As part of the NCAA-DoD CARE Consortium study of SRC, 30 American football players diagnosed with acute concussion and 28 matched controls received clinical assessments and underwent advanced magnetic resonance imaging scans. To avoid selection bias and partial volume effects, whole-brain skeletonized white matter was examined by tract-based spatial statistics to investigate between-group differences in DTI metrics and their associations with clinical outcome measures. Mean diffusivity was significantly higher in brain white matter of concussed athletes, particularly in frontal and subfrontal long white matter tracts. In the concussed group, axial diffusivity was significantly correlated with the Brief Symptom Inventory and there was a similar trend with the symptom severity score of the Sport Concussion Assessment Tool. In addition, concussed athletes with higher fractional anisotropy performed better on the cognitive component of the Standardized Assessment of Concussion. Overall, the results of this study are consistent with the hypothesis that SRC is associated with changes in white matter tracts shortly after injury, and these differences are correlated clinically with acute symptoms and functional impairments.

Author List

Mustafi SM, Harezlak J, Koch KM, Nencka AS, Meier TB, West JD, Giza CC, DiFiori JP, Guskiewicz KM, Mihalik JP, LaConte SM, Duma SM, Broglio SP, Saykin AJ, McCrea M, McAllister TW, Wu YC

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 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




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

Brain Concussion
Diffusion Tensor Imaging
Football
Humans
Male
White Matter
Young Adult