The November 14, 2012 on-line issue of the Journal of the American Medical Association (JAMA) contained a research letter authored by Inga Coerte, M.D., Birgit Ertl-Wagner, M.D., Maximilian Reiser, M.D., Ross Zafonte, D.O., and Martha E. Shenton, Ph.D. from Harvard University.

The researchers, interested in whether frequent sub concussive blows to the head in soccer players could lead to traumatic brain injury, evaluated concussion-naïve soccer players using high resolution DTI, which “is highly sensitive for detecting alterations in white matter architecture.” The researchers utilized forty soccer players, all right handed males, from two training groups of an elite-level soccer club in Germany.  All had been trained since childhood for a career in professional soccer.  A comparison cohort of swimmers was recruited from competitive clubs to match on age, handedness, and sex.  Those with a prior history of concussion or any other neuropsychiatric disorders were excluded. 

The researchers utilized diffusion tensor imaging (DTI).  Wide differences between groups were found with increase radial diffusivity in soccer players.  The researchers commented that “this study found differences in white matter integrity in a small sample of soccer players compared with swimmers.  Although only participants without previous symptomatic concussion were included, advanced DTI revealed widespread increase in radial diffusivity in soccer players, consistent with findings observed in patients with mild traumatic brain injury and suggesting possible demyelination.” 

This demonstrates that DTI is being used in the diagnosis and research of persons with mild traumatic brain injury. This is further support for the use  and the admissibility of DTI in trial of patients with mTBI.