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Wan Y, González-Cruz RD, Hoffman-Kim D, Kesari H. A mechanics theory for the exploration of a high-throughput, sterile 3D in vitro traumatic brain injury model. Biomech Model Mechanobiol 2024; 23:1179-1196. [PMID: 38970736 DOI: 10.1007/s10237-024-01832-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 02/19/2024] [Indexed: 07/08/2024]
Abstract
Brain injuries resulting from mechanical trauma represent an ongoing global public health issue. Several in vitro and in vivo models for traumatic brain injury (TBI) continue to be developed for delineating the various complex pathophysiological processes involved in its onset and progression. Developing an in vitro TBI model that is based on cortical spheroids is especially of great interest currently because they can replicate key aspects of in vivo brain tissue, including its electrophysiology, physicochemical microenvironment, and extracellular matrix composition. Being able to mechanically deform the spheroids are a key requirement in any effective in vitro TBI model. The spheroids' shape and size, however, make mechanically loading them, especially in a high-throughput, sterile, and reproducible manner, quite challenging. To address this challenge, we present an idea for a spheroid-based, in vitro TBI model in which the spheroids are mechanically loaded by being spun by a centrifuge. (An experimental demonstration of this new idea will be published shortly elsewhere.) An issue that can limit its utility and scope is that imaging techniques used in 2D and 3D in vitro TBI models cannot be readily applied in it to determine spheroid strains. In order to address this issue, we developed a continuum mechanics-based theory to estimate the spheroids' strains when they are being spun at a constant angular velocity. The mechanics theory, while applicable here to a special case of the centrifuge-based TBI model, is also of general value since it can help with the further exploration and development of TBI models.
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Affiliation(s)
- Yang Wan
- School of Engineering, Brown University, Providence, RI, 02912, USA
| | - Rafael D González-Cruz
- Department of Neuroscience, Brown University, Providence, RI, 02912, USA
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI, 02906, USA
| | - Diane Hoffman-Kim
- Department of Neuroscience, Brown University, Providence, RI, 02912, USA
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI, 02906, USA
- Center for Biomedical Engineering, Brown University, Providence, RI, 02912, USA
| | - Haneesh Kesari
- School of Engineering, Brown University, Providence, RI, 02912, USA.
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Dogra S, Arabshahi S, Wei J, Saidenberg L, Kang SK, Chung S, Laine A, Lui YW. Functional Connectivity Changes on Resting-State fMRI after Mild Traumatic Brain Injury: A Systematic Review. AJNR Am J Neuroradiol 2024; 45:795-801. [PMID: 38637022 PMCID: PMC11288594 DOI: 10.3174/ajnr.a8204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/22/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Mild traumatic brain injury is theorized to cause widespread functional changes to the brain. Resting-state fMRI may be able to measure functional connectivity changes after traumatic brain injury, but resting-state fMRI studies are heterogeneous, using numerous techniques to study ROIs across various resting-state networks. PURPOSE We systematically reviewed the literature to ascertain whether adult patients who have experienced mild traumatic brain injury show consistent functional connectivity changes on resting-state -fMRI, compared with healthy patients. DATA SOURCES We used 5 databases (PubMed, EMBASE, Cochrane Central, Scopus, Web of Science). STUDY SELECTION Five databases (PubMed, EMBASE, Cochrane Central, Scopus, and Web of Science) were searched for research published since 2010. Search strategies used keywords of "functional MR imaging" and "mild traumatic brain injury" as well as related terms. All results were screened at the abstract and title levels by 4 reviewers according to predefined inclusion and exclusion criteria. For full-text inclusion, each study was evaluated independently by 2 reviewers, with discordant screening settled by consensus. DATA ANALYSIS Data regarding article characteristics, cohort demographics, fMRI scan parameters, data analysis processing software, atlas used, data characteristics, and statistical analysis information were extracted. DATA SYNTHESIS Across 66 studies, 80 areas were analyzed 239 times for at least 1 time point, most commonly using independent component analysis. The most analyzed areas and networks were the whole brain, the default mode network, and the salience network. Reported functional connectivity changes varied, though there may be a slight trend toward decreased whole-brain functional connectivity within 1 month of traumatic brain injury and there may be differences based on the time since injury. LIMITATIONS Studies of military, sports-related traumatic brain injury, and pediatric patients were excluded. Due to the high number of relevant studies and data heterogeneity, we could not be as granular in the analysis as we would have liked. CONCLUSIONS Reported functional connectivity changes varied, even within the same region and network, at least partially reflecting differences in technical parameters, preprocessing software, and analysis methods as well as probable differences in individual injury. There is a need for novel rs-fMRI techniques that better capture subject-specific functional connectivity changes.
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Affiliation(s)
- Siddhant Dogra
- From the Department of Radiology (S.D., J.W., S.K.K., S.C., Y.L.), New York University Grossman School of Medicine, New York, New York
| | - Soroush Arabshahi
- Department of Biomedical Engineering (S.A., A.L.), Department of Radiology, Columbia University, New York, New York
| | - Jason Wei
- From the Department of Radiology (S.D., J.W., S.K.K., S.C., Y.L.), New York University Grossman School of Medicine, New York, New York
| | - Lucia Saidenberg
- Department of Neurology (L.S.), Department of Radiology. New York University Grossman School of Medicine, New York, New York
| | - Stella K Kang
- From the Department of Radiology (S.D., J.W., S.K.K., S.C., Y.L.), New York University Grossman School of Medicine, New York, New York
| | - Sohae Chung
- From the Department of Radiology (S.D., J.W., S.K.K., S.C., Y.L.), New York University Grossman School of Medicine, New York, New York
| | - Andrew Laine
- Department of Biomedical Engineering (S.A., A.L.), Department of Radiology, Columbia University, New York, New York
| | - Yvonne W Lui
- From the Department of Radiology (S.D., J.W., S.K.K., S.C., Y.L.), New York University Grossman School of Medicine, New York, New York
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Ruiz T, Brown S, Farivar R. Graph Analysis of the Visual Cortical Network during Naturalistic Movie Viewing Reveals Increased Integration and Decreased Segregation Following Mild TBI. Vision (Basel) 2024; 8:33. [PMID: 38804354 PMCID: PMC11130927 DOI: 10.3390/vision8020033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/03/2024] [Accepted: 04/18/2024] [Indexed: 05/29/2024] Open
Abstract
Traditional neuroimaging methods have identified alterations in brain activity patterns following mild traumatic brain injury (mTBI), particularly during rest, complex tasks, and normal vision. However, studies using graph theory to examine brain network changes in mTBI have produced varied results, influenced by the specific networks and task demands analyzed. In our study, we employed functional MRI to observe 17 mTBI patients and 54 healthy individuals as they viewed a simple, non-narrative underwater film, simulating everyday visual tasks. This approach revealed significant mTBI-related changes in network connectivity, efficiency, and organization. Specifically, the mTBI group exhibited higher overall connectivity and local network specialization, suggesting enhanced information integration without overwhelming the brain's processing capabilities. Conversely, these patients showed reduced network segregation, indicating a less compartmentalized brain function compared to healthy controls. These patterns were consistent across various visual cortex subnetworks, except in primary visual areas. Our findings highlight the potential of using naturalistic stimuli in graph-based neuroimaging to understand brain network alterations in mTBI and possibly other conditions affecting brain integration.
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Affiliation(s)
- Tatiana Ruiz
- Department of Ophthalmology & Visual Sciences, McGill University, Montreal, QC H4A 0A4, Canada (S.B.)
- Research Institute of the McGill University Health Center, Montreal, QC H3G 1A4, Canada
| | - Shael Brown
- Department of Ophthalmology & Visual Sciences, McGill University, Montreal, QC H4A 0A4, Canada (S.B.)
- Research Institute of the McGill University Health Center, Montreal, QC H3G 1A4, Canada
| | - Reza Farivar
- Department of Ophthalmology & Visual Sciences, McGill University, Montreal, QC H4A 0A4, Canada (S.B.)
- Research Institute of the McGill University Health Center, Montreal, QC H3G 1A4, Canada
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Tefr Faridová A, Heřman H, Danačíková Š, Svoboda J, Otáhal J. Serum biomarkers of hypoxic-ischemic brain injury. Physiol Res 2023; 72:S461-S474. [PMID: 38165751 PMCID: PMC10861251 DOI: 10.33549/physiolres.935214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Brain injury is a multifaceted condition arising from nonspecific damage to nervous tissue. The resulting cognitive developmental impairments reverberate through patients' lives, affecting their families, and even the broader economic landscape. The significance of early brain injury detection lies in its potential to stave off severe consequences and enhance the effectiveness of tailored therapeutic interventions. While established methods like neuroimaging and neurophysiology serve as valuable diagnostic tools, their demanding nature restricts their accessibility, particularly in scenarios such as small hospitals, nocturnal or weekend shifts, and cases involving unstable patients. Hence, there is a pressing need for more accessible and efficient diagnostic avenues. Among the spectrum of brain injuries, hypoxic-ischemic encephalopathy stands out as a predominant affliction in the pediatric population. Diagnosing brain injuries in newborns presents challenges due to the subjective nature of assessments like Apgar scores and the inherent uncertainty in neurological examinations. In this context, methods like magnetic resonance and ultrasound hold recommendations for more accurate diagnosis. Recognizing the potential of serum biomarkers derived from blood samples, this paper underscores their promise as a more expedient and resource-efficient means of assessing brain injuries. The review compiles current insights into serum biomarkers, drawing from experiments conducted on animal models as well as human brain pathologies. The authors aim to elucidate specific characteristics, temporal profiles, and the available corpus of experimental and clinical data for serum biomarkers specific to brain injuries. These include neuron-specific enolase (NSE), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), S100 calcium-binding protein beta (S100B), glial fibrillary acidic protein (GFAP), and high-mobility-group-protein-box-1 (HMGB1). This comprehensive endeavor contributes to advancing the understanding of brain injury diagnostics and potential avenues for therapeutic intervention.
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Affiliation(s)
- A Tefr Faridová
- A. Tefr Faridová, Department of Pathophysiology, Second Faculty of Medicine, Charles University, Prague 5, Czech Republic. and
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Ekdahl N, Möller MC, Deboussard CN, Stålnacke BM, Lannsjö M, Nordin LE. Investigating cognitive reserve, symptom resolution and brain connectivity in mild traumatic brain injury. BMC Neurol 2023; 23:450. [PMID: 38124076 PMCID: PMC10731820 DOI: 10.1186/s12883-023-03509-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND A proportion of patients with mild traumatic brain injury (mTBI) suffer long-term consequences, and the reasons behind this are still poorly understood. One factor that may affect outcomes is cognitive reserve, which is the brain's ability to maintain cognitive function despite injury. It is often assessed through educational level or premorbid IQ tests. This study aimed to explore whether there were differences in post-concussion symptoms and symptom resolution between patients with mTBI and minor orthopedic injuries one week and three months after injury. Additional aims were to explore the relationship between cognitive reserve and outcome, as well as functional connectivity according to resting state functional magnetic resonance imaging (rs-fMRI). METHOD Fifteen patients with mTBI and 15 controls with minor orthopedic injuries were recruited from the emergency department. Assessments, including Rivermead Post-Concussion Questionnaire (RPQ), neuropsychological testing, and rs-fMRI scans, were conducted on average 7 days (SD = 2) and 122 days (SD = 51) after injury. RESULTS At the first time point, significantly higher rates of post-concussion symptoms (U = 40.0, p = 0.003), state fatigue (U = 56.5, p = 0.014), and fatigability (U = 58.5, p = 0.025) were observed among the mTBI group than among the controls. However, after three months, only the difference in post-concussion symptoms remained significant (U = 27.0, p = 0.003). Improvement in post-concussion symptoms was found to be significantly correlated with cognitive reserve, but only in the mTBI group (Spearman's rho = -0.579, p = .038). Differences in the trajectory of recovery were also observed for fatigability between the two groups (U = 36.5, p = 0.015). Moreover, functional connectivity differences in the frontoparietal network were observed between the groups, and for mTBI patients, functional connectivity differences in an executive control network were observed over time. CONCLUSION The findings of this pilot study suggest that mTBI, compared to minor orthopedic trauma, is associated to both functional connectivity changes in the brain and concussion-related symptoms. While there is improvement in these symptoms over time, a small subgroup with lower cognitive reserve appears to experience more persistent and possibly worsening symptoms over time. This, however, needs to be validated in larger studies. TRIAL REGISTRATION NCT05593172. Retrospectively registered.
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Affiliation(s)
- Natascha Ekdahl
- Centre for Research and Development, Uppsala University/ County Council of Gävleborg, Gävle, Sweden.
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - Marika C Möller
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Catharina Nygren Deboussard
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Britt-Marie Stålnacke
- Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden
| | - Marianne Lannsjö
- Centre for Research and Development, Uppsala University/ County Council of Gävleborg, Gävle, Sweden
- Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden
| | - Love Engström Nordin
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
- Department of Diagnostic Medical Physics, Karolinska Institutet, Stockholm, Sweden
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Sultana T, Hasan MA, Kang X, Liou-Johnson V, Adamson MM, Razi A. Neural mechanisms of emotional health in traumatic brain injury patients undergoing rTMS treatment. Mol Psychiatry 2023; 28:5150-5158. [PMID: 37414927 DOI: 10.1038/s41380-023-02159-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 07/08/2023]
Abstract
Emotional dysregulation such as that seen in depression, are a long-term consequence of mild traumatic brain injury (TBI), that can be improved by using neuromodulation treatments such as repetitive transcranial magnetic stimulation (rTMS). Previous studies provide insights into the changes in functional connectivity related to general emotional health after the application of rTMS procedures in patients with TBI. However, these studies provide little understanding of the underlying neuronal mechanisms that drive the improvement of the emotional health in these patients. The current study focuses on inferring the effective (causal) connectivity changes and their association with emotional health, after rTMS treatment of cognitive problems in TBI patients (N = 32). Specifically, we used resting state functional magnetic resonance imaging (fMRI) together with spectral dynamic causal model (spDCM) to investigate changes in brain effective connectivity, before and after the application of high frequency (10 Hz) rTMS over left dorsolateral prefrontal cortex. We investigated the effective connectivity of the cortico-limbic network comprised of 11 regions of interest (ROIs) which are part of the default mode, salience, and executive control networks, known to be implicated in emotional processing. The results indicate that overall, among extrinsic connections, the strength of excitatory connections decreased while that of inhibitory connections increased after the neuromodulation. The cardinal region in the analysis was dorsal anterior cingulate cortex (dACC) which is considered to be the most influenced during emotional health disorders. Our findings implicate the altered connectivity of dACC with left anterior insula and medial prefrontal cortex, after the application of rTMS, as a potential neural mechanism underlying improvement of emotional health. Our investigation highlights the importance of these brain regions as treatment targets in emotional processing in TBI.
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Affiliation(s)
- Tajwar Sultana
- Department of Computer and Information Systems Engineering, NED University of Engineering & Technology, Karachi, 75270, Pakistan
- Department of Biomedical Engineering, NED University of Engineering & Technology, Karachi, 75270, Pakistan
- Neurocomputation Laboratory, National Centre of Artificial Intelligence, Peshawar, Pakistan
| | - Muhammad Abul Hasan
- Department of Biomedical Engineering, NED University of Engineering & Technology, Karachi, 75270, Pakistan
- Neurocomputation Laboratory, National Centre of Artificial Intelligence, Peshawar, Pakistan
| | - Xiaojian Kang
- WRIISC-WOMEN, VA Palo Alto Healthcare System, Palo Alto, CA, 94304, USA
- Rehabilitation Service, Veterans Affairs Palo Alto Healthcare System (VAPAHCS), 3801 Miranda Avenue, Palo Alto, CA, 94304, USA
| | - Victoria Liou-Johnson
- Rehabilitation Service, Veterans Affairs Palo Alto Healthcare System (VAPAHCS), 3801 Miranda Avenue, Palo Alto, CA, 94304, USA
- Clinical Excellence Research Center, Stanford University School of Medicine, Stanford, CA, 94304, USA
| | - Maheen Mausoof Adamson
- WRIISC-WOMEN, VA Palo Alto Healthcare System, Palo Alto, CA, 94304, USA
- Rehabilitation Service, Veterans Affairs Palo Alto Healthcare System (VAPAHCS), 3801 Miranda Avenue, Palo Alto, CA, 94304, USA
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, 94304, USA
| | - Adeel Razi
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, 3800, Australia.
- Wellcome Centre for Human Neuroimaging, University College London, WC1N 3AR, London, United Kingdom.
- CIFAR Azrieli Global Scholars Program, CIFAR, Toronto, ON, Canada.
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Neumann KD, Broshek DK, Newman BT, Druzgal TJ, Kundu BK, Resch JE. Concussion: Beyond the Cascade. Cells 2023; 12:2128. [PMID: 37681861 PMCID: PMC10487087 DOI: 10.3390/cells12172128] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 09/09/2023] Open
Abstract
Sport concussion affects millions of athletes each year at all levels of sport. Increasing evidence demonstrates clinical and physiological recovery are becoming more divergent definitions, as evidenced by several studies examining blood-based biomarkers of inflammation and imaging studies of the central nervous system (CNS). Recent studies have shown elevated microglial activation in the CNS in active and retired American football players, as well as in active collegiate athletes who were diagnosed with a concussion and returned to sport. These data are supportive of discordance in clinical symptomology and the inflammatory response in the CNS upon symptom resolution. In this review, we will summarize recent advances in the understanding of the inflammatory response associated with sport concussion and broader mild traumatic brain injury, as well as provide an outlook for important research questions to better align clinical and physiological recovery.
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Affiliation(s)
- Kiel D. Neumann
- Department of Diagnostic Imaging, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA;
| | - Donna K. Broshek
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22903, USA;
| | - Benjamin T. Newman
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA 22903, USA; (B.T.N.); (T.J.D.); (B.K.K.)
| | - T. Jason Druzgal
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA 22903, USA; (B.T.N.); (T.J.D.); (B.K.K.)
| | - Bijoy K. Kundu
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA 22903, USA; (B.T.N.); (T.J.D.); (B.K.K.)
| | - Jacob E. Resch
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22903, USA
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Esopenko C, Sollmann N, Bonke EM, Wiegand TLT, Heinen F, de Souza NL, Breedlove KM, Shenton ME, Lin AP, Koerte IK. Current and Emerging Techniques in Neuroimaging of Sport-Related Concussion. J Clin Neurophysiol 2023; 40:398-407. [PMID: 36930218 PMCID: PMC10329721 DOI: 10.1097/wnp.0000000000000864] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
SUMMARY Sport-related concussion (SRC) affects an estimated 1.6 to 3.8 million Americans each year. Sport-related concussion results from biomechanical forces to the head or neck that lead to a broad range of neurologic symptoms and impaired cognitive function. Although most individuals recover within weeks, some develop chronic symptoms. The heterogeneity of both the clinical presentation and the underlying brain injury profile make SRC a challenging condition. Adding to this challenge, there is also a lack of objective and reliable biomarkers to support diagnosis, to inform clinical decision making, and to monitor recovery after SRC. In this review, the authors provide an overview of advanced neuroimaging techniques that provide the sensitivity needed to capture subtle changes in brain structure, metabolism, function, and perfusion after SRC. This is followed by a discussion of emerging neuroimaging techniques, as well as current efforts of international research consortia committed to the study of SRC. Finally, the authors emphasize the need for advanced multimodal neuroimaging to develop objective biomarkers that will inform targeted treatment strategies after SRC.
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Affiliation(s)
- Carrie Esopenko
- Department of Rehabilitation and Movement Sciences, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
| | - Nico Sollmann
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Elena M. Bonke
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
- Graduate School of Systemic Neurosciences, Ludwig-Maximilians-Universität, Munich, Germany
| | - Tim L. T. Wiegand
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Felicitas Heinen
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Nicola L. de Souza
- School of Graduate Studies, Biomedical Sciences, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
| | - Katherine M. Breedlove
- Center for Clinical Spectroscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Martha E. Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | - Alexander P. Lin
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Center for Clinical Spectroscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Inga K. Koerte
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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Sheppard DP, Rau HK, Trittschuh EH, Werhane ML, Schindler AG, Hendrickson RC, Peskind ER, Pagulayan KF. Poorer prospective memory performance is associated with reduced time monitoring among OEF/OIF/OND Veterans with a history of blast-related mild traumatic brain injury. Clin Neuropsychol 2023; 37:577-594. [PMID: 35689397 DOI: 10.1080/13854046.2022.2068455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective:Prospective memory (PM) or "remembering to remember" has been shown to be reduced in Veterans with histories of mild traumatic brain injury (mTBI), particularly on tasks with high strategic demands such as recalling time-based information in the absence of external cues. This study examined whether time monitoring during a PM task was reduced in Veterans with a history of mTBI and was associated with time-based PM performance. Method:Veterans with a history of mTBI (n = 49) and Veterans without a history of TBI (n = 16) completed the Memory for Intentions Screening Test (MIST) as a measure of PM during which their time monitoring (i.e. number of clock checks) was recorded. Results:Adjusting for age, education, depression, and PTSD symptoms, negative binomial regression revealed that the mTBI group checked the clock less frequently compared to the control group (Cohen's d = 0.84, p = 0.005). Within the mTBI group, less frequent time monitoring across the entire MIST task was associated with poorer time-based MIST performance (rs = .57, p < 0.001), but not with event-based MIST (rs = .04, p = 0.768). Conclusions:Veterans with a history of mTBI evidenced significantly reduced time monitoring during a PM task compared to Veterans without a history mTBI, which was associated with strategically-demanding PM. Current findings provide that mTBI-associated difficulties with strategic aspects of PM may be due to reduced time monitoring. Future studies are needed to determine if reduced time monitoring also contributes to mTBI-associated PM difficulties in the real-world (e.g. medication non-adherence).
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Affiliation(s)
- David P Sheppard
- Veterans Affairs (VA) Northwest Network (VISN 20) Mental Illness, Research, Education, and Clinical Care (MIRECC), Veterans Affairs Puget Sound Health Care System, Seattle, WA
| | - Holly K Rau
- Veterans Affairs (VA) Northwest Network (VISN 20) Mental Illness, Research, Education, and Clinical Care (MIRECC), Veterans Affairs Puget Sound Health Care System, Seattle, WA
| | - Emily H Trittschuh
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA.,Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Puget Sound Health Care System, Seattle, WA
| | - Madeleine L Werhane
- Veterans Affairs (VA) Northwest Network (VISN 20) Mental Illness, Research, Education, and Clinical Care (MIRECC), Veterans Affairs Puget Sound Health Care System, Seattle, WA.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA
| | - Abigail G Schindler
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA.,Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Puget Sound Health Care System, Seattle, WA
| | - Rebecca C Hendrickson
- Veterans Affairs (VA) Northwest Network (VISN 20) Mental Illness, Research, Education, and Clinical Care (MIRECC), Veterans Affairs Puget Sound Health Care System, Seattle, WA.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA
| | - Elaine R Peskind
- Veterans Affairs (VA) Northwest Network (VISN 20) Mental Illness, Research, Education, and Clinical Care (MIRECC), Veterans Affairs Puget Sound Health Care System, Seattle, WA.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA
| | - Kathleen F Pagulayan
- Veterans Affairs (VA) Northwest Network (VISN 20) Mental Illness, Research, Education, and Clinical Care (MIRECC), Veterans Affairs Puget Sound Health Care System, Seattle, WA.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA
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10
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Wilson A, Stevens WD, Sergio L, Wojtowicz M. Altered Brain Functional Connectivity in Female Athletes Over the Course of a Season of Collision or Contact Sports. Neurotrauma Rep 2022; 3:377-387. [PMID: 36204391 PMCID: PMC9531888 DOI: 10.1089/neur.2022.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
University athletes are exposed to numerous impacts to the body and head, though the potential cumulative effects of such hits remain elusive. This study examined resting-state functional connectivity (rsFC) of brain networks in female varsity athletes over the course of a season. Nineteen female university athletes involved in collision (N = 12) and contact (N = 7) sports underwent functional magnetic resonance imaging scans at both pre- and post-season. A group-level independent component analysis (ICA) was used to investigate differences in rsFC over the course of a season and differences between contact and collision sport athletes. Decreased rsFC was observed over the course of the season between the default mode network (DMN) and regions in the frontal, parietal, and occipital lobe (p false discovery rate, ≤0.05) driven by differences in the contact group. There was also a main effect of group in the dorsal attention network (DAN) driven by differences between contact and collision groups at pre-season. Differences identified over the course of a season of play indicate largely decreased rsFC within the DMN, and level of contact was associated with differences in rsFC of the DAN. The association between exposure to repetitive head impacts (RHIs) and observed changes in network rsFC supplements the growing literature suggesting that even non-concussed athletes may be at risk for changes in brain functioning. However, the complexity of examining the direct effects of RHIs highlights the need to consider multiple factors, including mental health and sport-specific training and expertise, that may potentially be associated with neural changes.
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Affiliation(s)
- Alyssia Wilson
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - W. Dale Stevens
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Lauren Sergio
- School of Kinesiology, York University, Toronto, Ontario, Canada
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11
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A Descriptive Review of the Impact of Patient Motion in Early Childhood Resting-State Functional Magnetic Resonance Imaging. Diagnostics (Basel) 2022; 12:diagnostics12051032. [PMID: 35626188 PMCID: PMC9140169 DOI: 10.3390/diagnostics12051032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/08/2022] [Accepted: 04/19/2022] [Indexed: 11/18/2022] Open
Abstract
Resting-state functional magnetic images (rs-fMRIs) can be used to map and delineate the brain activity occurring while the patient is in a task-free state. These resting-state activity networks can be informative when diagnosing various neurodevelopmental diseases, but only if the images are high quality. The quality of an rs-fMRI rapidly degrades when the patient moves during the scan. Herein, we describe how patient motion impacts an rs-fMRI on multiple levels. We begin with how the electromagnetic field and pulses of an MR scanner interact with a patient’s physiology, how movement affects the net signal acquired by the scanner, and how motion can be quantified from rs-fMRI. We then present methods for preventing motion through educational and behavioral interventions appropriate for different age groups, techniques for prospectively monitoring and correcting motion during the acquisition process, and pipelines for mitigating the effects of motion in existing scans.
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12
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Chai WJ, Abd Hamid AI, Omar H, Abdul Rahman MR, Fitzrol DN, Idris Z, Ghani ARI, Wan Mohamad WNA, Mustafar F, Hanafi MH, Kandasamy R, Abdullah MZ, Amaruchkul K, Valdes-Sosa PA, Bringas-Vega ML, Biswal B, Songsiri J, Yaacob H, Ibrahim H, Sumari P, Noh NA, Musa KI, Ahmad AH, Azman A, Jamir Singh PS, Othman A, Abdullah JM. Neural alterations in working memory of mild-moderate TBI: An fMRI study in Malaysia. J Neurosci Res 2022; 100:915-932. [PMID: 35194817 DOI: 10.1002/jnr.25023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 10/10/2021] [Accepted: 12/31/2021] [Indexed: 02/05/2023]
Abstract
Working memory (WM) encompasses crucial cognitive processes or abilities to retain and manipulate temporary information for immediate execution of complex cognitive tasks in daily functioning such as reasoning and decision-making. The WM of individuals sustaining traumatic brain injury (TBI) was commonly compromised, especially in the domain of WM. The current study investigated the brain responses of WM in a group of participants with mild-moderate TBI compared to their healthy counterparts employing functional magnetic resonance imaging. All consented participants (healthy: n = 26 and TBI: n = 15) performed two variations of the n-back WM task with four load conditions (0-, 1-, 2-, and 3-back). The respective within-group effects showed a right hemisphere-dominance activation and slower reaction in performance for the TBI group. Random-effects analysis revealed activation difference between the two groups in the right occipital lobe in the guided n-back with cues, and in the bilateral occipital lobe, superior parietal region, and cingulate cortices in the n-back without cues. The left middle frontal gyrus was implicated in the load-dependent processing of WM in both groups. Further group analysis identified that the notable activation changes in the frontal gyri and anterior cingulate cortex are according to low and high loads. Though relatively smaller in scale, this study was eminent as it clarified the neural alterations in WM in the mild-moderate TBI group compared to healthy controls. It confirmed the robustness of the phenomenon in TBI with the reproducibility of the results in a heterogeneous non-Western sample.
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Affiliation(s)
- Wen Jia Chai
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Aini Ismafairus Abd Hamid
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Hazim Omar
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Muhammad Riddha Abdul Rahman
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,School of Medical Imaging, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Nerus, Malaysia
| | - Diana Noma Fitzrol
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Zamzuri Idris
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Abdul Rahman Izaini Ghani
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Wan Nor Azlen Wan Mohamad
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Faiz Mustafar
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Muhammad Hafiz Hanafi
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | | | - Mohd Zaid Abdullah
- School of Electrical and Electronic Engineering, Universiti Sains Malaysia, Nibong Tebal, Malaysia
| | - Kannapha Amaruchkul
- Graduate School of Applied Statistics, National Institute of Development Administration (NIDA), Bangkok, Thailand
| | - Pedro A Valdes-Sosa
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.,The Cuban Neurosciences Center, La Habana, Cuba
| | - Maria L Bringas-Vega
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.,The Cuban Neurosciences Center, La Habana, Cuba
| | - Bharat Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA
| | - Jitkomut Songsiri
- EE410 Control Systems Laboratory, Department of Electrical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
| | - Hamwira Yaacob
- Department of Computer Science, Kulliyyah of Information and Communication Technology, Kuala Lumpur, International Islamic University Malaysia, Kuala Lumpur, Malaysia
| | - Haidi Ibrahim
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,School of Electrical and Electronic Engineering, Universiti Sains Malaysia, Nibong Tebal, Malaysia
| | - Putra Sumari
- School of Computer Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Nor Azila Noh
- Department of Medical Science 1, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Asma Hayati Ahmad
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Azlinda Azman
- School of Medical Imaging, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Nerus, Malaysia.,School of Social Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | | | - Azizah Othman
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Jafri Malin Abdullah
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
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13
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Li MJ, Huang SH, Huang CX, Liu J. Morphometric changes in the cortex following acute mild traumatic brain injury. Neural Regen Res 2022; 17:587-593. [PMID: 34380898 PMCID: PMC8504398 DOI: 10.4103/1673-5374.320995] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Morphometric changes in cortical thickness (CT), cortical surface area (CSA), and cortical volume (CV) can reflect pathological changes after acute mild traumatic brain injury (mTBI). Most previous studies focused on changes in CT, CSA, and CV in subacute or chronic mTBI, and few studies have examined changes in CT, CSA, and CV in acute mTBI. Furthermore, acute mTBI patients typically show transient cognitive impairment, and few studies have reported on the relationship between cerebral morphological changes and cognitive function in patients with mTBI. This prospective cohort study included 30 patients with acute mTBI (15 males, 15 females, mean age 33.7 years) and 27 matched healthy controls (12 males, 15 females, mean age 37.7 years) who were recruited from the Second Xiangya Hospital of Central South University between September and December 2019. High-resolution T1-weighted images were acquired within 7 days after the onset of mTBI. The results of analyses using FreeSurfer software revealed significantly increased CSA and CV in the right lateral occipital gyrus of acute-stage mTBI patients compared with healthy controls, but no significant changes in CT. The acute-stage mTBI patients also showed reduced executive function and processing speed indicated by a lower score in the Digital Symbol Substitution Test, and reduced cognitive ability indicated by a longer time to complete the Trail Making Test-B. Both increased CSA and CV in the right lateral occipital gyrus were negatively correlated with performance in the Trail Making Test part A. These findings suggest that cognitive deficits and cortical alterations in CSA and CV can be detected in the acute stage of mTBI, and that increased CSA and CV in the right lateral occipital gyrus may be a compensatory mechanism for cognitive dysfunction in acute-stage mTBI patients. This study was approved by the Ethics Committee of the Second Xiangya Hospital of Central South University, China (approval No. 086) on February 9, 2019.
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Affiliation(s)
- Meng-Jun Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Si-Hong Huang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Chu-Xin Huang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Jun Liu
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
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14
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Dennis EL, Baron D, Bartnik‐Olson B, Caeyenberghs K, Esopenko C, Hillary FG, Kenney K, Koerte IK, Lin AP, Mayer AR, Mondello S, Olsen A, Thompson PM, Tate DF, Wilde EA. ENIGMA brain injury: Framework, challenges, and opportunities. Hum Brain Mapp 2022; 43:149-166. [PMID: 32476212 PMCID: PMC8675432 DOI: 10.1002/hbm.25046] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 04/23/2020] [Accepted: 05/03/2020] [Indexed: 12/19/2022] Open
Abstract
Traumatic brain injury (TBI) is a major cause of disability worldwide, but the heterogeneous nature of TBI with respect to injury severity and health comorbidities make patient outcome difficult to predict. Injury severity accounts for only some of this variance, and a wide range of preinjury, injury-related, and postinjury factors may influence outcome, such as sex, socioeconomic status, injury mechanism, and social support. Neuroimaging research in this area has generally been limited by insufficient sample sizes. Additionally, development of reliable biomarkers of mild TBI or repeated subconcussive impacts has been slow, likely due, in part, to subtle effects of injury and the aforementioned variability. The ENIGMA Consortium has established a framework for global collaboration that has resulted in the largest-ever neuroimaging studies of multiple psychiatric and neurological disorders. Here we describe the organization, recent progress, and future goals of the Brain Injury working group.
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Affiliation(s)
- Emily L. Dennis
- Department of NeurologyUniversity of Utah School of MedicineSalt Lake CityUtahUSA
- George E. Wahlen Veterans Affairs Medical CenterSalt Lake CityUtahUSA
- Imaging Genetics CenterStevens Neuroimaging & Informatics Institute, Keck School of Medicine of USCMarina del ReyCaliforniaUSA
| | - David Baron
- Western University of Health SciencesPomonaCaliforniaUSA
| | - Brenda Bartnik‐Olson
- Department of RadiologyLoma Linda University Medical CenterLoma LindaCaliforniaUSA
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of PsychologyDeakin UniversityBurwoodVictoriaAustralia
| | - Carrie Esopenko
- Department of Rehabilitation and Movement SciencesRutgers Biomedical Health SciencesNewarkNew JerseyUSA
| | - Frank G. Hillary
- Department of PsychologyPennsylvania State UniversityUniversity ParkPennsylvaniaUSA
- Social Life and Engineering Sciences Imaging CenterUniversity ParkPennsylvaniaUSA
| | - Kimbra Kenney
- Department of NeurologyUniformed Services University of the Health SciencesBethesdaMarylandUSA
- National Intrepid Center of ExcellenceWalter Reed National Military Medical CenterBethesdaMarylandUSA
| | - Inga K. Koerte
- Psychiatry Neuroimaging LaboratoryBrigham and Women's HospitalBostonMassachusettsUSA
- Department of Child and Adolescent Psychiatry, Psychosomatics and PsychotherapyLudwig‐Maximilians‐UniversitätMunichGermany
| | - Alexander P. Lin
- Center for Clinical SpectroscopyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Andrew R. Mayer
- Mind Research NetworkAlbuquerqueNew MexicoUSA
- Department of Neurology and PsychiatryUniversity of New Mexico School of MedicineAlbuquerqueNew MexicoUSA
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional ImagingUniversity of MessinaMessinaItaly
| | - Alexander Olsen
- Department of PsychologyNorwegian University of Science and TechnologyTrondheimNorway
- Department of Physical Medicine and RehabilitationSt. Olavs Hospital, Trondheim University HospitalTrondheimNorway
| | - Paul M. Thompson
- Imaging Genetics CenterStevens Neuroimaging & Informatics Institute, Keck School of Medicine of USCMarina del ReyCaliforniaUSA
- Department of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and OphthalmologyUniversity of Southern California (USC)Los AngelesCaliforniaUSA
| | - David F. Tate
- Department of NeurologyUniversity of Utah School of MedicineSalt Lake CityUtahUSA
- George E. Wahlen Veterans Affairs Medical CenterSalt Lake CityUtahUSA
| | - Elisabeth A. Wilde
- Department of NeurologyUniversity of Utah School of MedicineSalt Lake CityUtahUSA
- George E. Wahlen Veterans Affairs Medical CenterSalt Lake CityUtahUSA
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15
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Gumus M, Santos A, Tartaglia MC. Diffusion and functional MRI findings and their relationship to behaviour in postconcussion syndrome: a scoping review. J Neurol Neurosurg Psychiatry 2021; 92:1259-1270. [PMID: 34635568 DOI: 10.1136/jnnp-2021-326604] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/22/2021] [Indexed: 11/04/2022]
Abstract
Postconcussion syndrome (PCS) is a term attributed to the constellation of symptoms that fail to recover after a concussion. PCS is associated with a variety of symptoms such as headaches, concentration deficits, fatigue, depression and anxiety that have an enormous impact on patients' lives. There is currently no diagnostic biomarker for PCS. There have been attempts at identifying structural and functional brain changes in patients with PCS, using diffusion tensor imaging (DTI) and functional MRI (fMRI), respectively, and relate them to specific PCS symptoms. In this scoping review, we appraised, synthesised and summarised all empirical studies that (1) investigated structural or functional brain changes in PCS using DTI or fMRI, respectively, and (2) assessed behavioural alterations in patients with PCS. We performed a literature search in MEDLINE (Ovid), Embase (Ovid) and PsycINFO (Ovid) for primary research articles published up to February 2020. We identified 8306 articles and included 45 articles that investigated the relationship between DTI and fMRI parameters and behavioural changes in patients with PCS: 20 diffusion, 20 fMRI studies and 5 papers with both modalities. Most frequently studied structures were the corpus callosum, superior longitudinal fasciculus in diffusion and the dorsolateral prefrontal cortex and default mode network in the fMRI literature. Although some white matter and fMRI changes were correlated with cognitive or neuropsychiatric symptoms, there were no consistent, converging findings on the relationship between neuroimaging abnormalities and behavioural changes which could be largely due to the complex and heterogeneous presentation of PCS. Furthermore, the heterogeneity of symptoms in PCS may preclude discovery of one biomarker for all patients. Further research should take advantage of multimodal neuroimaging to better understand the brain-behaviour relationship, with a focus on individual differences rather than on group comparisons.
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Affiliation(s)
- Melisa Gumus
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Alexandra Santos
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Maria Carmela Tartaglia
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada .,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada.,Canadian Concussion Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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16
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Morelli N, Johnson NF, Kaiser K, Andreatta RD, Heebner NR, Hoch MC. Resting state functional connectivity responses post-mild traumatic brain injury: a systematic review. Brain Inj 2021; 35:1326-1337. [PMID: 34487458 DOI: 10.1080/02699052.2021.1972339] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Mild traumatic brain injuries (mTBI) are associated with functional network connectivity alterations throughout recovery. Yet, little is known about the adaptive or maladaptive nature of post-mTBI connectivity and which networks are predisposed to altered function and adaptation. The objective of this review was to determine functional connectivity changes post-mTBI and to determine the adaptive or maladaptive nature of connectivity through direct comparisons of connectivity and behavioral data. Literature was systematically searched and appraised for methodological quality. A total of 16 articles were included for review. There was conflicting evidence of post-mTBI connectivity responses as decreased connectivity was noted in 4 articles, 6 articles reported increased connectivity, 5 reported a mixture of increased and decreased connectivity, while 1 found no differences in connectivity. Supporting evidence for adaptive post-mTBI increases in connectivity were found, particularly in the frontoparietal, cerebellar, and default mode networks. Although initial results are promising, continued longitudinal research that systematically controls for confounding variables and that standardizes methodologies is warranted to adequately understand the neurophysiological recovery trajectory of mTBI.
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Affiliation(s)
- Nathan Morelli
- Department of Physical Therapy, High Point University, High Point, North Carolina, USA
| | - Nathan F Johnson
- Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Kimberly Kaiser
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Richard D Andreatta
- Rehabilitation Sciences Doctoral Program, College of Health Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Nicholas R Heebner
- Sports Medicine Research Institute, University of Kentucky, Lexington, Kentucky, USA
| | - Matthew C Hoch
- Sports Medicine Research Institute, University of Kentucky, Lexington, Kentucky, USA
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17
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Khanmohammadi S, Laurido-Soto O, Eisenman LN, Kummer TT, Ching S. Localizing focal brain injury via EEG spectral variance. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Gimbel SI, Ettenhofer ML, Cordero E, Roy M, Chan L. Brain bases of recovery following cognitive rehabilitation for traumatic brain injury: a preliminary study. Brain Imaging Behav 2021; 15:410-420. [PMID: 32328915 DOI: 10.1007/s11682-020-00269-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Many patients with traumatic brain injury (TBI) have persistent cognitive deficits, including decreased attention and working memory. This preliminary study examined fMRI data from a clinical trial implementing a 4-week virtual reality driving intervention to assess how sustained training can improve deficits related to traumatic brain injury. Previously-reported behavioral findings showed improvements in working memory and processing speed in those who received the intervention; this report explores the brain bases of these effects by comparing neural activity related to working memory (n-back task) and resting state connectivity before and after the intervention. In the baseline visit (n = 24), working memory activity was prominent in bilateral DLPFC and prefrontal cortex, anterior insula, medial superior frontal gyrus, left thalamus, bilateral supramarginal / angular gyrus, precuneus, and left posterior middle temporal gyrus. Following intervention, participants showed less global activation on the n-back task, with regions of activity only in the bilateral middle frontal cortex, posterior middle frontal gyrus, and supramarginal gyrus. Activity related to working memory load was reduced for the group that went through the intervention (n = 7) compared to the waitlist control group (n = 4). These results suggest that successful cognitive rehabilitation of working memory in TBI may be associated with increased efficiency of brain networks, evidenced by reduced activation of brain activity during cognitive processing. These results highlight the importance of examining brain activity related to cognitive rehabilitation of attention and working memory after brain injury.
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Affiliation(s)
- Sarah I Gimbel
- Naval Medical Center San Diego, 34730 Bob Wilson Drive, San Diego, CA, 92134, USA
- Henry M. Jackson Foundation, 6720A Rockledge Drive, Bethesda, MD, 20817, USA
- Defense and Veterans Brain Injury Center, 7700 Arlington Blvd Suite 5101, Falls Church, VA, 22041, USA
| | - Mark L Ettenhofer
- Naval Medical Center San Diego, 34730 Bob Wilson Drive, San Diego, CA, 92134, USA.
- Defense and Veterans Brain Injury Center, 7700 Arlington Blvd Suite 5101, Falls Church, VA, 22041, USA.
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
- Center for Neuroscience and Regenerative Medicine, 12725 Twinbrook Parkway, Rockville, MD, 20852, USA.
| | - Evelyn Cordero
- Naval Medical Center San Diego, 34730 Bob Wilson Drive, San Diego, CA, 92134, USA
- Henry M. Jackson Foundation, 6720A Rockledge Drive, Bethesda, MD, 20817, USA
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Michael Roy
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Center for Neuroscience and Regenerative Medicine, 12725 Twinbrook Parkway, Rockville, MD, 20852, USA
| | - Leighton Chan
- Center for Neuroscience and Regenerative Medicine, 12725 Twinbrook Parkway, Rockville, MD, 20852, USA
- National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
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19
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Acute cognitive impairment after traumatic brain injury predicts the occurrence of brain atrophy patterns similar to those observed in Alzheimer's disease. GeroScience 2021; 43:2015-2039. [PMID: 33900530 DOI: 10.1007/s11357-021-00355-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 03/10/2021] [Indexed: 10/21/2022] Open
Abstract
Traumatic brain injuries (TBIs) are often followed by persistent structural brain alterations and by cognitive sequalae, including memory deficits, reduced neural processing speed, impaired social function, and decision-making difficulties. Although mild TBI (mTBI) is a risk factor for Alzheimer's disease (AD), the extent to which these conditions share patterns of macroscale neurodegeneration has not been quantified. Comparing such patterns can not only reveal how the neurodegenerative trajectories of TBI and AD are similar, but may also identify brain atrophy features which can be leveraged to prognosticate AD risk after TBI. The primary aim of this study is to systematically map how TBI affects white matter (WM) and gray matter (GM) properties in AD-analogous patterns. Our findings identify substantial similarities in the regional macroscale neurodegeneration patterns associated with mTBI and AD. In cerebral GM, such similarities are most extensive in brain areas involved in memory and executive function, such as the temporal poles and orbitofrontal cortices, respectively. Our results indicate that the spatial pattern of cerebral WM degradation observed in AD is broadly similar to the pattern of diffuse axonal injury observed in TBI, which frequently affects WM structures like the fornix, corpus callosum, and corona radiata. Using machine learning, we find that the severity of AD-like brain changes observed during the chronic stage of mTBI can be accurately prognosticated based on acute assessments of post-traumatic mild cognitive impairment. These findings suggest that acute post-traumatic cognitive impairment predicts the magnitude of AD-like brain atrophy, which is itself associated with AD risk.
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20
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Philippi CL, Velez CS, Wade BSC, Drennon AM, Cooper DB, Kennedy JE, Bowles AO, Lewis JD, Reid MW, York GE, Newsome MR, Wilde EA, Tate DF. Distinct patterns of resting-state connectivity in U.S. service members with mild traumatic brain injury versus posttraumatic stress disorder. Brain Imaging Behav 2021; 15:2616-2626. [PMID: 33759113 DOI: 10.1007/s11682-021-00464-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 12/27/2022]
Abstract
Mild traumatic brain injury (mTBI) is highly prevalent in military populations, with many service members suffering from long-term symptoms. Posttraumatic stress disorder (PTSD) often co-occurs with mTBI and predicts worse clinical outcomes. Functional neuroimaging research suggests there are both overlapping and distinct patterns of resting-state functional connectivity (rsFC) in mTBI versus PTSD. However, few studies have directly compared rsFC of cortical networks in military service members with these two conditions. In the present study, U.S. service members (n = 137; ages 19-59; 120 male) underwent resting-state fMRI scans. Participants were divided into three study groups: mTBI only, PTSD only, and orthopedically injured (OI) controls. Analyses investigated group differences in rsFC for cortical networks: default mode (DMN), frontoparietal (FPN), salience, somatosensory, motor, auditory, and visual. Analyses were family-wise error (FWE) cluster-corrected and Bonferroni-corrected for number of network seeds regions at the whole brain level (pFWE < 0.002). Both mTBI and PTSD groups had reduced rsFC for DMN and FPN regions compared with OI controls. These group differences were largely driven by diminished connectivity in the PTSD group. rsFC with the middle frontal gyrus of the FPN was increased in mTBI, but decreased in PTSD. Overall, these results suggest that PTSD symptoms may have a more consistent signal than mTBI. Our novel findings of opposite patterns of connectivity with lateral prefrontal cortex highlight a potential biomarker that could be used to differentiate between these conditions.
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Affiliation(s)
- Carissa L Philippi
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA.
| | - Carmen S Velez
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA.,University of Utah, Salt Lake City, UT, USA
| | - Benjamin S C Wade
- University of Utah, Salt Lake City, UT, USA.,Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, CA, USA
| | - Ann Marie Drennon
- Defense and Veterans Brain Injury Center at the San Antonio VA Polytrauma Center, San Antonio, TX, USA
| | - Douglas B Cooper
- Defense and Veterans Brain Injury Center at the San Antonio VA Polytrauma Center, San Antonio, TX, USA.,Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Jan E Kennedy
- Defense and Veterans Brain Injury Center at the San Antonio VA Polytrauma Center, San Antonio, TX, USA
| | - Amy O Bowles
- Brooke Army Medical Center, San Antonio, TX, USA.,Uniformed Services University of Health Science, Bethesda, MD, USA
| | - Jeffrey D Lewis
- Brooke Army Medical Center, San Antonio, TX, USA.,Uniformed Services University of Health Science, Bethesda, MD, USA
| | - Matthew W Reid
- Defense and Veterans Brain Injury Center at the San Antonio VA Polytrauma Center, San Antonio, TX, USA
| | | | - Mary R Newsome
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.,H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX, USA
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21
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Abstract
OBJECTIVES Head impact exposure (HIE) in youth football is a public health concern. The objective of this study was to determine if one season of HIE in youth football was related to cognitive changes. METHOD Over 200 participants (ages 9-13) wore instrumented helmets for practices and games to measure the amount of HIE sustained over one season. Pre- and post-season neuropsychological tests were completed. Test score changes were calculated adjusting for practice effects and regression to the mean and used as the dependent variables. Regression models were calculated with HIE variables predicting neuropsychological test score changes. RESULTS For the full sample, a small effect was found with season average rotational values predicting changes in list-learning such that HIE was related to negative score change: standardized beta (β) = -.147, t(205) = -2.12, and p = .035. When analyzed by age clusters (9-10, 11-13) and adding participant weight to models, the R2 values increased. Splitting groups by weight (median split), found heavier members of the 9-10 cohort with significantly greater change than lighter members. Additionaly, significantly more participants had clinically meaningful negative changes: X2 = 10.343, p = .001. CONCLUSION These findings suggest that in the 9-10 age cluster, the average seasonal level of HIE had inverse, negative relationships with cognitive change over one season that was not found in the older group. The mediation effects of age and weight have not been explored previously and appear to contribute to the effects of HIE on cognition in youth football players.
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22
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Hemachandran N, Meena S, Kumar A, Sharma R, Gupta D, Gamanagatti S. Utility of admission perfusion CT for the prediction of suboptimal outcome following uncomplicated minor traumatic brain injury. Emerg Radiol 2021; 28:541-548. [PMID: 33420847 DOI: 10.1007/s10140-020-01876-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 11/25/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE To compare the perfusion parameters of patients with uncomplicated mild traumatic brain injury (mTBI) with healthy controls and to assess whether admission perfusion CT parameters can be used to predict outcome at 6 months post-injury in patients with uncomplicated mTBI. METHODS Institute ethical committee approval was obtained for this prospective cohort study and informed written consent obtained from all subjects. Patients who sustained mTBI and had no abnormalities on non-contrast CT from June 2010 to January 2012 (20 months) and 10 healthy controls were included and underwent perfusion CT at admission. Outcome was determined at 6 months follow-up using the extended Glasgow Coma Outcome Scale score. RESULTS Forty-nine patients were included, of which 16 (32.7%) had symptoms at 6 months post-injury (suboptimal outcome). The mean cerebral blood flow and volume were lower in both the gray and white matter of all three arterial territories in the study group than in the control group (p value < 0.05). In the study group, these values were lower in those with suboptimal outcome than in those with optimal outcome (no symptoms). Cerebral blood flow showed higher area under the curve for predicting the outcome. CONCLUSION Perfusion parameters are altered even in patients with uncomplicated mTBI. A single ROI (region of interest) evaluation of the gray matter in the posterior cerebral artery territory on admission perfusion CT could provide a quick and efficient way to predict patients who would have a suboptimal outcome at 6 months post-injury.
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Affiliation(s)
| | | | - Atin Kumar
- All India Institute of Medical Sciences, New Delhi, India
| | - Raju Sharma
- All India Institute of Medical Sciences, New Delhi, India
| | - Deepak Gupta
- All India Institute of Medical Sciences, New Delhi, India
| | - Shivanand Gamanagatti
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Room no. 81b, 110029, New Delhi, India.
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23
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Stika MM, Riordan P, Aaronson A, Herrold AA, Ellison RL, Kletzel S, Drzewiecki M, Evans CT, Mallinson T, High WM, Babcock-Parziale J, Urban A, Pape TLB, Smith B. Cognition and Other Predictors of Functional Disability Among Veterans With Mild Traumatic Brain Injury and Posttraumatic Stress Disorder. J Head Trauma Rehabil 2021; 36:44-55. [PMID: 32898030 PMCID: PMC8916049 DOI: 10.1097/htr.0000000000000611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Limitations in everyday functioning are frequently reported by veterans with a history of mild traumatic brain injury (mTBI) and/or posttraumatic stress disorder (PTSD). Multiple factors are associated with functional disability among veterans, including depression, poor social support, cognition, and substance use. However, the degree to which these factors, particularly cognitive capacities, contribute to functional limitations remains unclear. METHODS We evaluated performance on tests of processing speed, executive functioning, attention, and memory as predictors of functioning on the World Health Organization Disability Assessment Scale (WHODAS) 2.0 in 288 veterans. Participants were placed in one of the following groups: PTSD-only, mTBI-only, mTBI + PTSD, and neither PTSD nor mTBI (deployed control group). Cognitive test performances were evaluated as predictors of WHODAS 2.0 functional ratings in regression models that included demographic variables and a range of mood, behavioral health, and postconcussive symptom ratings. RESULTS Multiple cognitive test performances predicted WHODAS 2.0 scores in the deployed control group, but they generally did not predict functioning in the clinical groups when accounting for demographics, mood, behavioral health, and postconcussive symptoms. CONCLUSIONS In veterans with mTBI and/or PTSD, cognitive test performances are less associated with everyday functioning than mood and postconcussive symptoms.
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Affiliation(s)
- Monica M Stika
- Department of Veterans Affairs (VA), Edward Hines, Jr. VA Hospital: Spinal Cord Injury/Disorder Service (Dr Stika), Mental Health Service Line: Neuropsychology Service (Drs Riordan, Drzewiecki, and Urban) and Psychiatry Service (Dr Aaronson), Research Service (Drs Bender Pape, Herrold, Kletzel, and Ellison), Center of Innovation for Complex Chronic Healthcare (Drs Bender Pape, Herrold, Kletzel, Smith, and Evans), Hines, Illinois; Departments of Psychiatry & Behavioral Sciences (Drs Aaronson and Herrold), Physical Medicine and Rehabilitation (Dr Pape), and Pediatrics (Dr Smith), and Center for Health Services and Outcomes Research, Institute for Public Health and Medicine (Dr Evans), Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Clinical Research and Leadership, The George Washington University, Washington, District of Columbia (Dr Mallinson); Department of Veterans Affairs (VA), New Mexico VA Health Care System, Albuquerque (Dr High); Illinois Institute of Technology (IIT), Chicago (Dr Ellison); and Department of Veterans Affairs (VA), Southern AZ VA Health Care System (3-124), Tucson, Arizona (Dr Babcock-Parziale)
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24
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Bittencourt-Villalpando M, van der Horn HJ, Maurits NM, van der Naalt J. Disentangling the effects of age and mild traumatic brain injury on brain network connectivity: A resting state fMRI study. Neuroimage Clin 2020; 29:102534. [PMID: 33360020 PMCID: PMC7770973 DOI: 10.1016/j.nicl.2020.102534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/20/2020] [Accepted: 12/12/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Cognitive complaints are common shortly after mild traumatic brain injury (mTBI) but may persist up to years. Age-related cognitive decline can worsen these symptoms. However, effects of age on mTBI sequelae have scarcely been investigated. METHODS Fifty-four mTBI patients (median age: 35 years, range 19-64 years, 67% male) and twenty age- and sex-matched healthy controls were studied using resting state functional magnetic resonance imaging in the sub-acute phase. Independent component analysis was used to identify intrinsic connectivity networks (ICNs). A multivariate approach was adopted to evaluate the effects of age and group on the ICNs in terms of (static) functional network connectivity (FNC), intensities of spatial maps (SMs) and time-course spectral power (TC). RESULTS We observed significant age-related changes for a) FNC: changes between 10 pairs of ICNs, mostly involving the default mode (DM) and/or the cognitive-control (CC) domains; b) SMs: intensity decrease in clusters across three domains and intensity increase in clusters across two domains, including the CC but not the DM and c) TC: spectral power decrease within the 0-0.15 Hz range and increase within the 0.20-0.25 Hz range for increasing age within networks located in frontal areas, including the anterior DM. Groups only differed for TC within the 0.065-0.10 Hz range in the cerebellar ICN and no age × group interaction effect was found. CONCLUSIONS We showed robust effects of age on connectivity between and within ICNs that are associated with cognitive functioning. Differences between mTBI patients and controls were only found for activity in the cerebellar network, increasingly recognized to participate in cognition. Our results suggest that to allow for capturing the true effects related to mTBI and its effects on cognitive functioning, age should be included as a covariate in mTBI studies, in addition to age-matching groups.
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Affiliation(s)
- M Bittencourt-Villalpando
- University of Groningen, University Medical Center Groningen, Department of Neurology AB51, 9700RB Groningen, The Netherlands.
| | - H J van der Horn
- University of Groningen, University Medical Center Groningen, Department of Neurology AB51, 9700RB Groningen, The Netherlands
| | - N M Maurits
- University of Groningen, University Medical Center Groningen, Department of Neurology AB51, 9700RB Groningen, The Netherlands
| | - J van der Naalt
- University of Groningen, University Medical Center Groningen, Department of Neurology AB51, 9700RB Groningen, The Netherlands
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25
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Gallagher V, Vesci B, Mjaanes J, Breiter H, Chen Y, Herrold A, Reilly J. Eye movement performance and clinical outcomes among female athletes post-concussion. Brain Inj 2020; 34:1674-1684. [PMID: 33103479 DOI: 10.1080/02699052.2020.1830173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Most post-concussion eye movement (EM) research involves predominantly male samples. We evaluated pro- (PRO; reflexive shift of visual attention to target) and anti- (ANTI; executive control of visual attention away from target) computer-based saccade task performance among female, collegiate athletes with recent concussion (CON) versus healthy-control athletes (HC). We evaluated the relationship between EM performance and post-concussion outcomes. We hypothesized ANTI performance would differ among CON and HC due to greater executive control demands, and that EM performance (both tasks) would be associated with clinical outcomes in CON. METHODS 16 CON (assessed 4-10 days post-injury [M = 6.87, SD = 2.15 days]) and 16 age-matched HC athletes were recruited. General linear mixed modeling and Pearson's correlations were used. RESULTS On ANTI, CON demonstrated higher error rate [F(1,2863) = 12.650, p<.001] and shorter latency on error trials [F(1,469) = 5.976, p=.015] relative to HC. Multiple EM measures were associated with clinical outcomes: PRO duration predicted days to symptom remission (r=.44, p <.05); ANTI error rate was associated with symptom burden on the day of testing (r=.27, p <.05). CONCLUSION This study demonstrates promising utility of EM measures to detect cognitive control and sensorimotor effects of concussion among female athletes and their use as a prognostic indicators of recovery.
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Affiliation(s)
- Virginia Gallagher
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine , Chicago, Illinois, USA
| | - Brian Vesci
- Department of Sports Medicine, Northwestern University , Evanston, Illinois, USA
| | - Jeffrey Mjaanes
- Department of Sports Medicine, Northwestern University , Evanston, Illinois, USA
| | - Hans Breiter
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine , Chicago, Illinois, USA.,Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine , Chicago, Illinois, USA
| | - Yufen Chen
- Center for Translational Imaging, Department of Radiology, Northwestern University Feinberg School of Medicine , Chicago, Illinois, USA
| | - Amy Herrold
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine , Chicago, Illinois, USA.,Research Health Scientist, Edward Hines, Jr. VA Hospital , Hines IL, Oregon, USA
| | - James Reilly
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine , Chicago, Illinois, USA
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26
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Giudice JS, Alshareef A, Wu T, Gancayco CA, Reynier KA, Tustison NJ, Druzgal TJ, Panzer MB. An Image Registration-Based Morphing Technique for Generating Subject-Specific Brain Finite Element Models. Ann Biomed Eng 2020; 48:2412-2424. [PMID: 32725547 DOI: 10.1007/s10439-020-02584-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/22/2020] [Indexed: 01/10/2023]
Abstract
Finite element (FE) models of the brain are crucial for investigating the mechanisms of traumatic brain injury (TBI). However, FE brain models are often limited to a single neuroanatomy because the manual development of subject-specific models is time consuming. The objective of this study was to develop a pipeline to automatically generate subject-specific FE brain models using previously developed nonlinear image registration techniques, preserving both external and internal neuroanatomical characteristics. To verify the morphing-induced mesh distortions did not influence the brain deformation response, strain distributions predicted using the morphed model were compared to those from manually created voxel models of the same subject. Morphed and voxel models were generated for 44 subjects ranging in age, and simulated using head kinematics from a football concussion case. For each subject, brain strain distributions predicted by each model type were consistent, and differences in strain prediction was less than 4% between model type. This automated technique, taking approximately 2 h to generate a subject-specific model, will facilitate interdisciplinary research between the biomechanics and neuroimaging fields and could enable future use of biomechanical models in the clinical setting as a tool for improving diagnosis.
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Affiliation(s)
- J Sebastian Giudice
- Department of Mechanical and Aerospace Engineering, Center for Applied Biomechanics, University of Virginia, 4040 Lewis and Clark Dr., Charlottesville, VA, 229011, USA
| | - Ahmed Alshareef
- Department of Mechanical and Aerospace Engineering, Center for Applied Biomechanics, University of Virginia, 4040 Lewis and Clark Dr., Charlottesville, VA, 229011, USA
| | - Taotao Wu
- Department of Mechanical and Aerospace Engineering, Center for Applied Biomechanics, University of Virginia, 4040 Lewis and Clark Dr., Charlottesville, VA, 229011, USA
| | | | - Kristen A Reynier
- Department of Mechanical and Aerospace Engineering, Center for Applied Biomechanics, University of Virginia, 4040 Lewis and Clark Dr., Charlottesville, VA, 229011, USA
| | - Nicholas J Tustison
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA
| | - T Jason Druzgal
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA
| | - Matthew B Panzer
- Department of Mechanical and Aerospace Engineering, Center for Applied Biomechanics, University of Virginia, 4040 Lewis and Clark Dr., Charlottesville, VA, 229011, USA. .,Brain Injury and Sports Concussion Center, University of Virginia, Charlottesville, VA, USA.
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27
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Barton JJS, Ranalli PJ. Reply to "Concerning Vision Therapy and Ocular Motor Training in Mild TBI". Ann Neurol 2020; 88:1054-1055. [PMID: 32799326 DOI: 10.1002/ana.25876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 08/13/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Jason J S Barton
- Departments of Medicine (Neurology), Ophthalmology, and Visual Sciences, Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Paul J Ranalli
- Departments of Medicine (Neurology), Ophthalmology and Visual Sciences, Otolaryngology, University of Toronto, Toronto, Ontario, Canada
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28
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Wright T, Urban R, Durham W, Dillon EL, Randolph KM, Danesi C, Gilkison C, Karmonik C, Zgaljardic DJ, Masel B, Bishop J, Pyles R, Seidler R, Hierholzer AH, Sheffield-Moore M. Growth Hormone Alters Brain Morphometry, Connectivity, and Behavior in Subjects with Fatigue after Mild Traumatic Brain Injury. J Neurotrauma 2020; 37:1052-1066. [PMID: 31797721 PMCID: PMC7185353 DOI: 10.1089/neu.2019.6690] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Pituitary dysfunction with reduced growth hormone (GH) secretion is common in patients following traumatic brain injury (TBI), and these patients often develop chronic symptoms including fatigue and altered cognition. We examined 18 subjects with a history of mild TBI, fatigue, and insufficient GH secretion. Subjects received GH replacement in a year-long, double-blind, placebo-controlled, crossover study, and were assessed for changes in physical performance, body composition, resting energy expenditure, fatigue, sleep, mood, and neuropsychological status. Additionally, magnetic resonance imaging (MRI) was used to assess changes in brain structure and resting state functional connectivity. GH replacement resulted in decreased fatigue, sleep disturbance, and anxiety, as well as increased resting energy expenditure, improved body composition, and altered perception of submaximal effort when performing exercise testing. Associated brain changes included increased frontal cortical thickness and gray matter volume and resting state connectivity changes in regions associated with somatosensory networks. GH replacement altered brain morphology and connectivity and reduced fatigue and related symptoms in mild TBI patients. Additional studies are needed to understand the mechanisms causing TBI-related fatigue and symptom relief with GH replacement.
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Affiliation(s)
- Traver Wright
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
- Department of Health and Kinesiology, Texas A&M University, College Station, Texas
| | - Randall Urban
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - William Durham
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - E. Lichar Dillon
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Kathleen M. Randolph
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
- Department of Health and Kinesiology, Texas A&M University, College Station, Texas
| | - Christopher Danesi
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Charles Gilkison
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Christof Karmonik
- Radiology Department, Houston Methodist Research Institute, Houston, Texas
| | | | - Brent Masel
- Center for Neuro Skills, Bakersfield, California
| | - James Bishop
- Department of Radiology, Stanford University, Stanford, California
| | - Richard Pyles
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas
| | - Rachael Seidler
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
| | - Ashton H. Hierholzer
- Department of School of Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Melinda Sheffield-Moore
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
- Department of Health and Kinesiology, Texas A&M University, College Station, Texas
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29
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Uldall SW, Nielsen MØ, Carlsson J, Glenthøj B, Siebner HR, Madsen KH, Madsen CG, Leffers AM, Nejad AB, Rostrup E. Associations of neural processing of reward with posttraumatic stress disorder and secondary psychotic symptoms in trauma-affected refugees. Eur J Psychotraumatol 2020; 11:1730091. [PMID: 32194922 PMCID: PMC7067194 DOI: 10.1080/20008198.2020.1730091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 01/28/2020] [Accepted: 02/06/2020] [Indexed: 11/02/2022] Open
Abstract
Background: Psychological traumatic experiences can lead to posttraumatic stress disorder (PTSD). Secondary psychotic symptoms are not common but may occur. Objectives: Since psychotic symptoms of schizophrenia have been related to aberrant reward processing in the striatum, using the same paradigm we investigate whether the same finding extends to psychotic and anhedonic symptoms in PTSD. Methods: A total of 70 male refugees: 18 PTSD patients with no secondary psychotic symptoms (PTSD-NSP), 21 PTSD patients with secondary psychotic symptoms (PTSD-SP), and 31 healthy controls (RHC) were interviewed and scanned with functional magnetic resonance imaging (fMRI) during a monetary incentive delay task. Using region of interest analysis of the prefrontal cortex and ventral striatum, we investigated reward-related activity. Results: Compared to RHC, participants with PTSD had decreased neural activity during monetary reward. Also, participants with PTSD-SP exhibited decreased activity in the associative striatum relative to participants with PTSD-NSP during processing of motivational reward anticipation which correlated with severity of psychotic symptoms. However, the difference between the two PTSD groups disappeared when PTSD severity and trauma exposure were accounted for. Conclusions: Anhedonia and secondary psychotic symptoms in PTSD are characterized by dysfunctional reward consumption and anticipation processing, respectively. The latter may reflect a mechanism by which abnormal reward signals in the basal ganglia facilitates psychotic symptoms across psychiatric conditions.
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Affiliation(s)
- Sigurd Wiingaard Uldall
- Competence Centre for Transcultural Psychiatry (CTP), Mental Health Centre Ballerup, Ballerup, Denmark
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mette Ødegaard Nielsen
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, Glostrup, Denmark
| | - Jessica Carlsson
- Competence Centre for Transcultural Psychiatry (CTP), Mental Health Centre Ballerup, Ballerup, Denmark
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Birte Glenthøj
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, Glostrup, Denmark
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Kristoffer Hougaard Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Camilla Gøbel Madsen
- Department of Radiology, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Anne-Mette Leffers
- Department of Radiology, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Ayna Baladi Nejad
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Translational Medicine, Clinical Pharmacology & Translational Medicine, Novo Nordisk A/S, Søborg, Denmark
| | - Egill Rostrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, Glostrup, Denmark
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30
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Bedard M, Steffener J, Taler V. Long-term cognitive impairment following single mild traumatic brain injury with loss of consciousness: Findings from the Canadian Longitudinal Study on Aging. J Clin Exp Neuropsychol 2020; 42:344-351. [PMID: 31984839 DOI: 10.1080/13803395.2020.1714552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: We examined the extent to which loss of consciousness (LOC) following mild traumatic brain injury (mTBI) may be associated with impairments in executive functions and declarative memory more than a year after brain injury.Method: Analyses were run on 548 participants who had self-reported LOC of <1 min, 441 with LOC of 1-20 min, and 13,609 no brain injury comparison participants, taken from the Canadian Longitudinal Study on Aging (CLSA), a nationwide study on health and aging.Results: Those that had mTBI with LOC of 1-20 min were more likely than no head injury comparisons to be impaired on measures of executive functioning and declarative memory. Impairments were evident when examining for single- and two-test impairment rates on measures of executive functioning and declarative memory.Conclusions: A subset of people that had reported a single mTBI with LOC more than 12 months ago may experience impairments in executive functioning and declarative memory, particularly those who spent more time unconscious.
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Affiliation(s)
- Marc Bedard
- Bruyère Research Institute, Ottawa, Ontario, Canada.,School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Jason Steffener
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.,Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Vanessa Taler
- Bruyère Research Institute, Ottawa, Ontario, Canada.,School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
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31
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Peripheral blood neuroendocrine hormones are associated with clinical indices of sport-related concussion. Sci Rep 2019; 9:18605. [PMID: 31819094 PMCID: PMC6901546 DOI: 10.1038/s41598-019-54923-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 11/19/2019] [Indexed: 11/30/2022] Open
Abstract
The purpose of this study was to evaluate the relationship between neuroendocrine hormones and clinical recovery following sport-related concussion (SRC). Ninety-five athletes (n = 56 male, n = 39 female) from a cohort of 11 interuniversity sport teams at a single institution provided blood samples; twenty six athletes with SRC were recruited 2–7 days post-injury, and 69 uninjured athletes recruited prior to the start of their competitive season. Concentrations of seven neuroendocrine hormones were quantitated in either plasma or serum by solid-phase chemiluminescent immunoassay. The Sport Concussion Assessment Tool version 5 (SCAT-5) was used to evaluate symptoms at the time of blood sampling in all athletes. Multivariate partial least squares (PLS) analyses were used to evaluate the relationship between blood hormone concentrations and both (1) time to physician medical clearance and (2) initial symptom burden. A negative relationship was observed between time to medical clearance and both dehydroepiandrosterone sulfate (DHEA-S) and progesterone; a positive relationship was found between time to medical clearance and prolactin. Cognitive, somatic, fatigue and emotion symptom clusters were associated with distinct neuroendocrine signatures. Perturbations to the neuroendocrine system in athletes following SRC may contribute to initial symptom burden and longer recovery times.
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Abstract
Facial affect recognition deficits following traumatic brain injury (TBI) have been well documented, as has their relationship with impairment in several other cognitive domains. However, little is known about the neurobiological mechanisms underlying affect recognition deficits, in particular mechanisms underlying different aspects of facial affect recognition (e.g., perceptual and interpretive processes). In the current study, 33 adults with moderate-to-severe TBI and 24 demographically matched healthy comparison (HC) participants completed an fMRI facial affect recognition study. While in the scanner, participants were asked to match the affect of a target face to either (a) one of two faces differing in affect (perceptual condition) or (b) one of two written affect labels (interpretative condition). In both groups we found activations in regions typically involved in affect recognition. Our results revealed that in the perceptual condition individuals with TBI tended to activate the left dorsolateral prefrontal cortex less than HCs, and within the HC group individuals with higher perceptual affect recognition scores showed higher levels of activation in the same brain region. Individuals with TBI who were specifically impaired at interpretative affect recognition showed less activation than HCs in the right fusiform gyrus. Moreover, in the labeling condition individuals with TBI tended to de-activate medial prefrontal regions less than HCs. A region of interest analysis revealed that individuals with TBI showed significantly less activation than HCs in the FFA for all the contrasts of interest. Our results suggest involvement of several brain regions in facial affect recognition impairment post TBI, and provide neurobiological support for the notion that distinct aspects of facial affect recognition can be differentially impaired following TBI.
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Volume and shape analysis of the Hippocampus and amygdala in veterans with traumatic brain injury and posttraumatic stress disorder. Brain Imaging Behav 2019; 14:1850-1864. [DOI: 10.1007/s11682-019-00127-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Dardiotis E, Siokas V, Aloizou AM, Karampinis E, Brotis AG, Grigoriadis S, Paterakis K, Dardioti M, Komnos A, Kapsalaki E, Fountas K, Hadjigeorgiou GM. Effect of integrin AV and B8 gene polymorphisms in patients with traumatic brain injury. Brain Inj 2019; 33:836-845. [PMID: 31033358 DOI: 10.1080/02699052.2019.1606444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Α few genetic variants are associated with the outcome after traumatic brain injury (TBI). Integrins are glycoprotein receptors that play an important role in the integrity of microvasculature of the brain. Objective: To examine the role of integrin-AV (ITGAV) and integrin-B8 (ITGB8) tag single nucleotide polymorphisms (SNPs) on the outcome of patients with TBI. Methods: 363 participants were included and genotyped for 11 SNPs for ITGAV and 11 for ITGB8 gene. SNPs were tested for associations with the 6-month outcome after TBI, the presence of a hemorrhagic event after TBI, and the initial TBI severity after adjustment for TBI's main predictors. Results: The ITGAV rs3911239 CC and rs7596996 GG genotypes were associated with an unfavorable outcome after TBI, compared to the TT and AA genotypes, respectively. The ITGB8 rs10239099 CC and rs3757727 CC genotypes were associated with increased risk of any cerebral hemorrhagic event after TBI compared to GG and TT respectively. The ITGAV rs7589470 and rs7565633 were associated with the TBI's initial severity. Conclusions: ITGAV gene SNPs may be implicated in the outcome after TBI, as well as in the initial TBI severity, and also of ITGB8 gene SNPs in the risk of hemorrhagic event after a TBI.
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Affiliation(s)
- Efthimios Dardiotis
- a Department of Neurology, Laboratory of Neurogenetics , University of Thessaly, University Hospital of Larissa , Larissa , Greece
| | - Vasileios Siokas
- a Department of Neurology, Laboratory of Neurogenetics , University of Thessaly, University Hospital of Larissa , Larissa , Greece
| | - Athina-Maria Aloizou
- a Department of Neurology, Laboratory of Neurogenetics , University of Thessaly, University Hospital of Larissa , Larissa , Greece
| | - Emmanouil Karampinis
- a Department of Neurology, Laboratory of Neurogenetics , University of Thessaly, University Hospital of Larissa , Larissa , Greece
| | - Alexandros G Brotis
- b Department of Neurosurgery , University of Thessaly, University Hospital of Larissa , Larissa , Greece
| | - Savas Grigoriadis
- c Second Department of Neurosurgery , Hippokration University Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Konstantinos Paterakis
- b Department of Neurosurgery , University of Thessaly, University Hospital of Larissa , Larissa , Greece
| | - Maria Dardioti
- a Department of Neurology, Laboratory of Neurogenetics , University of Thessaly, University Hospital of Larissa , Larissa , Greece
| | - Apostolos Komnos
- d Intensive Care Unit , General Hospital of Larissa , Larissa , Greece
| | - Eftychia Kapsalaki
- e Department of Radiology , University of Thessaly, School of Medicine , Larissa , Greece
| | - Kostas Fountas
- b Department of Neurosurgery , University of Thessaly, University Hospital of Larissa , Larissa , Greece
| | - Georgios M Hadjigeorgiou
- a Department of Neurology, Laboratory of Neurogenetics , University of Thessaly, University Hospital of Larissa , Larissa , Greece.,f Department of Neurology , Medical School, University of Cyprus , Nicosia , USA
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Lajeunesse A, Potvin MJ, Audy J, Paradis V, Giguère JF, Rouleau I. Prospective memory assessment in acute mild traumatic brain injury. Clin Neuropsychol 2019; 33:1175-1194. [PMID: 31007154 DOI: 10.1080/13854046.2019.1598500] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Prospective memory (PM) is the ability to remember to perform an intention at the appropriate time in the future. It is of primary importance for daily living, and its disruption may impact functional autonomy. To date, few studies have examined PM during the acute phase of mild traumatic brain injury (mTBI), despite the high prevalence of this neurological condition and its potential impact on cognition. Method: Twenty mTBI patients (time since injury ranged from 45 to 73 days) and 15 healthy control participants performed the Ecological Test of Prospective Memory (TEMP), a simulated errand task in which participants were required to execute 10 event-based (EB) and five time-based (TB) tasks. The TEMP separately evaluates PM phases as well as prospective and retrospective components in event- and time-based conditions. Participants also completed a neuropsychological test battery. Correlations were performed between cognitive composite scores and the TEMP. Results: mTBI patients experienced difficulty in learning the content of intentions, retrieving these intentions in the time-based condition (prospective component) and recalling the associated actions in the event- and time-based conditions (retrospective component). Retrospective memory composite score was correlated with the learning and retention phases of the TEMP, whereas attention/working memory and executive composite scores were correlated with the time-based condition and performance on the ongoing task. Conclusion: These results suggest the presence of global PM impairment during the acute phase of mTBI, as well as impairment of retrospective memory, attention/working memory, and executive functions, which are key components for PM performance.
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Affiliation(s)
- Ariane Lajeunesse
- Department of Psychology, Université du Québec à Montréal , Montreal , Canada
| | - Marie-Julie Potvin
- Department of Psychology, Université du Québec à Montréal , Montreal , Canada.,Neurotraumatology Unit, Hôpital du Sacré-Coeur de Montréal , Montreal , Canada
| | - Julie Audy
- Department of Psychology, Université du Québec à Montréal , Montreal , Canada
| | - Véronique Paradis
- Department of Psychology, Université du Québec à Montréal , Montreal , Canada.,Neurotraumatology Unit, Hôpital du Sacré-Coeur de Montréal , Montreal , Canada
| | | | - Isabelle Rouleau
- Department of Psychology, Université du Québec à Montréal , Montreal , Canada
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Vergani L, Marton G, Pizzoli SFM, Monzani D, Mazzocco K, Pravettoni G. Training Cognitive Functions Using Mobile Apps in Breast Cancer Patients: Systematic Review. JMIR Mhealth Uhealth 2019; 7:e10855. [PMID: 30888326 PMCID: PMC6444278 DOI: 10.2196/10855] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 07/02/2018] [Accepted: 07/16/2018] [Indexed: 12/20/2022] Open
Abstract
Background Breast cancer is an invalidating disease and its treatment can bring serious side effects that have a physical and psychological impact. Specifically, cancer treatment generally has a strong impact on cognitive function. In recent years, new technologies and eHealth have had a growing influence on health care and innovative mobile apps can be useful tools to deliver cognitive exercise in the patient’s home. Objective This systematic review gives an overview of the state-of-the-art mobile apps aimed at training cognitive functions to better understand whether these apps could be useful tools to counteract cognitive impairment in breast cancer patients. Methods We searched in a systematic way all the full-text articles from the PubMed and Embase databases. Results We found eleven studies using mobile apps to deliver cognitive training. They included a total of 819 participants. App and study characteristics are presented and discussed, including cognitive domains trained (attention, problem solving, memory, cognitive control, executive function, visuospatial function, and language). None of the apps were specifically developed for breast cancer patients. They were generally developed for a specific clinical population. Only 2 apps deal with more than 1 cognitive domain, and only 3 studies focus on the efficacy of the app training intervention. Conclusions These results highlight the lack of empirical evidence on the efficacy of currently available apps to train cognitive function. Cognitive domains are not well defined across studies. It is noteworthy that no apps are specifically developed for cancer patients, and their applicability to breast cancer should not be taken for granted. Future studies should test the feasibility, usability, and effectiveness of available cognitive training apps in women with breast cancer. Due to the complexity and multidimensionality of cognitive difficulties in this cancer population, it may be useful to design, develop, and implement an ad hoc app targeting cognitive impairment in breast cancer patients.
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Affiliation(s)
- Laura Vergani
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (Istituto di Ricovero e Cura a Carattere Scientifico), Milan, Italy
| | - Giulia Marton
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (Istituto di Ricovero e Cura a Carattere Scientifico), Milan, Italy
| | - Silvia Francesca Maria Pizzoli
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (Istituto di Ricovero e Cura a Carattere Scientifico), Milan, Italy
| | - Dario Monzani
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (Istituto di Ricovero e Cura a Carattere Scientifico), Milan, Italy
| | - Ketti Mazzocco
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (Istituto di Ricovero e Cura a Carattere Scientifico), Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (Istituto di Ricovero e Cura a Carattere Scientifico), Milan, Italy
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Saxena S, Majnemer A, Li K, Beauchamp M, Gagnon I. A cross-sectional analysis on the effects of age on dual tasking in typically developing children. PSYCHOLOGICAL RESEARCH 2018; 83:104-115. [DOI: 10.1007/s00426-018-1126-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
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Leung A, Yang E, Lim M, Metzger-Smith V, Theilmann R, Song D, Lin L, Tsai A, Lee R. Pain-related white matter tract abnormalities in mild traumatic brain injury patients with persistent headache. Mol Pain 2018; 14:1744806918810297. [PMID: 30324850 PMCID: PMC6311536 DOI: 10.1177/1744806918810297] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The occurrence of debilitating chronic persistent (24/7) headache after mild traumatic brain injury represents a central neuropathic pain state. Previous studies suggest that this chronic headache state can be attributed to altered supraspinal modulatory functional connectivity in both resting and evoked pain states. Abnormalities in the myelin sheaths along the supraspinal superior longitudinal fasciculus and anterior thalamic radiation are frequently associated with alteration in pain modulation related to functional connectivity deficit with the prefrontal cortex. This study assessed the correlated axonal injury-related white matter tract abnormality underlying these previously observed prefrontal functional connectivity deficits by comparing the fractional anisotropy, axial diffusivity, and radial diffusivity of brain white matter in patients with mild traumatic brain injury-related headache to healthy controls. Result Diffusion tensor imaging data from patients (N = 12, average age ± SD = 35.0 ± 8.0 years old, 10 male) with mild traumatic brain injury-headache were compared with images acquired from healthy controls. The mild traumatic brain injury cohort demonstrated two areas of significant (P < 0.01, F value >16, cluster size >50 voxels) white matter tract abnormalities closely related to pain affective and modulatory functions in (1) the left superior longitudinal fasciculus which connects the prefrontal cortices with the parietal cortices and (2) the right anterior thalamic radiation connecting the prefrontal cortices with the anterior cingulate cortex. In addition, a significant (P < 0.01) decrease in axial diffusivity and increase in radial diffusivity at the superior longitudinal fasciculus cluster were noted in the mild traumatic brain injury cohort. Conclusion The identified white matter tract abnormalities may represent a state of Wallerian degeneration which correlates with the functional connectivity deficit in pain modulation and can contribute to the development of the chronic persistent headache in the patients with mild traumatic brain injury.
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Affiliation(s)
- Albert Leung
- 1 Division of Pain Medicine, Department of Anesthesiology, The University of California, San Diego, CA, USA.,2 Veteran Affairs San Diego Healthcare System, CA, USA
| | - Eric Yang
- 3 The University of California, San Diego, CA, USA
| | - Michael Lim
- 3 The University of California, San Diego, CA, USA
| | | | - Rebecca Theilmann
- 4 Department of Radiology, The University of California, San Diego, CA, USA
| | - David Song
- 2 Veteran Affairs San Diego Healthcare System, CA, USA.,5 Department of Neuroscience, The University of California, San Diego, CA, USA
| | - Lisa Lin
- 2 Veteran Affairs San Diego Healthcare System, CA, USA
| | - Alice Tsai
- 2 Veteran Affairs San Diego Healthcare System, CA, USA
| | - Roland Lee
- 2 Veteran Affairs San Diego Healthcare System, CA, USA.,4 Department of Radiology, The University of California, San Diego, CA, USA
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39
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Stout DM, Buchsbaum MS, Spadoni AD, Risbrough VB, Strigo IA, Matthews SC, Simmons AN. Multimodal canonical correlation reveals converging neural circuitry across trauma-related disorders of affect and cognition. Neurobiol Stress 2018; 9:241-250. [PMID: 30450388 PMCID: PMC6234282 DOI: 10.1016/j.ynstr.2018.09.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 07/02/2018] [Accepted: 09/14/2018] [Indexed: 11/30/2022] Open
Abstract
Trauma-related disorders of affect and cognition (TRACs) are associated with a high degree of diagnostic comorbidity, which may suggest that these disorders share a set of underlying neural mechanisms. TRACs are characterized by aberrations in functional and structural circuits subserving verbal memory and affective anticipation. Yet, it remains unknown how the neural circuitry underlying these multiple mechanisms contribute to TRACs. Here, in a sample of 47 combat Veterans, we measured affective anticipation using functional magnetic resonance imaging (fMRI), verbal memory with fluorodeoxyglucose positron emission tomography (FDG-PET), and grey matter volume with structural magnetic resonance imaging (sMRI). Using a voxel-based multimodal canonical correlation analysis (mCCA), the set of neural measures were statistically integrated, or fused, with a set of TRAC symptom measures including mild traumatic brain injury (mTBI), posttraumatic stress, and depression severity. The first canonical correlation pair revealed neural convergence in clusters encompassing the middle frontal gyrus and supplemental motor area, regions implicated in top-down cognitive control and affect regulation. These results highlight the potential of leveraging multivariate neuroimaging analysis for linking neurobiological mechanisms associated with TRACs, paving the way for transdiagnostic biomarkers and targets for treatment.
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Affiliation(s)
- Daniel M Stout
- Center of Excellence in Stress and Mental Health, San Diego VA Health Care System, USA.,Department of Psychiatry, University of California, San Diego, USA
| | - Monte S Buchsbaum
- Department of Psychiatry, University of California, San Diego, USA.,Department of Radiology, University of California, San Diego, USA
| | - Andrea D Spadoni
- Center of Excellence in Stress and Mental Health, San Diego VA Health Care System, USA.,Department of Psychiatry, University of California, San Diego, USA
| | - Victoria B Risbrough
- Center of Excellence in Stress and Mental Health, San Diego VA Health Care System, USA.,Department of Psychiatry, University of California, San Diego, USA
| | - Irina A Strigo
- Department of Psychiatry, University of California, San Francisco, & San Francisco VA Health Care System, USA
| | - Scott C Matthews
- Center of Excellence in Stress and Mental Health, San Diego VA Health Care System, USA.,Department of Psychiatry, University of California, San Diego, USA
| | - Alan N Simmons
- Center of Excellence in Stress and Mental Health, San Diego VA Health Care System, USA.,Department of Psychiatry, University of California, San Diego, USA
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40
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Al-Dahhak R, Khoury R, Qazi E, Grossberg GT. Traumatic Brain Injury, Chronic Traumatic Encephalopathy, and Alzheimer Disease. Clin Geriatr Med 2018; 34:617-635. [PMID: 30336991 DOI: 10.1016/j.cger.2018.06.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Traumatic brain injury (TBI) is a major health and economic burden. With increasing aging population, this issue is expected to continue to rise. Neurodegenerative disorders are more common with aging population in general regardless of history of TBI. Recent evidence continues to support a relation between a TBI and neurocognitive decline later in life (such as in athletes and military). This article summarizes the pathologic and clinical effects of TBI (regardless of severity) on the later development of dementia in individuals 65 years or older.
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Affiliation(s)
- Roula Al-Dahhak
- Department of Neurology, Saint Louis University, 1438 South Grand Boulevard, Suite 105, St Louis, MO 63104, USA.
| | - Rita Khoury
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, 1438 South Grand Boulevard, St Louis, MO 63104, USA
| | - Erum Qazi
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, 1438 South Grand Boulevard, St Louis, MO 63104, USA
| | - George T Grossberg
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, 1438 South Grand Boulevard, St Louis, MO 63104, USA
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Mayer AR, Kaushal M, Dodd AB, Hanlon FM, Shaff NA, Mannix R, Master CL, Leddy JJ, Stephenson D, Wertz CJ, Suelzer EM, Arbogast KB, Meier TB. Advanced biomarkers of pediatric mild traumatic brain injury: Progress and perils. Neurosci Biobehav Rev 2018; 94:149-165. [PMID: 30098989 DOI: 10.1016/j.neubiorev.2018.08.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/27/2018] [Accepted: 08/03/2018] [Indexed: 12/20/2022]
Abstract
There is growing public concern about neurodegenerative changes (e.g., Chronic Traumatic Encephalopathy) that may occur chronically following clinically apparent and clinically silent (i.e., sub-concussive blows) pediatric mild traumatic brain injury (pmTBI). However, there are currently no biomarkers that clinicians can use to objectively diagnose patients or predict those who may struggle to recover. Non-invasive neuroimaging, electrophysiological and neuromodulation biomarkers have promise for providing evidence of the so-called "invisible wounds" of pmTBI. Our systematic review, however, belies that notion, identifying a relative paucity of high-quality, clinically impactful, diagnostic or prognostic biomarker studies in the sub-acute injury phase (36 studies on unique samples in 28 years), with the majority focusing on adolescent pmTBI. Ultimately, well-powered longitudinal studies with appropriate control groups, as well as standardized and clearly-defined inclusion criteria (time post-injury, injury severity and past history) are needed to truly understand the complex pathophysiology that is hypothesized (i.e., still needs to be determined) to exist during the acute and sub-acute stages of pmTBI and may underlie post-concussive symptoms.
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Affiliation(s)
- Andrew R Mayer
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States; Neurology Department, University of New Mexico School of Medicine, Albuquerque, NM, 87131, United States; Psychiatry Department, University of New Mexico School of Medicine, Albuquerque, NM, 87131, United States; Psychology Department, University of New Mexico, Albuquerque, NM, 87131, United States.
| | - Mayank Kaushal
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, 53226, United States
| | - Andrew B Dodd
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Faith M Hanlon
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Nicholas A Shaff
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Rebekah Mannix
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, 02115, United States
| | - Christina L Master
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, PA, 19104, United States; Division of Orthopedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, United States
| | - John J Leddy
- UBMD Department of Orthopaedics and Sports Medicine, University at Buffalo, Buffalo, NY, 14214, United States
| | - David Stephenson
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Christopher J Wertz
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Elizabeth M Suelzer
- Medical College of Wisconsin Libraries, Medical College of Wisconsin, Milwaukee, WI, 53226, United States
| | - Kristy B Arbogast
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, PA, 19104, United States
| | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, 53226, United States; Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, 53226, United States
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Coyle HL, Ponsford J, Hoy KE. Understanding individual variability in symptoms and recovery following mTBI: A role for TMS-EEG? Neurosci Biobehav Rev 2018; 92:140-149. [PMID: 29885426 DOI: 10.1016/j.neubiorev.2018.05.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 05/15/2018] [Accepted: 05/25/2018] [Indexed: 10/14/2022]
Abstract
The pathophysiology associated with mild traumatic brain injury (mTBI) includes neurometabolic and cytoskeletal changes that have been shown to impair structural and functional connectivity. Evidence that persistent neuropsychological impairments post injury are linked to structural and functional connectivity changes is increasing. However, to date the relationship between connectivity changes, heterogeneity of persistent symptoms and recovery post mTBI has been poorly characterised. Recent innovations in neuroimaging provide new ways of exploring connectivity changes post mTBI. Namely, combined transcranial magnetic stimulation and electroencephalography (TMS-EEG) offers several advantages over traditional approaches for studying connectivity changes post TBI. Its ability to perturb neural function in a controlled manner allows for measurement of causal interactions or effective connectivity between brain regions. We review the current literature assessing structural and functional connectivity following mTBI and outline the rationale for the use of TMS-EEG as an ideal tool for investigating the neural substrates of connectivity dysfunction and reorganisation post mTBI. The diagnostic, prognostic and potential therapeutic implications will also be explored.
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Affiliation(s)
- Hannah L Coyle
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School, Melbourne, Australia.
| | - Jennie Ponsford
- School of Psychological Sciences, Monash University, Clayton, Australia
| | - Kate E Hoy
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School, Melbourne, Australia
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Dunkley BT, Urban K, Da Costa L, Wong SM, Pang EW, Taylor MJ. Default Mode Network Oscillatory Coupling Is Increased Following Concussion. Front Neurol 2018; 9:280. [PMID: 29755402 PMCID: PMC5932404 DOI: 10.3389/fneur.2018.00280] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 04/09/2018] [Indexed: 11/13/2022] Open
Abstract
Concussion is a common form of mild traumatic brain injury. Despite the descriptor "mild," a single injury can leave long-lasting and sustained alterations to brain function, including changes to localized activity and large-scale interregional communication. Cognitive complaints are thought to arise from such functional deficits. We investigated the impact of injury on neurophysiological and functionally specialized resting networks, known as intrinsic connectivity networks (ICNs), using magnetoencephalography. We assessed neurophysiological connectivity in 40 males, 20 with concussion and 20 without. Regions-of-interest that comprise nodes of ICNs were defined, and their time courses derived using a beamformer approach. Pairwise fluctuations and covariations in band-limited amplitude envelopes were computed reflecting measures of functional connectivity. Intra-network connectivity was compared between groups using permutation testing and correlated with symptoms. We observed increased resting spectral connectivity in the default mode network (DMN) and motor networks (MOTs) in our concussion group when compared with controls, across alpha through gamma ranges. Moreover, these differences were not explained by power spectrum density within the ICNs. Furthermore, this increased coupling was significantly associated with symptoms in the DMN and MOTs-but once accounting for comorbidities (including, depression, anxiety, and ADHD) only the DMN continued to be associated with symptoms. The DMN plays a critical role in shifting between cognitive tasks. These data suggest even a single concussion can perturb the intrinsic coupling of this functionally specialized network in the brain, and may explain persistent and wide-ranging symptomatology.
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Affiliation(s)
- Benjamin T. Dunkley
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
- Neurosciences & Mental Health Program, Sick Kids Research Institute, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Karolina Urban
- Holland-Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | | | - Simeon M Wong
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
| | - Elizabeth W. Pang
- Neurosciences & Mental Health Program, Sick Kids Research Institute, Toronto, ON, Canada
- Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Margot J. Taylor
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
- Neurosciences & Mental Health Program, Sick Kids Research Institute, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
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44
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Hocke LM, Duszynski CC, Debert CT, Dleikan D, Dunn JF. Reduced Functional Connectivity in Adults with Persistent Post-Concussion Symptoms: A Functional Near-Infrared Spectroscopy Study. J Neurotrauma 2018; 35:1224-1232. [PMID: 29373947 PMCID: PMC5962910 DOI: 10.1089/neu.2017.5365] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Concussion, or mild traumatic brain injury (mTBI), accounts for ∼80% of all TBIs across North America. The majority of mTBI patients recover within days to weeks; however, 14-36% of the time, acute mTBI symptoms persist for months or even years and develop into persistent post-concussion symptoms (PPCS). There is a need to find biomarkers in patients with PPCS, to improve prognostic ability and to provide insight into the pathophysiology underlying chronic symptoms. Recent research has pointed toward impaired network integrity and cortical communication as a biomarker. In this study we investigated functional near-infrared spectroscopy (fNIRS) as a technique to assess cortical communication deficits in adults with PPCS. Specifically, we aimed to identify cortical communication patterns in prefrontal and motor areas during rest and task, in adult patients with persistent symptoms. We found that (1) the PPCS group showed reduced connectivity compared with healthy controls, (2) increased symptom severity correlated with reduced coherence, and (3) connectivity differences were best distinguishable during task and in particular during the working memory task (n-back task) in the right and left dorsolateral prefrontal cortex (DLPFC). These data show that reduced brain communication may be associated with the pathophysiology of mTBI and that fNIRS, with a relatively simple acquisition paradigm, may provide a useful biomarker of this injury.
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Affiliation(s)
- Lia M Hocke
- 1 Hotchkiss Brain Institute , Calgary, Alberta, Canada .,2 Department of Radiology, Experimental Imaging Lab , Calgary, Alberta, Canada .,3 Department of Clinical Neurosciences, Foothills Medical Centre , Calgary, Alberta, Canada .,4 Cumming School of Medicine Calgary , Alberta, Canada
| | - Chris C Duszynski
- 1 Hotchkiss Brain Institute , Calgary, Alberta, Canada .,2 Department of Radiology, Experimental Imaging Lab , Calgary, Alberta, Canada .,3 Department of Clinical Neurosciences, Foothills Medical Centre , Calgary, Alberta, Canada .,4 Cumming School of Medicine Calgary , Alberta, Canada
| | - Chantel T Debert
- 1 Hotchkiss Brain Institute , Calgary, Alberta, Canada .,3 Department of Clinical Neurosciences, Foothills Medical Centre , Calgary, Alberta, Canada .,4 Cumming School of Medicine Calgary , Alberta, Canada
| | - Diane Dleikan
- 1 Hotchkiss Brain Institute , Calgary, Alberta, Canada .,2 Department of Radiology, Experimental Imaging Lab , Calgary, Alberta, Canada .,3 Department of Clinical Neurosciences, Foothills Medical Centre , Calgary, Alberta, Canada .,4 Cumming School of Medicine Calgary , Alberta, Canada
| | - Jeff F Dunn
- 1 Hotchkiss Brain Institute , Calgary, Alberta, Canada .,2 Department of Radiology, Experimental Imaging Lab , Calgary, Alberta, Canada .,3 Department of Clinical Neurosciences, Foothills Medical Centre , Calgary, Alberta, Canada .,4 Cumming School of Medicine Calgary , Alberta, Canada
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45
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Bedard M, Taler V, Steffener J. Long-term prospective memory impairment following mild traumatic brain injury with loss of consciousness: findings from the Canadian Longitudinal Study on Aging. Clin Neuropsychol 2017; 32:1002-1018. [DOI: 10.1080/13854046.2017.1404644] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Marc Bedard
- Bruyère Research Institute, Ottawa, Canada
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - Vanessa Taler
- Bruyère Research Institute, Ottawa, Canada
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - Jason Steffener
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
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46
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van der Horn HJ, Scheenen ME, de Koning ME, Liemburg EJ, Spikman JM, van der Naalt J. The Default Mode Network as a Biomarker of Persistent Complaints after Mild Traumatic Brain Injury: A Longitudinal Functional Magnetic Resonance Imaging Study. J Neurotrauma 2017; 34:3262-3269. [DOI: 10.1089/neu.2017.5185] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Harm J. van der Horn
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Myrthe E. Scheenen
- Department of Neuropsychology, University Medical Center Groningen, Groningen, The Netherlands
| | - Myrthe E. de Koning
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Edith J. Liemburg
- NeuroImaging Center of the Department of Neuroscience, University Medical Center Groningen, Groningen, The Netherlands
| | - Jacoba M. Spikman
- Department of Neuropsychology, University Medical Center Groningen, Groningen, The Netherlands
| | - Joukje van der Naalt
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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47
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Ledig C, Kamnitsas K, Koikkalainen J, Posti JP, Takala RSK, Katila A, Frantzén J, Ala-Seppälä H, Kyllönen A, Maanpää HR, Tallus J, Lötjönen J, Glocker B, Tenovuo O, Rueckert D. Regional brain morphometry in patients with traumatic brain injury based on acute- and chronic-phase magnetic resonance imaging. PLoS One 2017; 12:e0188152. [PMID: 29182625 PMCID: PMC5705131 DOI: 10.1371/journal.pone.0188152] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 11/01/2017] [Indexed: 02/02/2023] Open
Abstract
Traumatic brain injury (TBI) is caused by a sudden external force and can be very heterogeneous in its manifestation. In this work, we analyse T1-weighted magnetic resonance (MR) brain images that were prospectively acquired from patients who sustained mild to severe TBI. We investigate the potential of a recently proposed automatic segmentation method to support the outcome prediction of TBI. Specifically, we extract meaningful cross-sectional and longitudinal measurements from acute- and chronic-phase MR images. We calculate regional volume and asymmetry features at the acute/subacute stage of the injury (median: 19 days after injury), to predict the disability outcome of 67 patients at the chronic disease stage (median: 229 days after injury). Our results indicate that small structural volumes in the acute stage (e.g. of the hippocampus, accumbens, amygdala) can be strong predictors for unfavourable disease outcome. Further, group differences in atrophy are investigated. We find that patients with unfavourable outcome show increased atrophy. Among patients with severe disability outcome we observed a significantly higher mean reduction of cerebral white matter (3.1%) as compared to patients with low disability outcome (0.7%).
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Affiliation(s)
- Christian Ledig
- Imperial College London, Department of Computing, London, United Kingdom
- * E-mail:
| | | | - Juha Koikkalainen
- Combinostics, Tampere, Finland
- VTT Technical Research Centre of Finland, Tampere, Finland
| | - Jussi P. Posti
- Department of Clinical Medicine, University of Turku, Turku, Finland
- Division of Clinical Neurosciences, Turku Brain Injury Centre, Turku University Hospital, Turku, Finland
- Division of Clinical Neurosciences, Department of Neurosurgery, Turku University Hospital, Turku, Finland
| | - Riikka S. K. Takala
- Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital and University of Turku, Turku, Finland
| | - Ari Katila
- Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital and University of Turku, Turku, Finland
| | - Janek Frantzén
- Department of Clinical Medicine, University of Turku, Turku, Finland
- Division of Clinical Neurosciences, Turku Brain Injury Centre, Turku University Hospital, Turku, Finland
- Division of Clinical Neurosciences, Department of Neurosurgery, Turku University Hospital, Turku, Finland
| | - Henna Ala-Seppälä
- Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Anna Kyllönen
- Department of Clinical Medicine, University of Turku, Turku, Finland
| | | | - Jussi Tallus
- Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Jyrki Lötjönen
- Combinostics, Tampere, Finland
- VTT Technical Research Centre of Finland, Tampere, Finland
| | - Ben Glocker
- Imperial College London, Department of Computing, London, United Kingdom
| | - Olli Tenovuo
- Department of Clinical Medicine, University of Turku, Turku, Finland
- Division of Clinical Neurosciences, Turku Brain Injury Centre, Turku University Hospital, Turku, Finland
| | - Daniel Rueckert
- Imperial College London, Department of Computing, London, United Kingdom
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48
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Ben Shimon M, Zeimer T, Shavit Stein E, Artan-Furman A, Harnof S, Chapman J, Eisenkraft A, Pick CG, Maggio N. Recovery from trauma induced amnesia correlates with normalization of thrombin activity in the mouse hippocampus. PLoS One 2017; 12:e0188524. [PMID: 29182653 PMCID: PMC5705129 DOI: 10.1371/journal.pone.0188524] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 11/08/2017] [Indexed: 12/23/2022] Open
Abstract
Transient amnesia is a common consequence of minimal traumatic brain injury (mTBI). However, while recent findings have addressed the mechanisms involved in its onset, the processes contributing to its recovery have not yet been addressed. Recently, we have found that thrombin is detected at high concentrations in the brain of mice after exposure to mTBI and that in such settings amnesia is rescued by either inhibiting thrombin activity or by blockade of PAR1. Here, we report that mice spontaneously recover from amnesia after two weeks from mTBI exposure. At this time point, long term potentiation was equally evoked in injured vs. control animals with thrombin concentration in the brain being normalized at this stage. These findings, which refer to the specific aspect of memory retrieval upon mTBI, together with our previous work, hint to a strong correlation between cognitive defects in the context of mTBI and thrombin concentrations in the brain. This may suggest that a possible scavenging of thrombin in the brain at early phases following mTBI may improve memory function.
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Affiliation(s)
- Marina Ben Shimon
- Department of Neurology, The Chaim Sheba Medical Center, Ramat Gan, Israel
- Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Talya Zeimer
- Department of Neurology, The Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Efrat Shavit Stein
- Department of Neurology, The Chaim Sheba Medical Center, Ramat Gan, Israel
| | | | - Sagi Harnof
- Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Neurosurgery, Rabin Medical Center, Petah Tikva, Israel
| | - Joab Chapman
- Department of Neurology, The Chaim Sheba Medical Center, Ramat Gan, Israel
- Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Arik Eisenkraft
- The Institute for Research in Military Medicine, The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Chaim G. Pick
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Anatomy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nicola Maggio
- Department of Neurology, The Chaim Sheba Medical Center, Ramat Gan, Israel
- Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Talpiot Medical Leadership Program, The Chaim Sheba Medical Center, Ramat Gan, Israel
- * E-mail:
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49
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Guay S, De Beaumont L, Drisdelle BL, Lina JM, Jolicoeur P. Electrophysiological impact of multiple concussions in asymptomatic athletes: A re-analysis based on alpha activity during a visual-spatial attention task. Neuropsychologia 2017; 108:42-49. [PMID: 29162458 DOI: 10.1016/j.neuropsychologia.2017.11.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 10/31/2017] [Accepted: 11/16/2017] [Indexed: 01/02/2023]
Abstract
Most EEG studies used event-related potentials to assess long-term and cumulative effects of sport-related concussions on brain activity. Time-frequency methods provide another approach that allows the detection of subtle shifts in types and patterns of brain oscillations. We sought to discover whether event-related alpha activity would be significantly affected in asymptomatic multi-concussed athletes. We measured the amplitude of alpha activity (8-12Hz) from the EEG recorded during a visual-spatial attention task to compare event-related alpha perturbations in 13 multi-concussed athletes and 14 age-equivalent, non-concussed teammates. Relative to non-concussed athletes, multi-concussed athletes showed significantly less event-related perturbations time-locked to stimulus presentation. Alpha activity alterations were closely related to the number of concussions sustained. Event-related alpha activity differed in asymptomatic multi-concussed athletes when compared to controls. Our study suggests that low-level neurophysiological underpinnings of the deployment of visual-spatial attention are affected in multi-concussed athletes even though their last concussion occurred on average 30 months prior to testing.
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Affiliation(s)
- Samuel Guay
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada; Centre de recherche de l'Hôpital du Sacré-Coeur de Montréal, Montreal QC, Canada
| | - Louis De Beaumont
- Centre de recherche de l'Hôpital du Sacré-Coeur de Montréal, Montreal QC, Canada; Department of Surgery, Université de Montréal, Montreal, QC, Canada
| | - Brandi Lee Drisdelle
- Department of Psychology, Université de Montréal, Montreal, QC, Canada; Centre de recherche en neuropsychologie et cognition (CERNEC), Université de Montréal, Montreal, QC, Canada
| | - Jean-Marc Lina
- Centre de recherche de l'Hôpital du Sacré-Coeur de Montréal, Montreal QC, Canada; Montréal Polytechnique, Montreal, QC, Canada
| | - Pierre Jolicoeur
- Department of Psychology, Université de Montréal, Montreal, QC, Canada; Centre de recherche en neuropsychologie et cognition (CERNEC), Université de Montréal, Montreal, QC, Canada; Centre de recherche de l'Institut universitaire de gériatrie de Montreal, Montreal, QC, Canada.
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50
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Regan PM, Bleiberg J, Onge PS, Temme L. Feasibility of using normobaric hypoxic stress in mTBI research. Concussion 2017; 2:CNC44. [PMID: 30202585 PMCID: PMC6094798 DOI: 10.2217/cnc-2017-0008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 03/15/2017] [Indexed: 11/21/2022] Open
Abstract
Studies of mild traumatic brain injury (mTBI) recovery generally assess patients in unstressed conditions that permit compensation for impairments through increased effort expenditure. This possibility may explain why a subgroup of individuals report persistent mTBI symptoms yet perform normally on objective assessment. Accordingly, the development and utilization of stress paradigms may be effective for enhancing the sensitivity of mTBI assessment. Previous studies, discussed here, indirectly but plausibly support the use of normobaric hypoxia as a stressor in uncovering latent mTBI symptoms due to the overlapping symptomatology induced by both normobaric hypoxia and mTBI. Limited studies by our group and others further support this plausibility through proof-of-concept demonstrations that hypoxia reversibly induces disproportionately severe impairments of oculomotor, pupillometric, cognitive and autonomic function in mTBI individuals.
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Affiliation(s)
- Patrick M Regan
- National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center, Bethesda, MD, USA
- Laulima Government Solutions LLC, Orlando, FL 32826, USA
- National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center, Bethesda, MD, USA
- Laulima Government Solutions LLC, Orlando, FL 32826, USA
| | - Joseph Bleiberg
- National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Paul St Onge
- U.S. Army Aeromedical Research Laboratory, Fort Rucker, AL 36362, USA
- Laulima Government Solutions LLC, Orlando, FL 32826, USA
- U.S. Army Aeromedical Research Laboratory, Fort Rucker, AL 36362, USA
- Laulima Government Solutions LLC, Orlando, FL 32826, USA
| | - Leonard Temme
- U.S. Army Aeromedical Research Laboratory, Fort Rucker, AL 36362, USA
- U.S. Army Aeromedical Research Laboratory, Fort Rucker, AL 36362, USA
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