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Research ArticleBRAIN

Increased Diffusion in the Brain of Professional Boxers: A Preclinical Sign of Traumatic Brain Injury?

Lijuan Zhang, Lisa D. Ravdin, Norman Relkin, Robert D. Zimmerman, Barry Jordan, William E. Lathan and Aziz M. Uluğ
American Journal of Neuroradiology January 2003, 24 (1) 52-57;
Lijuan Zhang
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Lisa D. Ravdin
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Norman Relkin
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Robert D. Zimmerman
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Barry Jordan
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William E. Lathan
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Aziz M. Uluğ
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  • Fig 1.
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    Fig 1.

    Normalized brain diffusion distribution histograms in a control subject and a boxer (case 15). The areas under the two curves are the same. The Dav data (dots and circles) are fitted with a triple Gaussian function to represent the two-compartment nature and the mixing between the two compartments (lines). The narrow peak represents the distribution of the brain tissue about its mean. The second and the third compartments have a broader distribution. The mean of the brain tissue pixel distribution is recognized as a mean diffusion constant for the entire brain (BDav). The distribution width (σ) of the brain tissue compartment is also recorded. The fitted curve of the boxer (circles) shifts to the right as compared with the curve of the control subject (dots). The second compartment level of the boxer’s curve is higher than that of the control subject.

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    Fig 2.

    BDav versus σ for boxers and control subjects: Overall, the boxer group shows elevated BDav and σ.

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    Fig 3.

    Representative images of MR findings in boxers: A, Cavum septum pellucidum (case 14); B, nonspecific periventricular white matter disease (case 22); and C, mild subcortical white matter demyelination (case 21).

Tables

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    TABLE 1:

    Comparison of diffusion values and MR findings in boxers

    Case (No.)Age (y)BDavσMR Findings
    120.840.75620.1980Normal
    222.520.75020.2245Left minimal hippocampal atrophy, otherwise normal
    324.680.79330.1861Volume loss, CSP
    426.000.76370.1672CSP, mild atrophy, non-specific SWM
    526.510.76220.2419Normal
    627.040.73720.1558Normal
    727.090.75900.1795Normal
    827.710.76130.1812Normal
    927.720.74860.1667Normal
    1030.000.75800.2048Normal
    1130.070.74970.1984CSP, nonspecific SWM
    1230.170.75860.1655Nonspecific SWM in left frontal lobe
    1332.290.79200.2564Mild volume loss inappropriate to age
    1433.640.78280.2376CSP, SWM, mild volume loss
    1533.720.79470.2061Normal
    1634.130.78420.2655CSP
    1735.140.74440.1695Normal
    1836.100.74390.1526Normal
    1936.120.73370.1606Cerebellar atrophy, mild non-specific PWMD
    2038.050.75840.1711Atrophy in left inferior cerebella, mild dilatation of sulci
    2138.520.75220.1759Nonspecific SWM, atrophy inappropriate to age
    2240.000.74690.2397PWMD
    2342.920.73550.1979Normal
    2453.090.77860.1909Normal
    • Note.—CSP indicates cavum septum pellucidum; PWMD, nonspecific periventricular white matter disease; and SWM, subcortical white matter disease.

    • View popup
    TABLE 2:

    Distributions of BDav and σ in boxer group versus those in control group

    Age (y)BDav (10−5 cm2/s)σ (10−5 cm2/s)
    Boxers32.3 ± 7.2*0.760 ± 0.018*0.197 ± 0.033*
    Control subjects32.2 ± 7.3*0.732 ± 0.013*0.173 ± 0.014*
    Increase (%)0.33.6812.18
    SignificanceP > .05P < .0001P < .01
    • * Mean ± SD.

    • View popup
    TABLE 3:

    MR findings in boxers

    Premature Volume LossCSPPWMDSWMNormal
    Number (n)852413
    Percentage33.3%20.8%8.3%16.7%54.2%
    • Note.—Some boxers had more than one positive finding. CSP indicates cavum septum pellucidum; PWMD, nonspecific periventricular white matter disease; and SWM, subcortical white matter disease.

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American Journal of Neuroradiology: 24 (1)
American Journal of Neuroradiology
Vol. 24, Issue 1
1 Jan 2003
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Cite this article
Lijuan Zhang, Lisa D. Ravdin, Norman Relkin, Robert D. Zimmerman, Barry Jordan, William E. Lathan, Aziz M. Uluğ
Increased Diffusion in the Brain of Professional Boxers: A Preclinical Sign of Traumatic Brain Injury?
American Journal of Neuroradiology Jan 2003, 24 (1) 52-57;

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Increased Diffusion in the Brain of Professional Boxers: A Preclinical Sign of Traumatic Brain Injury?
Lijuan Zhang, Lisa D. Ravdin, Norman Relkin, Robert D. Zimmerman, Barry Jordan, William E. Lathan, Aziz M. Uluğ
American Journal of Neuroradiology Jan 2003, 24 (1) 52-57;
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