Longitudinal Analysis of DTI in a Sample of Professional Boxers

J Int Neuropsychol Soc. 2014 Mar;


Krishnan, K., C. Bosworth, S. Aslan, J. Gatson, M. Cullum, R. Diaz-Arrastia and C. Marquez De La Plata.



Objective: Repeated blows to the head, such as those endured by professional boxers, may have long-term detrimental consequences to the brain and cognitive abilities. Diffusion Tensor Imaging (DTI) may provide insights into acute structural white matter (WM) change after such insults. This study evaluated WM integrity changes among professional boxers before and after a fight in which they experienced a concussion. This study aimed to detect WM compromise and cognitive change associated with a concussion after a professional boxing match. Participants and Methods: DTI was acquired on 10 professional boxers using a single 3T magnet. Boxers were scanned and neuropsychological data (imPACT) was collected two weeks prior to a scheduled fight and again 7 days after a boxing-related concussion. White matter histogram and voxel based analyses (VBA) of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were performed and compromised WM regions were identified using John’s Hopkins WM Tract Atlas. Results: No differences in histogram characteristics were observed. VBA detected increased diffusivity in RD (3 clusters) and MD (1 cluster) from pre-fight to post-concussion (p[uncorrected ]<0.01, cluster size≥250 mm3) that involved right Anterior Thalamic Radiation (ATR) and forceps major. Increase in RD over time (within the ATR) was associated with slowing of reaction time between baseline and post-concussion. Similarly increase in RD over time within the Forceps major was associated with a decline in memory score between pre- and post-injury . Conclusions: Global WM integrity did not change after a boxing-related concussion; however, regional compromise in WM was observed and may reflect acute edema. Regional WM compromise may have clinical implications, as compromised structural connectivity measures were associated with decrease in outcome scores.

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