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Multiparametric MRI changes persist beyond recovery in concussed adolescent hockey players
Neurology
  • Kathryn Y. Manning, The University of Western Ontario
  • Amy Schranz, The University of Western Ontario
  • Robert Bartha, The University of Western Ontario
  • Gregory A. Dekaban, The University of Western Ontario
  • Christy Barreira, The University of Western Ontario
  • Arthur Brown, The University of Western Ontario
  • Lisa Fischer, Fowler Kennedy Sport Medicine Clinic
  • Kevin Asem, Fowler Kennedy Sport Medicine Clinic
  • Timothy J. Doherty, The University of Western Ontario
  • Douglas D. Fraser, London Health Sciences Centre
  • Jeff Holmes, The University of Western Ontario
  • Ravi S. Menon, The University of Western Ontario
Document Type
Article
Publication Date
1-1-2017
URL with Digital Object Identifier
10.1212/WNL.0000000000004669
Abstract

Objective: To determine whether multiparametric MRI data can provide insight into the acute and long-lasting neuronal sequelae after a concussion in adolescent athletes. Methods: Players were recruited from Bantam hockey leagues in which body checking is first introduced (male, age 11-14 years). Clinical measures, diffusion metrics, resting-state network and region-to-region functional connectivity patterns, and magnetic resonance spectroscopy absolute metabolite concentrations were analyzed from an independent, age-matched control group of hockey players (n = 26) and longitudinally in concussed athletes within 24 to 72 hours (n = 17) and 3 months (n = 14) after a diagnosed concussion. Results: There were diffusion abnormalities within multiple white matter tracts, functional hyperconnectivity, and decreases in choline 3 months after concussion. Tract-specific spatial statistics revealed a large region along the superior longitudinal fasciculus with the largest decreases in diffusivity measures, which significantly correlated with clinical deficits. This region also spatially intersected with probabilistic tracts connecting cortical regions where we found acute functional connectivity changes. Hyperconnectivity patterns at 3 months after concussion were present only in players with relatively less severe clinical outcomes, higher choline concentrations, and diffusivity indicative of relatively less axonal disruption. Conclusions: Changes persisted well after players' clinical scores had returned to normal and they had been cleared to return to play. Ongoing white matter maturation may make adolescent athletes particularly vulnerable to brain injury, and they may require extended recovery periods. The consequences of early brain injury for ongoing brain development and risk of more serious conditions such as second impact syndrome or neural degenerative processes need to be elucidated.

Citation Information
Kathryn Y. Manning, Amy Schranz, Robert Bartha, Gregory A. Dekaban, et al.. "Multiparametric MRI changes persist beyond recovery in concussed adolescent hockey players" Neurology Vol. 89 Iss. 21 (2017) p. 2157 - 2166
Available at: http://works.bepress.com/arthur-brown/11/