Acute White-Matter Abnormalities in Sports-Related Concussion: A Diffusion Tensor Imaging Study from the NCAA-DoD CARE Consortium

Sourajit Mitra Mustafi, Jaroslaw Harezlak, Kevin M. Koch, Andrew S. Nencka, Timothy B. Meier, John D. West, Christopher C. Giza, John P. DiFiori, Kevin M. Guskiewicz, Jason P. Mihalik, Stephen M. LaConte, Stefan M. Duma, Steven P. Broglio, Andrew J. Saykin, Michael McCrea, Thomas W. McAllister, Yu Chien Wu

Research output: Contribution to journalArticle

16 Scopus citations


Sports-related concussion (SRC) is an important public health issue. Although standardized assessment tools are useful in the clinical management of acute concussion, the underlying pathophysiology of SRC and the time course of physiological recovery after injury remain unclear. In this study, we used diffusion tensor imaging (DTI) to detect white matter alterations in football players within 48 h after SRC. As part of the NCAA-DoD CARE Consortium study of SRC, 30 American football players diagnosed with acute concussion and 28 matched controls received clinical assessments and underwent advanced magnetic resonance imaging scans. To avoid selection bias and partial volume effects, whole-brain skeletonized white matter was examined by tract-based spatial statistics to investigate between-group differences in DTI metrics and their associations with clinical outcome measures. Mean diffusivity was significantly higher in brain white matter of concussed athletes, particularly in frontal and subfrontal long white matter tracts. In the concussed group, axial diffusivity was significantly correlated with the Brief Symptom Inventory and there was a similar trend with the symptom severity score of the Sport Concussion Assessment Tool. In addition, concussed athletes with higher fractional anisotropy performed better on the cognitive component of the Standardized Assessment of Concussion. Overall, the results of this study are consistent with the hypothesis that SRC is associated with changes in white matter tracts shortly after injury, and these differences are correlated clinically with acute symptoms and functional impairments.

Original languageEnglish (US)
Pages (from-to)2653-2664
Number of pages12
JournalJournal of neurotrauma
Issue number22
StatePublished - Nov 15 2018



  • CARE
  • acute
  • diffusion tensor imaging
  • sports-related concussion tract-based spatial statistics
  • white matters

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Mustafi, S. M., Harezlak, J., Koch, K. M., Nencka, A. S., Meier, T. B., West, J. D., Giza, C. C., DiFiori, J. P., Guskiewicz, K. M., Mihalik, J. P., LaConte, S. M., Duma, S. M., Broglio, S. P., Saykin, A. J., McCrea, M., McAllister, T. W., & Wu, Y. C. (2018). Acute White-Matter Abnormalities in Sports-Related Concussion: A Diffusion Tensor Imaging Study from the NCAA-DoD CARE Consortium. Journal of neurotrauma, 35(22), 2653-2664.