Assessment of the DTI ‐ ALPS Index in Adolescents With Sport‐Related Concussion

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: = 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.