A longitudinal diffusion tensor imaging study assessing white matter fiber tracts after sports-related concussion

Murali Murugavel, Valerie Cubon, Margot Putukian, Ruben Echemendia, Javier Cabrera, Daniel Osherson, Annegret Dettwiler

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99 Scopus citations


The extent of structural injury in sports-related concussion (SRC) is central to the course of recovery, long-term effects, and the decision to return to play. In the present longitudinal study, we used diffusion tensor imaging (DTI) to assess white matter (WM) fiber tract integrity within 2 days, 2 weeks, and 2 months of concussive injury. Participants were righthanded male varsity contact-sport athletes (20.2 ± 1.0 years of age) with a medically diagnosed SRC (no loss of consciousness). They were compared to right-handed male varsity non-contact-sport athletes serving as controls (19.9 ± 1.7 years). We found significantly increased radial diffusivity (RD) in concussed athletes (n = 12; paired t-test, tract-based spatial statistics; p < 0.025) at 2 days, when compared to the 2-week postinjury time point. The increase was found in a cluster of right hemisphere voxels, spanning the posterior limb of the internal capsule (IC), the retrolenticular part of the IC, the inferior longitudinal fasciculus, the inferior fronto-occipital fasciculus (sagittal stratum), and the anterior thalamic radiation. Post-hoc, univariate, between-group (controls vs. concussed), mixed-effects analysis of the cluster showed significantly higher RD at 2 days (p = 0.002), as compared to the controls, with a trend in the same direction at 2 months (p = 0.11). Results for fractional anisotropy (FA) in the same cluster showed a similar, but inverted, pattern; FA was decreased at 2 days and at 2 months postinjury, when compared to healthy controls. At 2 weeks postinjury, no statistical differences between concussed and control athletes were found with regard to either RD or FA. These results support the hypothesis of increased RD and reduced FA within 72 h postinjury, followed by recovery that may extend beyond 2 weeks. RD appears to be a sensitive measure of concussive injury.

Original languageEnglish (US)
Pages (from-to)1860-1871
Number of pages12
JournalJournal of Neurotrauma
Issue number22
StatePublished - Nov 15 2014

All Science Journal Classification (ASJC) codes

  • Clinical Neurology


  • Diffusion tensor imaging
  • Longitudinal study
  • Radial diffusivity
  • Sports-related concussion
  • mTBI


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