title: White matter alterations in college football players: a longitudinal diffusion tensor imaging study.
abstract: The aim of this study was to evaluate longitudinal changes in the diffusion characteristics of brain white matter (WM) in collegiate athletes at three time points: prior to the start of the football season (T1), after one season of football (T2), followed by six months of no-contact rest (T3). Fifteen male collegiate football players and 5 male non-athlete student controls underwent diffusion MR imaging and computerized cognitive testing at all three timepoints. Whole-brain tract-based spatial statistics (TBSS) were used to compare fractional anisotropy (FA), radial diffusivity (RD), axial diffusivity (AD), and trace between all timepoints. Average diffusion values were obtained from statistically significant clusters for each individual. No athlete suffered a concussion during the study period. After one season of play (T1 to T2), we observed a significant increase in trace in a cluster located in the brainstem and left temporal lobe, and a significant increase in FA in the left parietal lobe. After six months of no-contact rest (T2 to T3), there was a significant decrease in trace and FA in clusters that were partially overlapping or in close proximity with the initial clusters (T1 to T2), with no significant changes from T1 to T3. Repetitive head impacts (RHI) sustained during a single football season may result in alterations of the brain's WM in collegiate football players. These changes appear to return to baseline after 6 months of no-contact rest, suggesting remission of WM alterations. Our preliminary results suggest that collegiate football players might benefit from periods without exposure to RHI.
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany.|Psychiatry Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Michael Christian
authors.initials: MC
authors.lastname: Mayinger
authors.affiliation: Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
authors.forename: Kian
authors.initials: K
authors.lastname: Merchant-Borna
authors.affiliation: Psychiatry Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|Department of Pediatric Neurology, Dr. von Hauner Children's Hospital, Ludwig-Maximilians- Universität, Munich, Germany.
authors.forename: Jakob
authors.initials: J
authors.lastname: Hufschmidt
authors.affiliation: Psychiatry Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|Institute for Clinical Radiology, Ludwig-Maximilians-Universität, Munich, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Muehlmann
authors.affiliation: Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
authors.forename: Isabelle Ruth
authors.initials: IR
authors.lastname: Weir
authors.affiliation: Psychiatry Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|Institute for Clinical Radiology, Ludwig-Maximilians-Universität, Munich, Germany.
authors.forename: Boris-Stephan
authors.initials: BS
authors.lastname: Rauchmann
authors.affiliation: Psychiatry Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|VA Boston Healthcare System, Brockton Division, Brockton, MA, USA.
authors.forename: Martha Elizabeth
authors.initials: ME
authors.lastname: Shenton
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany. ikoerte@bwh.harvard.edu.|Psychiatry Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. ikoerte@bwh.harvard.edu.
authors.forename: Inga Katharina
authors.initials: IK
authors.lastname: Koerte
authors.affiliation: Psychiatry Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Jeffrey John
authors.initials: JJ
authors.lastname: Bazarian
mesh_terms: D056352:Athletes; D001265:Athletic Injuries / Q000000981:diagnostic imaging*; D001921:Brain / Q000000981:diagnostic imaging*; D001924:Brain Concussion / Q000000981:diagnostic imaging* / Q000209:etiology; D056324:Diffusion Tensor Imaging; D005538:Football / Q000293:injuries*; D016489:Head Injuries, Closed / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012146:Rest; D014495:Universities; D066127:White Matter / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Athletics; Diffusion tensor imaging; Football; Fractional anisotropy; High magnitude impact; Human studies; Longitudinal; Repetitive head impacts; Sports; Subconcussive head trauma; TBSS; White matter