Concussion related to white matter abnormalities and cognitive dysfunction in aging athletes.

T he incidence and consequences of concussion among athletes have comeunder intense scrutiny in the setting of the untimely deaths of several notable professional athletes. Brain injury in its most severe forms has been exhaustively studied, butwehave onlybegun to scratch the surface of our understanding of milder injuries.Historically, these types of injuries have been difficult to study because patients did not frequently come to medical attention and there were no meaningful imaging correlates that confirmed the diagnosis. The acute and subacute side effects of concussion in young athletes include cognitive and psychiatric disorders, and concussive injuries have been linked to pathological findings of thewhitematter of the brain associated with aging and neurodegenerative conditions. Recently, advanced magnetic resonance imaging techniques like diffusion tensor imaging (DTI) have been used to detect white matter abnormalities after concussive injuries. Tremblay et al used these techniques to explore one of the more vexing questions in concussion research: What are the long-term consequences in older individuals with a history of concussion? To examine for even the subtlest of abnormalities, the investigators recruited 15 clinically normal, former university-level football and hockey players with a mean age of 60 who had a history of sports-related concussion. None of these individuals had other meaningful medical or psychiatric problems, and they had suffered