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A preliminary report of cerebral white matter microstructural changes associated with adolescent sports concussion acutely and subacutely using diffusion tensor imaging

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Abstract

Diffusion tensor imaging (DTI) has demonstrated its utility in detecting microscopic post-concussion cerebral white matter structural changes, which are not routinely evident on conventional neuroimaging modalities. In this study, we compared 10 adolescents with sports concussion (SC) to 12 orthopedically-injured (OI) individuals within 96 h and three months post injury to 12 typically-developing (TD) participants using DTI and volumetric analyses. In terms of volume, no group differences were noted between SC, OI and TD groups at both 96 h and three months post concussion. Results did not show significant differences between SC, OI, and TD groups for both fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in all regions of interest within 96 h post concussion. However, at three months post-injury, the SC group exhibited significantly lower FA than the TD group in various regions of interest. In terms of ADC, significant group differences between SC and TD groups were found in some regions, with SC group having higher ADC than TD. No group differences for FA and ADC were noted between SC and OI groups at three months post-injury. However, several moderate effect sizes on between-group analyses were noted such that FA was lower and ADC was higher in SC relative to OI. Longitudinally, the SC group demonstrated decreased FA and increased ADC in some areas. The findings highlight the fact that the brain continues to change during the post-injury recovery period, and raises the possibility that adverse changes may result from the neurometabolic cascade that purportedly ensues following SC. DTI may potentially be used to characterize the nature of brain changes that occur following sports-related concussions.

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Acknowledgements

This work was supported by the National Institutes of Health grants 5R21-NS086714 and 5P01-NS056202. The funding sources had no role in the interpretation of data, writing of this paper, or in the decision to submit for publication. The contents of this paper are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health. The authors wish to thank James Montier and English Pratts, Baylor College of Medicine, for their assistance in the preparation of this manuscript, Drs. Claudia Robertson and James McCarthy for their help with recruitment, and Vipulkumar Patel for his assistance in MRI acquisition.

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  1. Trevor Wu and Tricia L. Merkley contributed equally and therefore are both first authors for this manuscript.

Authors and Affiliations

  1. Mercy Health St. Mary’s, Michigan State University, 220 Cherry St SE, Grand Rapids, MI, 49503, USA

    Trevor Wu

  2. Barrow Neurological Institute, 222 W. Thomas Road, Suite 315, Phoenix, AZ, 85013, USA

    Tricia L. Merkley

  3. Baylor College of Medicine, One Baylor Plaza BCM637, Houston, TX, 77030-3411, USA

    Elisabeth A. Wilde, Xiaoqi Li, Zili David Chu, Stephen R. McCauley, Jill V. Hunter & Harvey S. Levin

  4. University of Miami Miller School of Medicine, 1600 NW 10th Ave #1440, Miami, FL, 33136, USA

    Amanda Barnes

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  1. Trevor Wu
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Corresponding author

Correspondence to Elisabeth A. Wilde.

Ethics declarations

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, and the applicable revisions at the time of the investigation.

Conflict of interest

Trevor Wu, PhD, Tricia Merkley, PhD, Elisabeth Wilde, PhD, Amanda Barnes, MPH, Xiaoqi Li, PhD, Zili David Chu, PhD, Stephen McCauley, PhD, Jill Hunter, MD, and Harvey Levin, PhD declare that they have no conflict of interest.

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Informed consent was obtained from all patients (via parental consent and participant assent, where applicable) for being included in the study.

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Wu, T., Merkley, T.L., Wilde, E.A. et al. A preliminary report of cerebral white matter microstructural changes associated with adolescent sports concussion acutely and subacutely using diffusion tensor imaging. Brain Imaging and Behavior 12, 962–973 (2018). https://doi.org/10.1007/s11682-017-9752-5

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  • DOI: https://doi.org/10.1007/s11682-017-9752-5

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