Widespread White Matter Abnormalities in Concussed Athletes Detected by 7T Diffusion Magnetic Resonance ImagingShow others and affiliations
2024 (English)In: Journal of Neurotrauma, ISSN 0897-7151, E-ISSN 1557-9042, Vol. 41, no 13-14, p. 1533-1549Article in journal (Refereed) Published
Abstract [en]
Sports-related concussions may cause white matter injuries and persistent post-concussive symptoms (PPCS). We hypothesized that athletes with PPCS would have neurocognitive impairments and white matter abnormalities that could be revealed by advanced neuroimaging using ultra-high field strength diffusion tensor (DTI) and diffusion kurtosis (DKI) imaging metrics and cerebrospinal fluid (CSF) biomarkers. A cohort of athletes with PPCS severity limiting the ability to work/study and participate in sport school and/or social activities for ≥6 months completed 7T magnetic resonance imaging (MRI) (morphological T1-weighed volumetry, DTI and DKI), extensive neuropsychological testing, symptom rating, and CSF biomarker sampling. Twenty-two athletes with PPCS and 22 controls were included. Concussed athletes performed below norms and significantly lower than controls on all but one of the psychometric neuropsychology tests. Supratentorial white and gray matter, as well as hippocampal volumes did not differ between concussed athletes and controls. However, of the 72 examined white matter tracts, 16% of DTI and 35% of DKI metrics (in total 28%) were significantly different between concussed athletes and controls. DKI fractional anisotropy and axial kurtosis were increased, and DKI radial diffusivity and radial kurtosis decreased in concussed athletes when compared with controls. CSF neurofilament light (NfL; an axonal injury marker), although not glial fibrillary acidic protein, correlated with several diffusion metrics. In this first 7T DTI and DKI study investigating PPCS, widespread microstructural alterations were observed in the white matter, correlating with CSF markers of axonal injury. More white matter changes were observed using DKI than using DTI. These white matter alterations may indicate persistent pathophysiological processes following concussion in sport.
Place, publisher, year, edition, pages
Mary Ann Liebert, 2024. Vol. 41, no 13-14, p. 1533-1549
Keywords [en]
7T MRI, biomarkers, neuropsychology, persistent post-concussion symptoms, sports-related concussion
National Category
Neurology Radiology, Nuclear Medicine and Medical Imaging
Research subject
Health Science
Identifiers
URN: urn:nbn:se:ltu:diva-105521DOI: 10.1089/neu.2023.0099ISI: 001217169600001PubMedID: 38481124Scopus ID: 2-s2.0-85192491727OAI: oai:DiVA.org:ltu-105521DiVA, id: diva2:1858870
Funder
Swedish National Centre for Research in Sports, CIF2023-0065The Swedish Brain Foundation, 2022-0081Swedish Research Council, 2018-02500Hans-Gabriel och Alice Trolle-Wachtmeisters stiftelse för medicinsk forskningSwedish Research Council, VR-RFI 829-2010-5928Swedish Research Council, 2017-00915Alzheimerfonden, AF-930351Alzheimerfonden, AF-939721Alzheimerfonden, AF-968270The Swedish Brain Foundation, FO2017-0243The Swedish Brain Foundation, ALZ2022-0006Swedish Research Council, 2023-00356Swedish Research Council, 2022-01018Swedish Research Council, 2019-02397EU, Horizon Europe, 101053962The Swedish Brain Foundation, FO2022-0270EU, Horizon 2020, 860197
Note
Validerad;2024;Nivå 2;2024-08-16 (signyg);
Funder: Alborada Trust (2023-25); the Alzheimer Drug Discovery Foundation (ADDF); (RDAPB-201809-2016615); the ALF-agreement (ALFGBG-71598; ALFGBG-965240); the European Union Joint Program for Neurodegenerative Disorders (JPND2019-466-236); the National Institute of Health (NIH), USA (1R01AG068398-01); the Alzheimer’s Association 2021 Zenith Award (ZEN-21-848495); Swedish State Support for Clinical Research (ALFGBG-71320); the Alzheimer Drug Discovery Foundation (ADDF), USA (201809-2016862); the AD Strategic Fund and the Alzheimer’s Association (ADSF-21-831376-C; ADSF-21-831381-C; ADSF-21-831377-C; ADSF24-1284328-C); the Bluefield Project; Cure Alzheimer’s Fund; the Olav Thon Foundation; the Erling-Persson Family Foundation; Familjen Rönströms Stiftelse; Stiftelsen för Gamla Tjänarinnor; the European Union Joint Programme—Neurodegenerative Disease Research (JPND2021-00694); the National Institute for Health and Care Research University College London Hospitals Biomedical Research Centre; the UK Dementia Research Institute at UCL (UKDRI-1003);
Fulltext license: CC BY
2024-05-202024-05-202024-08-16Bibliographically approved