Journal
JOURNAL OF NEUROTRAUMA
Volume 36, Issue 11, Pages 1776-1785Publisher
MARY ANN LIEBERT, INC
DOI: 10.1089/neu.2018.6055
Keywords
concussion; MRI; mTBI; sport; white matter hyperintensity
Funding
- Grand Alliance Concussion Assessment, Research, and Education (CARE) Consortium - National Collegiate Athletic Association (NCAA)
- Department of Defense (DOD)
- Office of the Assistant Secretary of Defense for Health Affairs through the Psychological Health and Traumatic Brain Injury Program [W81XWH-14-2-0151]
- Defense Health Program under the Department of Defense Broad Agency Announcement for Extramural Medical Research [W81XWH-14-1-0561]
- National Center for Advancing Translational Sciences, National Institutes of Health, [UL1TR001436]
- U.S. Army Medical Research Acquisition Activity, (Fort Detrick)
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Previous studies have shown that mild traumatic brain injury (mTBI) can cause abnormalities in clinically relevant magnetic resonance imaging (MRI) sequences. No large-scale study, however, has prospectively assessed this in athletes with sport-related concussion (SRC). The aim of the current study was to characterize and compare the prevalence of acute, trauma-related MRI findings and clinically significant, non-specific MRI findings in athletes with and without SRC. College and high-school athletes were prospectively enrolled and participated in scanning sessions between January 2015 through August 2017. Concussed contact sport athletes (n = 138; 14 female [F]; 19.5 +/- 1.6 years) completed up to four scanning sessions after SRC. Non-concussed contact (n = 135; 15 F; 19.7 +/- 1.6) and non-contact athletes (n = 96; 15 F; 20.0 +/- 1.7) completed similar scanning sessions and served as controls. Board-certified neuroradiologists, blinded to SRC status, reviewed T-1-weighted and T-2-weighted fluid-attenuated inversion recovery and T-2*-weighted and T-2-weighted images for acute (i.e., injury-related) or non-acute findings that prompted recommendation for clinical follow-up. Concussed athletes were more likely to have MRI findings relative to contact (30.4% vs. 15.6%; odds ratio [OR] = 2.32; p = 0.01) and non-contact control athletes (19.8%; OR = 2.11; p = 0.04). Female athletes were more likely to have MRI findings than males (43.2% vs. 19.4%; OR = 2.62; p = 0.01). One athlete with SRC had an acute, injury-related finding; group differences were largely driven by increased rate of non-specific white matter hyperintensities in concussed athletes. This prospective, large-scale study demonstrates that <1% of SRCs are associated with acute injury findings on qualitative structural MRI, providing empirical support for clinical guidelines that do not recommend use of MRI after SRC.
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