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A systematic literature search identified 22 datasets with longitudinal diffusion magnetic resonance imaging data. Four datasets were centrally pooled to perform uniform quality control and data preprocessing. A total of 131 non\u2010concussed active athletes (American football, rugby, ice hockey; mean age: 20.06\u2009\u00b1\u20092.06\u2009years) with baseline and post\u2010season data were included. Nonparametric permutation inference (one\u2010sample <jats:italic>t<\/jats:italic> tests, one\u2010sided) was applied to analyze the difference maps of multiple diffusion parameters. The analyses revealed widespread lateralized patterns of sports\u2010season\u2010related increases and decreases in mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) across spatially distinct white matter regions. Increases were shown across one MD\u2010cluster (3195 voxels; mean change: 2.34%), one AD\u2010cluster (5740 voxels; mean change: 1.75%), and three RD\u2010clusters (817 total voxels; mean change: 3.11 to 4.70%). Decreases were shown across two MD\u2010clusters (1637 total voxels; mean change: \u22121.43 to \u22121.48%), two RD\u2010clusters (1240 total voxels; mean change: \u22121.92 to \u22121.93%), and one AD\u2010cluster (724 voxels; mean change: \u22121.28%). The resulting pattern implies the presence of strain\u2010induced injuries in central and brainstem regions, with comparatively milder physical exercise\u2010induced effects across frontal and superior regions of the left hemisphere, which need further investigation. This article highlights key considerations that need to be addressed in future work to enhance our understanding of the nature of observed white matter changes, improve the comparability of findings across studies, and promote data pooling initiatives to allow more detailed investigations (e.g., exploring sex\u2010 and sport\u2010specific effects).<\/jats:p>","DOI":"10.1002\/hbm.26811","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T10:30:11Z","timestamp":1724668211000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Uncovering the hidden effects of repetitive subconcussive head impact exposure: A mega\u2010analytic approach characterizing seasonal brain microstructural changes in contact and collision sports athletes"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6296-0718","authenticated-orcid":false,"given":"Anna","family":"Kwiatkowski","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty RWTH Aachen University  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Weidler","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty RWTH Aachen University  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ute","family":"Habel","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty RWTH Aachen University  Aachen Germany"},{"name":"Institute of Neuroscience and Medicine 10, Research Centre J\u00fclich  J\u00fclich Germany"},{"name":"JARA\u2010BRAIN Institute Brain Structure Function Relationship, Research Center J\u00fclich and RWTH Aachen University  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole S.","family":"Coverdale","sequence":"additional","affiliation":[{"name":"Centre for Neuroscience Studies, Queen's University  Kingston Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan A.","family":"Hirad","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Rochester Medical Center  Rochester New York USA"},{"name":"Department of Neuroscience University of Rochester Medical Center  Rochester New York USA"},{"name":"Del Monte Neuroscience Institute, University of Rochester  New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn Y.","family":"Manning","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Calgary and Alberta Children's Hospital Research Institute  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Rauscher","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine University of British Columbia  Vancouver British Columbia Canada"},{"name":"Department of Pediatrics, Division of Neurology University of British Columbia  Vancouver British Columbia Canada"},{"name":"Department of Physics and Astronomy University of British Columbia  Vancouver British Columbia Canada"},{"name":"UBC MRI Research Centre, University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey J.","family":"Bazarian","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Rochester School of Medicine and Dentistry  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas J.","family":"Cook","sequence":"additional","affiliation":[{"name":"Centre for Neuroscience Studies, Queen's University  Kingston Ontario Canada"},{"name":"Division of Neurosurgery, Department of Surgery Queen's University  Kingston Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David K. 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