Alexander Rauscher PhD, MSc, Presenter: Advisory Board, F. Hoffmann-La Roche Ltd

Michael Jarrett MSc, Abstract Co-Author: Nothing to Disclose

Elham Shahinfard, Abstract Co-Author: Nothing to Disclose

Enedino Hernandez Torres PhD, Abstract Co-Author: Nothing to Disclose

Yinshan Zhao, Abstract Co-Author: Nothing to Disclose

Shiroy Dadachanji, Abstract Co-Author: Nothing to Disclose

Warren Rienzie Perera MBBS, Abstract Co-Author: Nothing to Disclose

Roger Tam PhD, Abstract Co-Author: Nothing to Disclose

Nancy Mary Theresa Martin MD, Abstract Co-Author: Nothing to Disclose

Jack E. Taunton, Abstract Co-Author: Nothing to Disclose

David Kwok Boon Li MD, Abstract Co-Author: Researcher, sanofi-aventis Group Researcher, F. Hoffmann-La Roche Ltd Researcher, Merck KGaA Researcher, Novartis AG Researcher, Nuron Biotech, Inc Researcher, PAREXEL International Corporation Consultant, sanofi-aventis Group Consultant, F. Hoffmann-La Roche Ltd Scientific Advisory Board, Novartis AG Scientific Advisory Board, Nuron Biotech, Inc Scientific Advisory Board, Opexa Therapeutics, Inc

Mild traumatic brain injury is common. We prospectively investigated brain volume (BV) changes, white matter hyperintensities (WMHI) and microbleeds prospectively in a group of 45 male and female university ice hockey players along with 15 age matched controls. 

All players underwent neuropsychological testing and 3T MRI (3D T1 spoiled gradient scho susceptibility weighting imaging (SWI) with multiple echoes and 3D fluid-attenuated inversion recovery (FLAIR)) at the beginning and the end of the season. Concussed athletes underwent additional imaging and neuropsychological testing at 72 hours, two weeks, and two months post injury. WMHI and microbleeds were identified by two radiologists by consensus, blinded to the clinical status and scan timing . Volume changes over time measured using SIENA and were modeled by a linear mixed-effects model.

At the end of the hockey season, BV was reduced compared to baseline by 0.32% (p<0.001) in the whole cohort and by 0.26% (p<0.01) in the concussed athletes. Two months after concussion, BV was reduced by 0.23% (p=0.016). No significant volume changes were found at 72 hours and two weeks after concussion, nor in the control group. Hockey players had on average 3.5 WMHI compared to 2.1 per control. WMHI were significantly (p < 0.001) closer to the cortical gray matter in hockey players (2.6 ± 2.6 mm) than in controls (5.2 ± 1.7 mm). Only 1 player had a microbleed at baseline that persisted throughout the study. 

The lack of increase in volume during the first two weeks after injury suggests that there is no edema related increase in brain volume. The significant brain volume reduction in both the concussed and non-concussed athletes at the end of the season suggests an association with playing hockey. WMHI were significantly closer to the nearest gray matter in hockey players compared to controls but greater number was not significantly associated with concussion. Microbleeds were uncommon.

A deeper understanding of the changes in brain volume and lesion load after concussion, as assessed by MRI, will help inform clinical interventions and return to play decisions. 

Rauscher, A, Jarrett, M, Shahinfard, E, Hernandez Torres, E, Zhao, Y, Dadachanji, S, Perera, W, Tam, R, Martin, N, Taunton, J, Li, D, Assessment of Brain Volume Changes, White Matter Hyperintensities and Microbleeds in Concussed Hockey Players Purpose .  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14019686.html