Citation

Mustafi SM, Harezlak J, Koch KM, Nencka AS, Meier T, West JD, Giza CC, Difiori J, Guskiewicz KK, Mihalik J, LaConte SM, Duma SM, Broglio SP, Saykin AJ, McCrea M, McAllister T, Wu YC. J. Neurotrauma 2018; 35(22): 2653-2664.

Affiliation

Indiana University School of Medicine, 12250, Radiology and Imaging Sciences , 355 West 16th Street , Indianapolis, Indiana, United States , 46202-5114 ; yucwu@iupui.edu.

Copyright

(Copyright © 2018, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2017.5158

PMID

29065805

Abstract

Sport-related concussion (SRC) is an important public health issue. While 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 hours 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 MRI scans. To avoid selection bias and partial voluming effects, whole-brain skeletonized white matter was examined via tract-based spatial statistics (TBSS) to investigate between group differences in DTI metrics and their associations with clinical outcome measures. Mean diffusivity was significantly higher in the brain white matter of the concussed athletes, particularly in frontal and sub-frontal long white-matter tracts. While no DTI metric was associated to any clinical measure in the contact-sport controls, in the concussed group, DTI exhibited correlations with clinical measures. Axial diffusivity demonstrated a significant positive correlation with the Brief Symptom Inventory (BSI) and a trend for a positive correlation with the symptom severity score of the Sports Concussion Assessment Tool (SCAT). In addition, concussed athletes with higher fractional anisotropy performed worse on the cognitive component of the Standardized Assessment of Concussion (SAC). 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.

Language: en

Keywords

ADULT BRAIN INJURY; AXONAL INJURY; Diffusion Tensor Imaging; HEAD TRAUMA; HUMAN STUDIES