About DTI DTI helps to measure structural damage to the brain by helping doctors look at a part of a neuron called an axon. Axons are like power lines of a nerve cell. Whenever a neuron fires, it transmits an electrical signal down these wires so that it can pass the message along to the next neuron in the chain. DTI measures the continuous movement of water through these “wires”.

The resulting image is actually something quite beautiful and remarkable to see. Almost like something you can hang in an art exhibition as you can see below:

One of the things that has been well established is that concussions can damage a lot of the axons in the brain through a process called axonal shearing. It’s basically like a hurricane coming in and knocking down your town’s power lines.

When these axons get damaged, that beautiful DTI image that you saw before hand will start to show some gaps like you see below:

Back to Football and Young Brains

So we know that concussions definitely cause axonal injury, but what about all those hits to the head that happen without a concussion? Could they also damage these axons?

According to these 2 recent studies, a year of youth or high school football can make observable changes in the structure of the brain.

The studies also showed that the players who had impacts that were more frequent or more forceful correlated with greater signs of damage.

In high school athletes, the researchers also measured functional changes in the brain and showed that players with greater or more frequent impact showed decreased delta wave activity which is a characteristic sign of brain injury.

So far, not so good.

Imaging Is Not A Death Sentence

So before we draw any conclusions, let’s talk about 2 things.

1. 1st these were small studies looking at 1 year of football. Bigger studies and longer studies are needed to make stronger conclusions
2. 2nd I’ve frequently talked about how you are not your imaging findings. You can look at that article here:
3. You Are Not Your MRI Results: A Guide to Living Beyond a Diagnosis

While we know that these DTI findings are related to concussion and head impact diagnosis, we have no idea if this means anything for the health and quality of life of the patient in the future.

Findings on DTI are NOT predictive of how impaired a patient is, nor does it predict if a patient will have future brain damage or post concussion syndrome. In fact, findings on DTI don’t predict all that much at this point in time.

Obviously we prefer that brains don’t suffer any damage at all, but we do know this:

Most people who suffer head impact and concussions will go on to live normal healthy lives.

Now it’s up to science to figure out how much can someone’s brain take, and how do we take care of these people who are at risk for future brain disease.