Sports-related concussion (SRC) is sustained by millions of people per year, yet the spatiotemporal patterns of white matter (WM) injury remain poorly understood. Several SRC studies have implemented the standardised approach Tract-Based Spatial Statistics (TBSS). The aim of this image-based meta-analysis was to identify consensus patterns of SRC-related WM injury across TBSS studies. We included studies comparing the diffusion MRI measurement fractional anisotropy (FA) in SRC or subconcussive injury vs. controls using TBSS, as FA is the most frequently examined diffusion tensor imaging metric. Authors of eligible studies were contacted to request unthresholded statistical map outputs from TBSS, and image-based meta-analyses were performed using Seed-Based d-Mapping. Eight studies contributed to our meta-analyses, comprising 174 SRC or subconcussive injury participants and 160 controls. Our primary meta-analysis (n = 8), encompassing subjects with acute SRC (n = 2), chronic SRC (n = 4) and subconcussive injuries (n = 2) revealed dominant bilateral increased FA in the superior longitudinal fasciculus (SLF) and internal capsule. Subconcussive injury was associated with small clusters of increased and decreased FA in the arcuate fasciculus compared to control. In acute SRC, we found diffuse foci of raised FA at WM/grey matter border-zone associated with the bilateral SLF and right inferior fronto-occipital fasciculus. In contrast, chronic SRC had a pattern of deep WM alteration, asymmetrically located in the right optic radiations and arcuate fasciculus. Our findings represent the most powerful analysis of TBSS data in SRC, supporting the use of this approach to analyse diffusion data. TBSS is sensitive to WM abnormalities resulting from SRC or subconcussive injury over a range of temporal and clinical scenarios. Our data show spatially concordant patterns of WM injury unique to subconcussive, acute and chronic phases, highlighting the future utility of diffusion MRI for concussion diagnosis.

中文翻译：

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运动相关脑震荡中白质束损伤的特征模式：基于图像的荟萃分析。

与体育有关的脑震荡（SRC）每年由数百万人维持，但是对白质（WM）损伤的时空模式仍然知之甚少。几项SRC研究已经实施了基于行径的空间统计（TBSS）的标准化方法。这项基于图像的荟萃分析的目的是在整个TBSS研究中确定SRC相关WM损伤的共识模式。我们纳入的研究比较了SRC或脑震荡中的弥散MRI测量分数各向异性（FA）与使用TBSS的对照，因为FA是最常检查的弥散张量成像指标。与符合条件的研究的作者联系，要求TBSS提供无阈值的统计图输出，并使用基于种子的d-Mapping执行基于图像的荟萃分析。八项研究有助于我们进行荟萃分析，包括174名SRC或脑震荡损伤参与者和160名对照组。我们的主要荟萃分析（n = 8），包括患有急性SRC（n = 2），慢性SRC（n = 4）和脑震荡下损伤（n = 2）的受试者，显示上纵筋膜（SLF）的主要双侧FA升高。和内部胶囊。与对照组相比，脑震荡后损伤与弓状筋膜中FA增加和减少的小簇相关。在急性SRC中，我们发现与双侧SLF和右下额枕筋膜相关的WM /灰质边界区FA升高的弥散灶。相比之下，慢性SRC具有WM深度改变的模式，不对称地位于右视辐射和弓形束中。我们的发现代表了SRC中最强大的TBSS数据分析，支持使用这种方法来分析扩散数据。在一系列时间和临床情况下，TBSS对由SRC或脑震荡引起的WM异常敏感。我们的数据显示了在脑震荡，急性和慢性期独有的WM损伤的空间协调模式，突出了弥散MRI在脑震荡诊断中的未来应用。