Diffusion tensor imaging of sport related concussion in adolescents

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Abstract

Objectives

To establish the short-term changes in white matter integrity following sport related concussion in adolescents and to examine the association between changes in white matter integrity and a clinical measure of concussion.

Design

Cross-sectional within cohort study.

Setting

University hospital and community ice hockey arenas.

Subjects

Twelve adolescents with sport related concussion (ages 14–17 years) within 2 months of injury and 10, active adolescents with no previous history of concussion.

Assessment of Risk Factors

Adolescents within 2 months of sport-related concussion and healthy adolescents with no history of concussion were assessed using the Sport Concussion Assessment Tool 2 (SCAT2) and total SCAT2 score (/100) was considered.

Outcome Measures

Two measures of diffusion tensor imaging (DTI): fractional anisotropy (FA) and mean diffusivity (MD).

Results

Whole brain FA values were significantly increased (F (1,40)=6.29, p=0.01) and MD values decreased (F(1,40)=4.75, p=0.036) in concussed athletes compared with control participants. SCAT2 total scores were associated with whole brain FA and MD values with lower scores associated with higher FA (R2=0.25, p=0.017) and lower MD (R2=0.2, p=0.038).

Conclusion

This preliminary study provides evidence of microstructural changes in the integrity of the white matter in adolescent athletes following a sport related concussion. In addition, we found a relationship between measures of white matter integrity and the SCAT2 up to 16–61 days following concussion, which may indicate persistent structural change in the adolescent brain after injury. Further study should chart the trajectory of brain injury and recovery in this population.

Acknowledgements

Martha Piper Research Fund, University of British Columbia and the Brain Research Centre, University of British Columbia.

Competing interests

None.

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