Diffusion tensor imaging of sports-related concussion in adolescents

Concussion is among the least understood neurologic injuries. The impact of concussion on the adolescent brain remains largely unknown. This study sought to establish short-term changes in white-matter integrity after sports-related concussion in adolescents, and examine the association between changes in white-matter integrity and a clinical measure of concussion. Twelve adolescents, aged 14-17 years with a sports-related concussion within 2 months, and 10 age-matched adolescents with no history of concussion were evaluated with the Sports Concussion Assessment Tool 2 and diffusion tensor imaging. Two measures compared the two groups: fractional anisotropy and mean diffusivity. Whole-brain fractional anisotropy values significantly increased (F(1,40) = 6.29, P = 0.010), and mean diffusivity values decreased (F(1,40) = 4.75, P = 0.036), in concussed athletes compared with control participants. Total scores on the Sports Concussion Assessment Tool 2 were associated with whole-brain fractional anisotropy. Mean diffusivity values with lower scores were associated with higher fractional anisotropy (R(2) = 0.25, P = 0.017) and lower mean diffusivity (R(2) = 0.20, P = 0.038). We provide evidence of structural changes in the integrity of white matter in adolescent athletes after sports-related concussion.