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A Diffusion Tensor Imaging Study on the White Matter Skeleton in Individuals with Sports-Related Concussion
Open accessAbstract
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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“the severity of symptoms after mTBI correlates with reduction of white matter integrity on DTI, suggesting that persistent microstructural brain injury underlies the symptoms of PCS [45].”
From The neuropathology of sport (2014) · cites this paper as [45]
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Metadata
- 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
- Venue
- Journal of Neurotrauma
- Publisher
- SAGE Publications
- Published
- 2011-02
- Volume
- 28
- Issue
- 2
- Pages
- 189-201
- ISSN
- 0897-7151 (ISSN-L)
- 1557-9042
- 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
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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