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The association between white-matter tract abnormalities, and neuropsychiatric and cognitive symptoms in retired professional football players with multiple concussions

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An Erratum to this article was published on 01 June 2016

Abstract

Retired professional athletes, who have suffered repetitive concussions, report symptoms of depression, anxiety, and memory impairment over time. Moreover, recent imaging data suggest chronic white-matter tract deterioration in sport-related concussion. The aim of this study is to evaluate the impact of repetitive concussions in retired professional football players on white-matter tracts, and relate these changes to neuropsychological function. All subjects (18 retired professional football players and 17 healthy controls) underwent imaging, neuropsychological assessment, and reported on concussion-related symptoms. Whole brain tract-based spatial statistics analysis revealed increased axial diffusivity in the right hemisphere of retired players in the (1) superior longitudinal fasciculus (SLF), (2) corticospinal tract, and (3) anterior thalamic radiations, suggesting chronic axonal degeneration in these tracts. Moreover, retired players report significantly higher neuropsychiatric and cognitive symptoms than healthy controls, and worsening of these symptoms since their last concussion. Loss of integrity in the right SLF significantly correlated with participants’ visual learning ability. In sum, these results suggest that repetitive concussions in retired professional football players are associated with focal white-matter tract abnormalities that could explain some of the neuropsychiatric symptoms and cognitive deficits experienced by these retired athletes.

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Acknowledgments

We thank all the participants for their contribution to our study. We thank E. Hlasny and Dr. A. Crawley for their support in image acquisition.

Author information

Authors and Affiliations

  1. Canadian Sports Concussion Project, Memory Clinic, Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Disease, 399 Bathurst St., West Wing 5-449, Toronto, ON, M5T 2S8, Canada

    Namita Multani, Ruma Goswami, Mozhgan Khodadadi, Ahmed Ebraheem, Karen D. Davis, Charles H. Tator, Richard Wennberg, David J. Mikulis, Leo Ezerins & Maria Carmela Tartaglia

  2. Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, 60 Leonard Avenue, Toronto, ON, M5T 2S8, Canada

    Namita Multani & Maria Carmela Tartaglia

  3. Division of Brain, Imaging and Behaviour-Systems Neuroscience, Toronto Western Hospital, Toronto Western Research Institute, University Health Network, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada

    Ruma Goswami, Karen D. Davis, Charles H. Tator & David J. Mikulis

  4. Institute of Medical Science, University of Toronto, 1 King’s College Circle, Toronto, ON, M5S 1A8, Canada

    Karen D. Davis, Charles H. Tator & David J. Mikulis

  5. Department of Surgery, University of Toronto, 149 College Street, Toronto, ON, M5T 1P5, Canada

    Karen D. Davis & Charles H. Tator

  6. Division of Neurosurgery, Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada

    Charles H. Tator

  7. Division of Neurology, Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada

    Namita Multani, Richard Wennberg & Maria Carmela Tartaglia

  8. Department of Medical Imaging, Toronto Western Hospital, University Health Network, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada

    David J. Mikulis

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  1. Namita Multani
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  2. Ruma Goswami
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  4. Ahmed Ebraheem
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  5. Karen D. Davis
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  10. Maria Carmela Tartaglia
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Correspondence to Maria Carmela Tartaglia.

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PSI Foundation and the Canadian Sports Concussion Project, Krembil Neuroscience Centre, Toronto Western Hospital (Toronto General & Western Hospital Foundation).

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standards

The study procedures were approved by the University Health Network Research Ethics Board and were performed in accordance with the ethical principles and guidelines for the protection of human subjects of research.

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Multani, N., Goswami, R., Khodadadi, M. et al. The association between white-matter tract abnormalities, and neuropsychiatric and cognitive symptoms in retired professional football players with multiple concussions. J Neurol 263, 1332–1341 (2016). https://doi.org/10.1007/s00415-016-8141-0

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