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

Published Online:Oct 24 2016https://doi.org/10.1148/radiol.2016160564

Abstract

Our study adds to the growing body of evidence that a season of play in a contact sport can result in brain MR imaging changes, even in the absence of concussion.

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 (RWE_CP). 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 RWE_CP was also investigated. Linear regression analysis was conducted to determine the association between RWE_CP and change in fiber tract FA during the season.

Results

There were statistically significant linear relationships between RWE_cp 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 RWE_CP was also observed (R² = 0.2893; P = .028).

Conclusion

This study found a statistically significant relationship between head impact exposure and change of FA 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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Article History

Received March 17, 2016; revision requested April 26; revision received July 8; accepted July 25; final version accepted August 25.
Published online: Oct 24 2016
Published in print: Dec 2016

Vol. 281, No. 3

Supplemental Material

Funding/Support

Supported by National Institutes of Health (grant no. R01NS082453 NINDS and R03NS088082 NINDS).

Abbreviations

Abbreviations:
FA	fractional anisotropy
HIT	Head Impact Telemetry
IFOF	inferior fronto-occipital fasciculus
ILF	inferior longitudinal fasciculus
RWE	risk-weighted cumulative exposure
RWE_CP	combined-probability RWE
SLF	superior longitudinal fasciculus
TBI	traumatic brain injury
WM	white matter

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