title: The association between white-matter tract abnormalities, and neuropsychiatric and cognitive symptoms in retired professional football players with multiple concussions.
abstract: Retired professional athletes, who have suffered repetitive concussions, report symptoms of depression, anxiety, and memory impairment over time. Moreover, recent imaging data suggest chronic white-matter tract deterioration in sport-related concussion. The aim of this study is to evaluate the impact of repetitive concussions in retired professional football players on white-matter tracts, and relate these changes to neuropsychological function. All subjects (18 retired professional football players and 17 healthy controls) underwent imaging, neuropsychological assessment, and reported on concussion-related symptoms. Whole brain tract-based spatial statistics analysis revealed increased axial diffusivity in the right hemisphere of retired players in the (1) superior longitudinal fasciculus (SLF), (2) corticospinal tract, and (3) anterior thalamic radiations, suggesting chronic axonal degeneration in these tracts. Moreover, retired players report significantly higher neuropsychiatric and cognitive symptoms than healthy controls, and worsening of these symptoms since their last concussion. Loss of integrity in the right SLF significantly correlated with participants' visual learning ability. In sum, these results suggest that repetitive concussions in retired professional football players are associated with focal white-matter tract abnormalities that could explain some of the neuropsychiatric symptoms and cognitive deficits experienced by these retired athletes.
authors.affiliation: Canadian Sports Concussion Project, Memory Clinic, Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Disease, 399 Bathurst St., West Wing 5-449, Toronto, ON, M5T 2S8, Canada.|Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, 60 Leonard Avenue, Toronto, ON, M5T 2S8, Canada.|Division of Neurology, Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada.
authors.forename: Namita
authors.initials: N
authors.lastname: Multani
authors.affiliation: Canadian Sports Concussion Project, Memory Clinic, Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Disease, 399 Bathurst St., West Wing 5-449, Toronto, ON, M5T 2S8, Canada.|Division of Brain, Imaging and Behaviour-Systems Neuroscience, Toronto Western Hospital, Toronto Western Research Institute, University Health Network, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada.
authors.forename: Ruma
authors.initials: R
authors.lastname: Goswami
authors.affiliation: Canadian Sports Concussion Project, Memory Clinic, Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Disease, 399 Bathurst St., West Wing 5-449, Toronto, ON, M5T 2S8, Canada.
authors.forename: Mozhgan
authors.initials: M
authors.lastname: Khodadadi
authors.affiliation: Canadian Sports Concussion Project, Memory Clinic, Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Disease, 399 Bathurst St., West Wing 5-449, Toronto, ON, M5T 2S8, Canada.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ebraheem
authors.affiliation: Canadian Sports Concussion Project, Memory Clinic, Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Disease, 399 Bathurst St., West Wing 5-449, Toronto, ON, M5T 2S8, Canada.|Division of Brain, Imaging and Behaviour-Systems Neuroscience, Toronto Western Hospital, Toronto Western Research Institute, University Health Network, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada.|Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.|Department of Surgery, University of Toronto, 149 College Street, Toronto, ON, M5T 1P5, Canada.
authors.forename: Karen D
authors.initials: KD
authors.lastname: Davis
authors.affiliation: Canadian Sports Concussion Project, Memory Clinic, Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Disease, 399 Bathurst St., West Wing 5-449, Toronto, ON, M5T 2S8, Canada.|Division of Brain, Imaging and Behaviour-Systems Neuroscience, Toronto Western Hospital, Toronto Western Research Institute, University Health Network, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada.|Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.|Department of Surgery, University of Toronto, 149 College Street, Toronto, ON, M5T 1P5, Canada.|Division of Neurosurgery, Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Tator
authors.affiliation: Canadian Sports Concussion Project, Memory Clinic, Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Disease, 399 Bathurst St., West Wing 5-449, Toronto, ON, M5T 2S8, Canada.|Division of Neurology, Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Wennberg
authors.affiliation: Canadian Sports Concussion Project, Memory Clinic, Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Disease, 399 Bathurst St., West Wing 5-449, Toronto, ON, M5T 2S8, Canada.|Division of Brain, Imaging and Behaviour-Systems Neuroscience, Toronto Western Hospital, Toronto Western Research Institute, University Health Network, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada.|Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.|Department of Medical Imaging, Toronto Western Hospital, University Health Network, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada.
authors.forename: David J
authors.initials: DJ
authors.lastname: Mikulis
authors.affiliation: Canadian Sports Concussion Project, Memory Clinic, Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Disease, 399 Bathurst St., West Wing 5-449, Toronto, ON, M5T 2S8, Canada.
authors.forename: Leo
authors.initials: L
authors.lastname: Ezerins
authors.affiliation: Canadian Sports Concussion Project, Memory Clinic, Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Disease, 399 Bathurst St., West Wing 5-449, Toronto, ON, M5T 2S8, Canada. carmela.tartaglia@uhn.ca.|Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, 60 Leonard Avenue, Toronto, ON, M5T 2S8, Canada. carmela.tartaglia@uhn.ca.|Division of Neurology, Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada. carmela.tartaglia@uhn.ca.
authors.forename: Maria Carmela
authors.initials: MC
authors.lastname: Tartaglia
mesh_terms: D000328:Adult; D056352:Athletes; D001924:Brain Concussion / Q000150:complications* / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D001523:Mental Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D008875:Middle Aged; D059906:Neuroimaging; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D012179:Retirement; D018709:Statistics, Nonparametric
keywords: Diffusion tensor imaging; Repetitive mild traumatic brain injury; Sport-related concussion; Superior longitudinal fasciculus; Visuospatial function