The role of diffusion tensor imaging in characterizing injury patterns on athletes with concussion and subconcussive injury: a systematic review

ABSTRACT

Traumatic brain injury (TBI) is a major public health problem. The majority of TBIs are in the form of mild TBI (also known as concussion) with sports-related concussion (SRC) receiving public attention in recent years.

Here we have performed a systematic review of the literature on the use of Diffusion Tensor Imaging (DTI) on sports-related concussion and subconcussive injuries. Our review found different patterns of change in DTI parameters between concussed and subconcussed groups. The Fractional Anisotropy (FA) was either unchanged or increased for the concussion group, while the subconcussed group generally experienced a decrease in FA. A reverse pattern was observed for Mean Diffusivity (MD) – where the concussed group experienced a decrease in MD while the subconcussed group showed an increase in MD. However, in general, discrepancies were observed in the results reported in the literature – likely due to the huge variations in DTI acquisition parameters, and image processing and analysis methods used in these studies. This calls for more comprehensive and well-controlled studies in this field, including those that combine the advanced brain imaging with biomechancial modeling and kinematic sensors – to shed light on the underlying mechanisms behind the structural changes observed from the imaging studies.

KEYWORDS:

• Sports-related concussion
• mild traumatic brain injury
• magnetic resonance imaging
• diffusion tensor imaging

Declaration of interest

This work was supported by the fund from the Ministry of Business, Innovation and Employment of New Zealand Catalyst Grant (PROP-55749-INTCS-UOA)

Additional information

Funding

This work was supported by the funding from the Ministry of Business, Innovation and Employment of New Zealand’s Catalyst Fund (PROP-55749-INTCS-UOA) and the Global Infrastructure Program through the National Research Foundation of Korea (NRF-2017K1A3A1A17092641 work was supported by the Ministry of Business, Innovation and Employment [PROP-55749-INTCS-UOA].