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A longitudinal diffusion tensor imaging study assessing white matter fiber tracts after sports-related concussion.
J Neurotrauma. 2014 Nov 15; 31(22):1860-71.JN

Abstract

The extent of structural injury in sports-related concussion (SRC) is central to the course of recovery, long-term effects, and the decision to return to play. In the present longitudinal study, we used diffusion tensor imaging (DTI) to assess white matter (WM) fiber tract integrity within 2 days, 2 weeks, and 2 months of concussive injury. Participants were right-handed male varsity contact-sport athletes (20.2±1.0 years of age) with a medically diagnosed SRC (no loss of consciousness). They were compared to right-handed male varsity non-contact-sport athletes serving as controls (19.9±1.7 years). We found significantly increased radial diffusivity (RD) in concussed athletes (n=12; paired t-test, tract-based spatial statistics; p<0.025) at 2 days, when compared to the 2-week postinjury time point. The increase was found in a cluster of right hemisphere voxels, spanning the posterior limb of the internal capsule (IC), the retrolenticular part of the IC, the inferior longitudinal fasciculus, the inferior fronto-occipital fasciculus (sagittal stratum), and the anterior thalamic radiation. Post-hoc, univariate, between-group (controls vs. concussed), mixed-effects analysis of the cluster showed significantly higher RD at 2 days (p=0.002), as compared to the controls, with a trend in the same direction at 2 months (p=0.11). Results for fractional anisotropy (FA) in the same cluster showed a similar, but inverted, pattern; FA was decreased at 2 days and at 2 months postinjury, when compared to healthy controls. At 2 weeks postinjury, no statistical differences between concussed and control athletes were found with regard to either RD or FA. These results support the hypothesis of increased RD and reduced FA within 72 h postinjury, followed by recovery that may extend beyond 2 weeks. RD appears to be a sensitive measure of concussive injury.

Authors+Show Affiliations

1 Princeton Neuroscience Institute, Princeton University , Princeton New Jersey.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24786666

Citation

Murugavel, Murali, et al. "A Longitudinal Diffusion Tensor Imaging Study Assessing White Matter Fiber Tracts After Sports-related Concussion." Journal of Neurotrauma, vol. 31, no. 22, 2014, pp. 1860-71.
Murugavel M, Cubon V, Putukian M, et al. A longitudinal diffusion tensor imaging study assessing white matter fiber tracts after sports-related concussion. J Neurotrauma. 2014;31(22):1860-71.
Murugavel, M., Cubon, V., Putukian, M., Echemendia, R., Cabrera, J., Osherson, D., & Dettwiler, A. (2014). A longitudinal diffusion tensor imaging study assessing white matter fiber tracts after sports-related concussion. Journal of Neurotrauma, 31(22), 1860-71. https://doi.org/10.1089/neu.2014.3368
Murugavel M, et al. A Longitudinal Diffusion Tensor Imaging Study Assessing White Matter Fiber Tracts After Sports-related Concussion. J Neurotrauma. 2014 Nov 15;31(22):1860-71. PubMed PMID: 24786666.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A longitudinal diffusion tensor imaging study assessing white matter fiber tracts after sports-related concussion. AU - Murugavel,Murali, AU - Cubon,Valerie, AU - Putukian,Margot, AU - Echemendia,Ruben, AU - Cabrera,Javier, AU - Osherson,Daniel, AU - Dettwiler,Annegret, Y1 - 2014/09/23/ PY - 2014/5/3/entrez PY - 2014/5/3/pubmed PY - 2015/7/25/medline KW - diffusion tensor imaging KW - longitudinal study KW - mTBI KW - radial diffusivity KW - sports-related concussion SP - 1860 EP - 71 JF - Journal of neurotrauma JO - J Neurotrauma VL - 31 IS - 22 N2 - The extent of structural injury in sports-related concussion (SRC) is central to the course of recovery, long-term effects, and the decision to return to play. In the present longitudinal study, we used diffusion tensor imaging (DTI) to assess white matter (WM) fiber tract integrity within 2 days, 2 weeks, and 2 months of concussive injury. Participants were right-handed male varsity contact-sport athletes (20.2±1.0 years of age) with a medically diagnosed SRC (no loss of consciousness). They were compared to right-handed male varsity non-contact-sport athletes serving as controls (19.9±1.7 years). We found significantly increased radial diffusivity (RD) in concussed athletes (n=12; paired t-test, tract-based spatial statistics; p<0.025) at 2 days, when compared to the 2-week postinjury time point. The increase was found in a cluster of right hemisphere voxels, spanning the posterior limb of the internal capsule (IC), the retrolenticular part of the IC, the inferior longitudinal fasciculus, the inferior fronto-occipital fasciculus (sagittal stratum), and the anterior thalamic radiation. Post-hoc, univariate, between-group (controls vs. concussed), mixed-effects analysis of the cluster showed significantly higher RD at 2 days (p=0.002), as compared to the controls, with a trend in the same direction at 2 months (p=0.11). Results for fractional anisotropy (FA) in the same cluster showed a similar, but inverted, pattern; FA was decreased at 2 days and at 2 months postinjury, when compared to healthy controls. At 2 weeks postinjury, no statistical differences between concussed and control athletes were found with regard to either RD or FA. These results support the hypothesis of increased RD and reduced FA within 72 h postinjury, followed by recovery that may extend beyond 2 weeks. RD appears to be a sensitive measure of concussive injury. SN - 1557-9042 UR - https://www.unboundmedicine.com/medline/citation/24786666/A_longitudinal_diffusion_tensor_imaging_study_assessing_white_matter_fiber_tracts_after_sports_related_concussion_ L2 - https://www.liebertpub.com/doi/10.1089/neu.2014.3368?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -