J Neurotrauma. 2012 Sep 5. [Epub ahead of print]
A Systematic Review of Diffusion Tensor Imaging Findings in Sports-Related Concussion.
Gardner A, Kay-Lambkin FJ, Stanwell P, Donnelly JF, Williams WH, Hiles A, Schofield PW, Levi CR, Jones DK.
University of Newcastle, School of Medicine & Public Health, Faculty of Health, Newcastle, New South Wales, Australia; firstname.lastname@example.org.
Sports-related concussion (SRC) is typically associated with functional, as opposed to structural, injury. The results of traditional structural neuroimaging techniques used to assess SRC tend to be normal in many athletes, and are only clinically helpful in ruling out a more serious injury. Diffusion tensor imaging (DTI) has increasingly been touted as a method offering greater clinical potential in mild traumatic brain injury (mTBI). Despite this, the utility of DTI as a clinical tool for diagnosing and managing SRC has received considerably less attention than it has in the general TBI research literature. The aim of this paper is to conduct a systematic review of DTI in SRC, and to provide a focus and overview of research findings using this MRI technique in SRC. A systematic
review of articles published in English language, up to February 2012, was retrieved via PsycINFO, Medline, Embase, SportDiscus, Scopus, Web of Science, and Informit; using the key search terms: diffusion tensor imaging, diffusion magnetic resonance imaging, diffusion weighted MRI, diffusion MRI, fractional anisotropy, tractography, apparent diffusion coefficient, magnetic resonance imaging, mild traumatic brain injury, mTBI, traumatic brain injury, concussion, sport, athletic and athlete. Observational, cohort, correlation, cross-sectional and longitudinal studies were all included in the current review. Results of the review found eight articles that met inclusion criteria, which included data on 214 athletes and 96 controls. Seven of eight studies reported some type of DTI abnormality, although the neuroanatomical sites involved varied. While considerable methodological variations exist across studies, the current review suggests that DTI may possess adequate diagnostic sensitivity to detect SRC in affected athletes. Further longitudinal studies are required to demonstrate its discriminate validity and prognostic capacity within this field. Key Words: MRI, Traumatic Brain Injury, Neural Injury.
PMID: 22950876 [PubMed – as supplied by publisher]