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Acute sports concussion
Diffusion tensor imaging of sport related concussion in adolescents
  1. Naznin Virji-Babul1,*,
  2. Michael Borich1,
  3. Nadia Makan1,
  4. Tiffany Moore1,
  5. Kira Frew1,
  6. Carolyn A Emery2,
  7. Lara Boyd1
  1. 1Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
  2. 2Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada


    Objectives To establish the short-term changes in white matter integrity following sport related concussion in adolescents and to examine the association between changes in white matter integrity and a clinical measure of concussion.

    Design Cross-sectional within cohort study.

    Setting University hospital and community ice hockey arenas.

    Subjects Twelve adolescents with sport related concussion (ages 14–17 years) within 2 months of injury and 10, active adolescents with no previous history of concussion.

    Assessment of Risk Factors Adolescents within 2 months of sport-related concussion and healthy adolescents with no history of concussion were assessed using the Sport Concussion Assessment Tool 2 (SCAT2) and total SCAT2 score (/100) was considered.

    Outcome Measures Two measures of diffusion tensor imaging (DTI): fractional anisotropy (FA) and mean diffusivity (MD).

    Results Whole brain FA values were significantly increased (F (1,40)=6.29, p=0.01) and MD values decreased (F(1,40)=4.75, p=0.036) in concussed athletes compared with control participants. SCAT2 total scores were associated with whole brain FA and MD values with lower scores associated with higher FA (R2=0.25, p=0.017) and lower MD (R2=0.2, p=0.038).

    Conclusion This preliminary study provides evidence of microstructural changes in the integrity of the white matter in adolescent athletes following a sport related concussion. In addition, we found a relationship between measures of white matter integrity and the SCAT2 up to 16–61 days following concussion, which may indicate persistent structural change in the adolescent brain after injury. Further study should chart the trajectory of brain injury and recovery in this population.

    Acknowledgements Martha Piper Research Fund, University of British Columbia and the Brain Research Centre, University of British Columbia.

    Competing interests None.

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