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. 2016 Dec;281(3):919-926.
doi: 10.1148/radiol.2016160564. Epub 2016 Oct 24.

Subconcussive Head Impact Exposure and White Matter Tract Changes over a Single Season of Youth Football

Naeim Bahrami  1 , Dev Sharma  1 , Scott Rosenthal  1 , Elizabeth M Davenport  1 , Jillian E Urban  1 , Benjamin Wagner  1 , Youngkyoo Jung  1 , Christopher G Vaughan  1 , Gerard A Gioia  1 , Joel D Stitzel  1 , Christopher T Whitlow  1 , Joseph A Maldjian  1
Affiliations

Subconcussive Head Impact Exposure and White Matter Tract Changes over a Single Season of Youth Football

Naeim Bahrami et al. Radiology. 2016 Dec.

Abstract

Purpose To examine the effects of subconcussive impacts resulting from a single season of youth (age range, 8-13 years) football on changes in specific white matter (WM) tracts as detected with diffusion-tensor imaging in the absence of clinically diagnosed concussions. Materials and Methods Head impact data were recorded by using the Head Impact Telemetry system and quantified as the combined-probability risk-weighted cumulative exposure (RWECP). Twenty-five male participants were evaluated for seasonal fractional anisotropy (FA) changes in specific WM tracts: the inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus, and superior longitudinal fasciculus (SLF). Fiber tracts were segmented into a central core and two fiber terminals. The relationship between seasonal FA change in the whole fiber, central core, and the fiber terminals with RWECP was also investigated. Linear regression analysis was conducted to determine the association between RWECP and change in fiber tract FA during the season. Results There were statistically significant linear relationships between RWEcp and decreased FA in the whole (R2 = 0.433; P = .003), core (R2 = 0.3649; P = .007), and terminals (R2 = 0.5666; P < .001) of left IFOF. A trend toward statistical significance (P = .08) in right SLF was observed. A statistically significant correlation between decrease in FA of the right SLF terminal and RWECP was also observed (R2 = 0.2893; P = .028). Conclusion This study found a statistically significant relationship between head impact exposure and change of FA fractional anisotropy value of whole, core, and terminals of left IFOF and right SLF's terminals where WM and gray matter intersect, in the absence of a clinically diagnosed concussion. © RSNA, 2016.

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Figures

Figure 1a:
Figure 1a:
(a) Linear regression plot depicts the relationship between percent change of FA of the left IFOF and cumulative exposure. The blue shaded area indicates the estimated confidence interval region around the true regression line. RWECP = RWECP. (b) MR images of left IFOF (top) before and (middle) after the playing season, and (bottom) the overlay. In the overlay (bottom), the red region is after the season and the blue region is before the season.
Figure 1b:
Figure 1b:
(a) Linear regression plot depicts the relationship between percent change of FA of the left IFOF and cumulative exposure. The blue shaded area indicates the estimated confidence interval region around the true regression line. RWECP = RWECP. (b) MR images of left IFOF (top) before and (middle) after the playing season, and (bottom) the overlay. In the overlay (bottom), the red region is after the season and the blue region is before the season.
Figure 2:
Figure 2:
Linear regression plot depicts the relationship between percent change of FA of the core part of left IFOF and cumulative exposure. The blue shaded area indicates the estimated confidence interval region around the true regression line. RWECP = RWECP.
Figure 3:
Figure 3:
Linear regression plot depicts the relationship between percent change of FA of the terminal part of left IFOF and cumulative exposure. The blue shaded area indicates the estimated confidence interval region around the true regression line. RWECP = RWECP.
Figure 4:
Figure 4:
Linear regression plot depicts the relationship between percent change of FA of the terminal part of right SLF and cumulative exposure. The blue shaded area indicates the estimated confidence interval region around the true regression line. RWECP = RWECP.
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