Longitudinal white-matter abnormalities in sports-related concussion: a diffusion MRI study of the NCAA-DoD CARE Consortium

Objective To study longitudinal recovery trajectories of white-matter after sports-related concussion (SRC), we performed diffusion tensor imaging (DTI) on collegiate athletes who sustained SRC. Methods Collegiate athletes (n=219, 82 concussed athletes, 68 contact-sport controls, and 69 non-contact-sport controls) were included from the Concussion Assessment, Research and Education (CARE) Consortium. The participants completed clinical assessments and DTI at four time points: 24-48-hours post-injury, asymptomatic state, seven days following return-to-play, and six-months post-injury. Tract-based spatial statistics were used to investigate group differences in DTI metrics and identify white-matter areas with persistent abnormalities. Generalized linear mixed models were used to study longitudinal changes and associations between outcome measures and DTI metrics. Cox proportional hazards model was used to study effects of white-matter abnormalities on recovery time. Res...