ABSTRACT Background Sport‐related concussion (SRC) can be associated with glymphatic system dysfunction that may be assessed using the diffusion tensor imaging along the perivascular space (DTI‐ALPS) index. Here, DTI‐ALPS between adolescent athletes within 10 days of SRC and after recovery with control adolescents are compared, and associations between the DTI‐ALPS and clinical outcomes are explored. Study Type Prospective case control. Population Thirty‐five SRC participants (diagnosed according to the 5th International Conference on Concussion in Sport guidelines; 42.9% female, mean age 15.31 years) and 34 controls (44.1% female, mean age 15.79 years). Field Strength/Sequence 3D DTI using an echo‐planar imaging sequence at 3T. Assessment MRI, self‐report questionnaires, and a physical examination were conducted within 10 days of SRC (at recruitment for controls) and 2 weeks after clinical recovery (1 month for controls). The physical examination consisted of balance and vision assessments, including near‐point convergence. Mean, left, and right DTI‐ALPS were calculated and compared between groups and visits. Statistical Tests Independent and paired t‐tests assessed group DTI‐ALPS indices at Visit 1 and Visit 2 and between visits, respectively. A p value of < 0.05 was significant. Linear regressions assessed associations between DTI‐ALPS and demographic/clinical variables. A Bonferroni‐corrected p value of < 0.0167 was significant. Groups did not differ significantly at Visit 1 for mean, left, or right ( p = 0.843, 0.533, 0.744) DTI‐ALPS or at Visit 2 (mean p = 0.827, left p = 0.706, right p = 0.992). There were no significant changes between visits for the SRC (mean p = 0.946, left p = 0.787, right p = 0.888) or control groups (mean p = 0.777, left p = 0.791, right p = 0.813). Near‐point convergence and right DTI‐ALPS were significantly associated in the SRC group at Visit 1, but significance was not retained after correction ( p = 0.040, beta = 0.111, R 2 = 0.137). Data Conclusion The DTI‐ALPS index may not be an indicator of glymphatic dysfunction in adolescent athletes within 10 days of SRC. Evidence Level 2. Technical Efficacy Stage 2.
Castro et al. (Wed,) studied this question.