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Hockey Concussion Education Project, Part 3. White Matter Microstructure in Ice Hockey Players with a History of Concussion: A Diffusion Tensor Imaging Study

Institution:
Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Publication Date:
Apr-2014
Journal:
J Neurosurg
Volume Number:
120
Issue Number:
4
Pages:
882-90
Citation:
J Neurosurg. 2014 Apr;120(4):882-90.
PubMed ID:
24471841
PMCID:
PMC4863636
Keywords:
concussion, mild traumatic brain injury, diffusion tensor imaging, ice hockey, fractional anisotropy, white matter
Appears in Collections:
NAC, PNL, SLICER, SPL
Sponsors:
P41 EB015902/EB/NIBIB NIH HHS/United States
P41 RR013218/RR/NCRR NIH HHS/United States
R01 MH074794/MH/NIMH NIH HHS/United States
Generated Citation:
Sasaki T., Pasternak O., Mayinger M., Muehlmann M., Savadjiev P., Bouix S., Kubicki M., Fredman E., Dahlben B., Helmer K.G., Johnson A.M., Holmes J.D., Forwell L.A., Skopelja E.N., Shenton M.E., Echlin P.S., Koerte I.K. Hockey Concussion Education Project, Part 3. White Matter Microstructure in Ice Hockey Players with a History of Concussion: A Diffusion Tensor Imaging Study. J Neurosurg. 2014 Apr;120(4):882-90. PMID: 24471841. PMCID: PMC4863636.
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The aim of this study was to examine the brain's white matter microstructure by using MR diffusion tensor imaging (DTI) in ice hockey players with a history of clinically symptomatic concussion compared with players without a history of concussion. Methods Sixteen players with a history of concussion (concussed group; mean age 21.7 ± 1.5 years; 6 female) and 18 players without a history of concussion (nonconcussed group; mean age 21.3 ± 1.8 years, 10 female) underwent 3-T DTI at the end of the 2011-2012 Canadian Interuniversity Sports ice hockey season. Tract-based spatial statistics (TBSS) was used to test for group differences in fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and the measure "trace," or mean diffusivity. Cognitive evaluation was performed using the Immediate Postconcussion Assessment and Cognitive Test (ImPACT) and the Sport Concussion Assessment Tool-2 (SCAT2). Results TBSS revealed a significant increase in FA and AD, and a significant decrease in RD and trace in several brain regions in the concussed group, compared with the nonconcussed group (p < 0.05). The regions with increased FA and decreased RD and trace included the right posterior limb of the internal capsule, the right corona radiata, and the right temporal lobe. Increased AD was observed in a small area in the left corona radiata. The DTI measures correlated with neither the ImPACT nor the SCAT2 scores. Conclusions The results of the current study indicate that a history of concussion may result in alterations of the brain's white matter microstructure in ice hockey players. Increased FA based on decreased RD may reflect neuroinflammatory or neuroplastic processes of the brain responding to brain trauma. Future studies are needed that include a longitudinal analysis of the brain's structure and function following a concussion to elucidate further the complex time course of DTI changes and their clinical meaning.

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