Cited by 297Traumatic Brain Injury ResearchAdvanced Neuroimaging Techniques and ApplicationsAutomotive and Human Injury Biomechanics

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A Diffusion Tensor Imaging Study on the White Matter Skeleton in Individuals with Sports-Related Concussion

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Cubon, Valerie A., Putukian, Margot, Boyer, Cynthia, Dettwiler, Annegret·2011·Journal of Neurotrauma

DOI 10.1089/neu.2010.1430PMC PMC3037804

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Abstract

Recognizing and managing the effects of cerebral concussion is very challenging, given the discrete symptomatology. Most individuals with sports-related concussion will not score below 15 on the Glasgow Coma Scale, but will present with rapid onset of short-lived neurological impairment, demonstrating no structural changes on traditional magnetic resonance imaging (MRI) and computed tomography (CT) scans. The return-to-play decision is one of the most difficult responsibilities facing the physician, and so far this decision has been primarily based on neurological examination, symptom checklists, and neuropsychological (NP) testing. Diffusion tensor imaging (DTI) may be a more objective tool to assess the severity and recovery of function after concussion. We assessed white matter (WM) fiber tract integrity in varsity level college athletes with sports-related concussion without loss of consciousness, who experienced protracted symptoms for at least 1 month after injury. Evaluation of fractional anisotropy (FA) and mean diffusivity (MD) of the WM skeleton using tract-based spatial statistics (TBSS) revealed a large cluster of significantly increased MD for concussed subjects in several WM fiber tracts in the left hemisphere, including parts of the inferior/superior longitudinal and fronto-occipital fasciculi, the retrolenticular part of the internal capsule, and posterior thalamic and acoustic radiations. Qualitative comparison of average FA and MD suggests that with increasing level of injury severity (ranging from sports-related concussion to severe traumatic brain injury), MD might be more sensitive at detecting mild injury, whereas FA captures more severe injuries. In conclusion, the TBSS analysis used to evaluate diffuse axonal injury of the WM skeleton seems sensitive enough to detect structural changes in sports-related concussion.

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Authors: Cubon, V. A., Putukian, M., Boyer, C., & Dettwiler, A.
Affiliations: Princeton University (US)
Brain Injury Services, Bancroft NeuroHealth, Cherry Hill, New Jersey.
Corresponding author: Dettwiler, Annegret
ORCID: Putukian, Margot
Dettwiler, Annegret
Venue: Journal of Neurotrauma
Publisher: SAGE Publications
Published: 2011-02
Volume: 28
Issue: 2
Pages: 189-201
ISSN: 0897-7151 (ISSN-L)
1557-9042
DOI: 10.1089/neu.2010.1430
PMC: PMC3037804
OpenAlex: W1998393686
Cited by: 297
References: 82
Citations by year: 2026: 2 · 2025: 8 · 2024: 7 · 2023: 12 · 2022: 19 · 2021: 17 · 2020: 16 · 2019: 27 · 2018: 19 · 2017: 29 · 2016: 24 · 2015: 21 · 2014: 28 · 2013: 29 · 2012: 25
FWCI: 15.70
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.liebertpub.com/nv/resources-tools/text-and-data-mining-policy/121/ (tdm)
Locations: Journal of Neurotrauma (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: W.K. Kellogg Foundation
National Institutes of Health (5r21hd049546-02)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD049546-01)
Topics: Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
Physical Sciences › Engineering › Biomedical Engineering › Automotive and Human Injury Biomechanics
Keywords: sports-related concussion, white matter integrity, diffusion tensor imaging, fractional anisotropy, mean diffusivity, tract-based spatial statistics, diffuse axonal injury, college athletes, return to sport, mild traumatic brain injury
MeSH terms: Adolescent, Athletic Injuries, Brain Concussion, Brain Injuries, Brain Mapping, Female, Humans, Male, Nerve Fibers, Myelinated, Young Adult, Diffusion Tensor Imaging

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A Diffusion Tensor Imaging Study on the White Matter Skeleton in Individuals with Sports-Related Concussion

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