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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 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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Zhuo J, Raghavan P, Jiang L, Roys S, Tchoquessi RLN, Chen H, Wickwire EM, Parikh GY, Schwartzbauer GT, Grattan LM, Wang Z, Gullapalli RP, Badjatia N. Longitudinal Assessment of Glymphatic Changes Following Mild Traumatic Brain Injury: Insights from PVS burden and DTI-ALPS Imaging. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.01.24307927. [PMID: 38854000 PMCID: PMC11160843 DOI: 10.1101/2024.06.01.24307927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Traumatic brain injury (TBI) even in the mild form may result in long-lasting post-concussion symptoms. TBI is also a known risk to late-life neurodegeneration. Recent studies suggest that dysfunction in the glymphatic system, responsible for clearing protein waste from the brain, may play a pivotal role in the development of dementia following TBI. Given the diverse nature of TBI, longitudinal investigations are essential to comprehending the dynamic changes in the glymphatic system and its implications for recovery. In this prospective study, we evaluated two promising glymphatic imaging markers, namely the enlarged perivascular space (ePVS) burden and Diffusion Tensor Imaging-based ALPS index, in 44 patients with mTBI at two early post-injury time points: approximately 14 days (14Day) and 6-12 months (6-12Mon) post-injury, while also examining their associations with post-concussion symptoms. Additionally, 37 controls, comprising both orthopedic patients and healthy individuals, were included for comparative analysis. Our key findings include: 1) White matter ePVS burden (WM-ePVS) and ALPS index exhibit significant correlations with age. 2) Elevated WM-ePVS burden in acute mTBI (14Day) is significantly linked to a higher number of post-concussion symptoms, particularly memory problems. 3) The increase in the ALPS index from acute (14Day) to the chronic (6-12Mon) phases in mTBI patients correlates with improvement in sleep measures. Furthermore, incorporating WM-ePVS burden and the ALPS index from acute phase enhances the prediction of chronic memory problems beyond socio-demographic and basic clinical information, highlighting their distinct roles in assessing glymphatic structure and activity. Early evaluation of glymphatic function could be crucial for understanding TBI recovery and developing targeted interventions to improve patient outcomes.
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Affiliation(s)
- Jiachen Zhuo
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Prashant Raghavan
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Li Jiang
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Steven Roys
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Rosy Linda Njonkou Tchoquessi
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Hegang Chen
- Department of Epidemiology & public Health, University of Maryland School of Medicine, Baltimore, MD
| | - Emerson M. Wickwire
- Department of Psychiatry & Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Gunjan Y. Parikh
- Program in Trauma, University of Maryland School of Medicine, Baltimore, MD
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD
| | - Gary T. Schwartzbauer
- Program in Trauma, University of Maryland School of Medicine, Baltimore, MD
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD
| | - Lynn M. Grattan
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD
| | - Ze Wang
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Rao P. Gullapalli
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Neeraj Badjatia
- Program in Trauma, University of Maryland School of Medicine, Baltimore, MD
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD
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Kagialis A, Simos N, Manolitsi K, Vakis A, Simos P, Papadaki E. Functional connectivity-hemodynamic (un)coupling changes in chronic mild brain injury are associated with mental health and neurocognitive indices: a resting state fMRI study. Neuroradiology 2024; 66:985-998. [PMID: 38605104 PMCID: PMC11133187 DOI: 10.1007/s00234-024-03352-9] [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: 01/29/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE To examine hemodynamic and functional connectivity alterations and their association with neurocognitive and mental health indices in patients with chronic mild traumatic brain injury (mTBI). METHODS Resting-state functional MRI (rs-fMRI) and neuropsychological assessment of 37 patients with chronic mTBI were performed. Intrinsic connectivity contrast (ICC) and time-shift analysis (TSA) of the rs-fMRI data allowed the assessment of regional hemodynamic and functional connectivity disturbances and their coupling (or uncoupling). Thirty-nine healthy age- and gender-matched participants were also examined. RESULTS Patients with chronic mTBI displayed hypoconnectivity in bilateral hippocampi and parahippocampal gyri and increased connectivity in parietal areas (right angular gyrus and left superior parietal lobule (SPL)). Slower perfusion (hemodynamic lag) in the left anterior hippocampus was associated with higher self-reported symptoms of depression (r = - 0.53, p = .0006) and anxiety (r = - 0.484, p = .002), while faster perfusion (hemodynamic lead) in the left SPL was associated with lower semantic fluency (r = - 0.474, p = .002). Finally, functional coupling (high connectivity and hemodynamic lead) in the right anterior cingulate cortex (ACC)) was associated with lower performance on attention and visuomotor coordination (r = - 0.50, p = .001), while dysfunctional coupling (low connectivity and hemodynamic lag) in the left ventral posterior cingulate cortex (PCC) and right SPL was associated with lower scores on immediate passage memory (r = - 0.52, p = .001; r = - 0.53, p = .0006, respectively). Uncoupling in the right extrastriate visual cortex and posterior middle temporal gyrus was negatively associated with cognitive flexibility (r = - 0.50, p = .001). CONCLUSION Hemodynamic and functional connectivity differences, indicating neurovascular (un)coupling, may be linked to mental health and neurocognitive indices in patients with chronic mTBI.
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Affiliation(s)
- Antonios Kagialis
- Department of Psychiatry, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
- Department of Radiology, School of Medicine, University of Crete, University Hospital of Heraklion, 71003, Crete, Greece
| | - Nicholas Simos
- Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Crete, Greece
| | - Katina Manolitsi
- Department of Neurosurgery, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Antonios Vakis
- Department of Neurosurgery, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Panagiotis Simos
- Department of Psychiatry, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
- Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Crete, Greece
| | - Efrosini Papadaki
- Department of Radiology, School of Medicine, University of Crete, University Hospital of Heraklion, 71003, Crete, Greece.
- Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Crete, Greece.
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Wiseman N, Iraji A, Haacke EM, Calhoun V, Kou Z. Extracting functional connectivity brain networks at the resting state from pulsed arterial spin labeling data. META-RADIOLOGY 2023; 1:100023. [PMID: 38298860 PMCID: PMC10830167 DOI: 10.1016/j.metrad.2023.100023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Introduction Functional connectivity in the brain is often studied with blood oxygenation level dependent (BOLD) resting state functional magnetic resonance imaging (rsfMRI), but the BOLD signal is several steps removed from neuronal activity. Arterial spin labeling (ASL), particularly pulsed ASL (PASL), has also the capacity to measure the blood-flow changes in response to activity. In this paper, we investigated the feasibility of extracting major brain networks from PASL data, in contrast with rsfMRI analsyis. Materials and methods In this retrospective study, we analyzed a cohort dataset that consists of 21 mild traumatic brain injury (mTBI) patients and 29 healthy controls, which was collected in a previous study. By extracting 10 major brain networks from the data of both PASL and rsfMRI, we contrasted their similarities and differences in the 10 networks extracted from both modalities. Results Our data demonstrated that PASL could be used to extract all 10 major brain networks. Eight out of 10 networks demonstrated over 60 % similarity to rsfMRI data. Meanwhile, there are similar but not identical changes in networks detected between mTBI patients and healthy controls with both modalities. Notably, the PASL-extracted default mode network (DMN), other than the rsfMRI-extracted DMN, includes some regions known to be associated with the DMN in other studies. It demonstrated that PASL data can be analyzed to identify resting state networks with reasonable reliability, even without rsfMRI data. Conclusion Our analysis provides an opportunity to extract functional connectivity information in heritage datasets in which ASL but not BOLD was collected.
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Affiliation(s)
- Natalie Wiseman
- Department of Psychiatry and Behavioral Sciences, Wayne State University, Detroit, MI, USA
| | - Armin Iraji
- Department of Computer Science, Georgia State University, Atlanta, GA, USA
| | - E Mark Haacke
- Departments of Biomedical Engineering and Radiology, Wayne State University, Detroit, MI, USA
| | - Vince Calhoun
- Department of Computer Science, Georgia State University, Atlanta, GA, USA
| | - Zhifeng Kou
- Departments of Biomedical Engineering and Radiology, Wayne State University, Detroit, MI, USA
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5
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Baragi VM, Gattu R, Trifan G, Woodard JL, Meyers K, Halstead TS, Hipple E, Haacke EM, Benson RR. Neuroimaging Markers for Determining Former American Football Players at Risk for Alzheimer's Disease. Neurotrauma Rep 2022; 3:398-414. [PMID: 36204386 PMCID: PMC9531889 DOI: 10.1089/neur.2022.0020] [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: 11/26/2022] Open
Abstract
NFL players, by virtue of their exposure to traumatic brain injury (TBI), are at higher risk of developing dementia and Alzheimer's disease (AD) than the general population. Early recognition and intervention before the onset of clinical symptoms could potentially avert/delay the long-term consequences of these diseases. Given that AD is thought to have a long pre-clinical incubation period, the aim of the current research was to determine whether former NFL players show evidence of incipient dementia in their structural imaging before diagnosis of AD. To identify neuroimaging markers of AD, against which former NFL players would be compared, we conducted a whole-brain volumetric analysis using a cohort of AD patients (ADNI clinical database) to produce a set of brain regions demonstrating sensitivity to early AD pathology (i.e., the “AD fingerprint”). A group of 46 former NFL players' brain magnetic resonance images were then interrogated using the AD fingerprint, that is, the former NFL subjects were compared volumetrically to AD patients using a T1-weighted magnetization-prepared rapid gradient echo sequence. The FreeSurfer image analysis suite (version 6.0) was used to obtain volumetric and cortical thickness data. The Automated Neuropsychological Assessment Metric-Version 4 was used to assess current cognitive functioning. A total of 55 brain regions demonstrated significant atrophy or ex vacuo dilatation bilaterally in AD patients versus controls. Of the 46 former NFL players, 41% demonstrated a greater than expected number of atrophied/dilated AD regions compared with age-matched controls, presumably reflecting AD pathology.
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Affiliation(s)
| | - Ramtilak Gattu
- Center for Neurological Studies, Dearborn, Michigan, USA
| | | | | | | | | | | | - Ewart Mark Haacke
- HUH-MR Research/Radiology, Wayne State University/Detroit Receiving Hospital, Detroit, Michigan, USA
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6
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Gumus M, Mack ML, Green R, Khodadadi M, Wennberg R, Crawley A, Colella B, Tarazi A, Mikulis DJ, Tator CH, Tartaglia MC. Brain Connectivity Changes in Post-Concussion Syndrome as the Neural Substrate of a Heterogeneous Syndrome. Brain Connect 2022; 12:711-724. [PMID: 35018791 DOI: 10.1089/brain.2021.0127] [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: 11/12/2022] Open
Abstract
BACKGROUND Post-concussion syndrome (PCS) or persistent symptoms of concussion refers to a constellation of symptoms that persist for weeks and months after a concussion. To better capture the heterogeneity of the symptoms of patients with post-concussion syndrome, we aimed to separate patients into clinical subtypes based on brain connectivity changes. METHODS Subject-specific structural and functional connectomes were created based on Diffusion Weighted and Resting State Functional Magnetic Resonance Imaging, respectively. Following an informed dimensionality reduction, a gaussian mixture model was used on patient specific structural and functional connectivity matrices to find potential patient clusters. For validation, the resulting patient subtypes were compared in terms of cognitive, neuropsychiatric, and post-concussive symptom differences. RESULTS Multimodal analyses of brain connectivity were predictive of behavioural outcomes. Our modelling revealed 2 patient subtypes; mild and severe. The severe group showed significantly higher levels of depression, anxiety, aggression, and a greater number of symptoms than the mild patient subgroup. CONCLUSION This study suggests that structural and functional connectivity changes together can help us better understand the symptom severity and neuropsychiatric profiles of patients with post-concussion syndrome. This work allows us to move towards precision medicine in concussions and provides a novel machine learning approach that can be applicable to other heterogeneous conditions.
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Affiliation(s)
- Melisa Gumus
- University of Toronto, 7938, 60 Leonard Avenue, Krembil Discovery Tower, Toronto, Toronto, Ontario, Canada, M5S 1A1;
| | | | - Robin Green
- University of Toronto, 7938, Toronto, Ontario, Canada;
| | | | | | | | - Brenda Colella
- University Health Network, 7989, Toronto, Ontario, Canada;
| | - Apameh Tarazi
- University Health Network, 7989, Toronto, Ontario, Canada;
| | - David J Mikulis
- Toronto Western Hospital, 26625, Joint Department of Medical Imaging, 399 Bathurst St., Toronto, Ontario, Canada, m5t2s8;
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7
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Lower cortical volume is associated with poor sleep quality after traumatic brain injury. Brain Imaging Behav 2022; 16:1362-1371. [PMID: 35018551 DOI: 10.1007/s11682-021-00615-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 11/02/2022]
Abstract
Traumatic brain injury (TBI) is known to be associated with poor sleep. In this report, we aimed to identify associations between differences in cortical volume and sleep quality post-TBI. MRI anatomical scans from 88 cases with TBI were analyzed in this report. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Voxel Based Morphometry (VBM), was used to obtain statistical maps of the association between PSQI and cortical volume in gray matter and white matter voxels. Higher PSQI total scores (poor sleep quality) were strongly associated with smaller gray matter volume in the cerebellum. White matter volume was not associated with total PSQI. The sleep disturbance subcomponent showed a significant association with gray and white matter volumes in the cerebellum. Although not significant, cortical areas such as the cingulate and medial frontal regions were associated with sleep quality. The cerebellum with higher contribution to motor and autonomic systems was associated strongly with poor sleep quality. Additionally, regions that play critical roles in inhibitory brain function and suppress mind wandering (i.e., default mode network including medial frontal and cingulate regions) were associated (although to a lesser extent) with sleep. Our findings suggest that poor sleep quality following TBI is significantly associated with lower cerebellar volume, with trending relationships in regions associated with inhibitory function.
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8
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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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9
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Anders JPV, Kraemer WJ, Newton RU, Post EM, Caldwell LK, Beeler MK, DuPont WH, Martini ER, Volek JS, Häkkinen K, Maresh CM, Hayes SM. Acute Effects of High-intensity Resistance Exercise on Cognitive Function. J Sports Sci Med 2021; 20:391-397. [PMID: 34267577 PMCID: PMC8256515 DOI: 10.52082/jssm.2021.391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 04/22/2021] [Indexed: 12/20/2022]
Abstract
The purpose of the present study was to examine the influence of an acute bout of high-intensity resistance exercise on measures of cognitive function. Ten men (Mean ± SD: age = 24.4 ± 3.2 yrs; body mass = 85.7 ± 11.8 kg; height = 1.78 ± 0.08 m; 1 repetition maximum (1RM) = 139.0 ± 24.1 kg) gave informed consent and performed a high-intensity 6 sets of 10 repetitions of barbell back squat exercise at 80% 1RM with 2 minutes rest between sets. The Automated Neuropsychological Assessment Metrics (ANAM) was completed to assess various cognitive domains during the familiarization period, immediately before, and immediately after the high-intensity resistance exercise bout. The repeated measures ANOVAs for throughput scores (r·m-1) demonstrated significant mean differences for the Mathematical Processing task (MTH; p < 0.001, η2p = 0.625) where post hoc pairwise comparisons demonstrated that the post-fatigue throughput (32.0 ± 8.8 r·m-1) was significantly greater than the pre-fatigue (23.8 ± 7.4 r·m-1, p = 0.003, d = 1.01) and the familiarization throughput (26.4 ± 5.3 r·m-1, p = 0.024, d = 0.77). The Coded Substitution-Delay task also demonstrated significant mean differences (CDD; p = 0.027, η2p = 0.394) with post hoc pairwise comparisons demonstrating that the post-fatigue throughput (49.3 ± 14.4 r·m-1) was significantly less than the pre-fatigue throughput (63.2 ± 9.6 r·m-1, p = 0.011, d = 1.14). The repeated measures ANOVAs for reaction time (ms) demonstrated significant mean differences for MTH (p < 0.001, η2p = 0.624) where post hoc pairwise comparisons demonstrated that the post-fatigue reaction time (1885.2 ± 582.8 ms) was significantly less than the pre-fatigue (2518.2 ± 884.8 ms, p = 0.005, d = 0.85) and familiarization (2253.7 ± 567.6 ms, p = 0.009, d = 0.64) reaction times. The Go/No-Go task demonstrated significant mean differences (GNG; p = 0.031, η2p = 0.320) with post hoc pairwise comparisons demonstrating that the post-fatigue (285.9 ± 16.3 ms) was significantly less than the pre-fatigue (298.5 ± 12.1 ms, p = 0.006, d = 0.88) reaction times. High-intensity resistance exercise may elicit domain-specific influences on cognitive function, characterized by the facilitation of simple cognitive tasks and impairments of complex cognitive tasks.
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Affiliation(s)
- John Paul V Anders
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
- Department of Education and Human Sciences, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup WA 6027, Australia
| | - Emily M Post
- Exercise Science Department, Ohio Dominican, Columbus, Ohio, USA
| | - Lydia K Caldwell
- Applied Physiology Laboratory, University of North Texas, Denton, TX, USA
| | - Matthew K Beeler
- Department of Exercise Science, Hastings College, Hastings, NE, USA
| | - William H DuPont
- Department of Biomedical Sciences, Quinnipiac University, Hamden, CT, USA
| | - Emily R Martini
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Jeff S Volek
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Keijo Häkkinen
- Department of Biology of Physical Activity & Neuromuscular Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Carl M Maresh
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Scott M Hayes
- Department of Psychology, The Ohio State University, Columbus, OH, USA
- Chronic Brain Injury Initiative, The Ohio State University, Columbus, OH, USA
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10
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Churchill NW, Hutchison MG, Graham SJ, Schweizer TA. Brain function associated with reaction time after sport-related concussion. Brain Imaging Behav 2021; 15:1508-1517. [PMID: 32851585 DOI: 10.1007/s11682-020-00349-9] [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] [Indexed: 12/11/2022]
Abstract
Concussion is associated with significant functional disturbances in the first week post-injury. Computerized neurocognitive testing tools have become widely adopted in concussion management, to identify specific domains of impairment and obtain more objective measures of recovery. Reaction time (RT) slowing is a common sequela of concussion, however, the functional brain networks that underlie RT performance remain under-studied in both healthy and concussed athletic cohorts. This study used blood-oxygenation-level-dependent function magnetic resonance imaging (BOLD fMRI) to evaluate resting brain function of 45 university-level athletes with concussion in the first week post-injury, along with a control cohort of 102 athletes without recent concussion. We evaluated the main effects of concussion and RT on functional connectivity, along with concussion × RT interactions, using multivariate analysis techniques. Concussion was associated with reduced connectivity throughout the brain, whereas RT slowing was associated with elevated connectivity in parietal and temporal regions, for both control and concussed groups. For the concussed group, RT slowing was also associated with disrupted connectivity between fronto-insular and default mode networks. For concussed athletes, the brain networks associated with slower post-injury RT also showed similar but non-significant associations with longitudinal changes in RT performance relative to pre-injury baseline. These study findings provide new insights into the effects of concussion on neurocognitive function and suggest the presence of functional brain networks that are specific to concussion-related RT slowing.
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Affiliation(s)
- Nathan W Churchill
- Keenan Research Centre of the Li Ka Shing Knowledge Institute at St. Michael's Hospital Neuroscience Research Program, St. Michael's Hospital, Toronto, ON, Canada. .,Neuroscience Research Program, St. Michael's Hospital, ON, Toronto, Canada.
| | - Michael G Hutchison
- Keenan Research Centre of the Li Ka Shing Knowledge Institute at St. Michael's Hospital Neuroscience Research Program, St. Michael's Hospital, Toronto, ON, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Simon J Graham
- Physical Sciences Platform, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, ON, Toronto, Canada.,Department of Medical Biophysics, University of Toronto, ON, Toronto, Canada
| | - Tom A Schweizer
- Keenan Research Centre of the Li Ka Shing Knowledge Institute at St. Michael's Hospital Neuroscience Research Program, St. Michael's Hospital, Toronto, ON, Canada.,Neuroscience Research Program, St. Michael's Hospital, ON, Toronto, Canada.,Faculty of Medicine (Neurosurgery), University of Toronto, Toronto, ON, Canada.,The Institute of Biomaterials & Biomedical Engineering (IBBME), University of Toronto, ON, Toronto, Canada
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11
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Quinn DK, Upston J, Jones T, Brandt E, Story-Remer J, Fratzke V, Wilson JK, Rieger R, Hunter MA, Gill D, Richardson JD, Campbell R, Clark VP, Yeo RA, Shuttleworth CW, Mayer AR. Cerebral Perfusion Effects of Cognitive Training and Transcranial Direct Current Stimulation in Mild-Moderate TBI. Front Neurol 2020; 11:545174. [PMID: 33117255 PMCID: PMC7575722 DOI: 10.3389/fneur.2020.545174] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/28/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Persistent post-traumatic symptoms (PPS) after traumatic brain injury (TBI) can lead to significant chronic functional impairment. Pseudocontinuous arterial spin labeling (pCASL) has been used in multiple studies to explore changes in cerebral blood flow (CBF) that may result in acute and chronic TBI, and is a promising neuroimaging modality for assessing response to therapies. Methods: Twenty-four subjects with chronic mild-moderate TBI (mmTBI) were enrolled in a pilot study of 10 days of computerized executive function training combined with active or sham anodal transcranial direct current stimulation (tDCS) for treatment of cognitive PPS. Behavioral surveys, neuropsychological testing, and magnetic resonance imaging (MRI) with pCASL sequences to assess global and regional CBF were obtained before and after the training protocol. Results: Robust improvements in depression, anxiety, complex attention, and executive function were seen in both active and sham groups between the baseline and post-treatment visits. Global CBF decreased over time, with differences in regional CBF noted in the right inferior frontal gyrus (IFG). Active stimulation was associated with static or increased CBF in the right IFG, whereas sham was associated with reduced CBF. Neuropsychological performance and behavioral symptoms were not associated with changes in CBF. Discussion: The current study suggests a complex picture between mmTBI, cerebral perfusion, and recovery. Changes in CBF may result from physiologic effect of the intervention, compensatory neural mechanisms, or confounding factors. Limitations include a small sample size and heterogenous injury sample, but these findings suggest promising directions for future studies of cognitive training paradigms in mmTBI.
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Affiliation(s)
- Davin K Quinn
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, United States
| | - Joel Upston
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, United States
| | - Thomas Jones
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, United States
| | - Emma Brandt
- Department of Neuroscience, University of New Mexico, Albuquerque, NM, United States
| | | | - Violet Fratzke
- Department of Neuroscience, University of New Mexico, Albuquerque, NM, United States.,Chicago Medical School, Chicago, IL, United States
| | - J Kevin Wilson
- Department of Neuroscience, University of New Mexico, Albuquerque, NM, United States
| | - Rebecca Rieger
- Department of Neuroscience, University of New Mexico, Albuquerque, NM, United States
| | | | - Darbi Gill
- Department of Neuroscience, University of New Mexico, Albuquerque, NM, United States
| | - Jessica D Richardson
- Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque, NM, United States
| | - Richard Campbell
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, United States.,Department of Neuroscience, University of New Mexico, Albuquerque, NM, United States
| | - Vincent P Clark
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States.,Mind Research Network, Albuquerque, NM, United States
| | - Ronald A Yeo
- Department of Neuroscience, University of New Mexico, Albuquerque, NM, United States.,Department of Psychology, University of New Mexico, Albuquerque, NM, United States
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12
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Puig J, Ellis MJ, Kornelsen J, Figley TD, Figley CR, Daunis-i-Estadella P, Mutch WAC, Essig M. Magnetic Resonance Imaging Biomarkers of Brain Connectivity in Predicting Outcome after Mild Traumatic Brain Injury: A Systematic Review. J Neurotrauma 2020; 37:1761-1776. [DOI: 10.1089/neu.2019.6623] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Josep Puig
- Department of Radiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain
| | - Michael J. Ellis
- Canada North Concussion Network, Winnipeg, Manitoba, Canada
- Department of Surgery and Pediatrics and Child Health, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Section of Neurosurgery, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Pan Am Concussion Program, Winnipeg, Manitoba, Canada
- Childrens Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Jennifer Kornelsen
- Department of Radiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Neuroscience Research Program, Kleysen Institute for Advanced Medicine, Winnipeg Health Sciences Center, Winnipeg, Manitoba, Canada
- Department of Physiology and Pathophysiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Teresa D. Figley
- Department of Radiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Neuroscience Research Program, Kleysen Institute for Advanced Medicine, Winnipeg Health Sciences Center, Winnipeg, Manitoba, Canada
| | - Chase R. Figley
- Department of Radiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Neuroscience Research Program, Kleysen Institute for Advanced Medicine, Winnipeg Health Sciences Center, Winnipeg, Manitoba, Canada
- Department of Physiology and Pathophysiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Pepus Daunis-i-Estadella
- Department of Computer Science, Applied Mathematics and Statistics, Universitat de Girona, Girona, Spain
| | - W. Alan C. Mutch
- Canada North Concussion Network, Winnipeg, Manitoba, Canada
- Neuroscience Research Program, Kleysen Institute for Advanced Medicine, Winnipeg Health Sciences Center, Winnipeg, Manitoba, Canada
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Marco Essig
- Department of Radiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Canada North Concussion Network, Winnipeg, Manitoba, Canada
- Neuroscience Research Program, Kleysen Institute for Advanced Medicine, Winnipeg Health Sciences Center, Winnipeg, Manitoba, Canada
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13
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Si T, Xing G, Han Y. Subjective Cognitive Decline and Related Cognitive Deficits. Front Neurol 2020; 11:247. [PMID: 32508729 PMCID: PMC7248257 DOI: 10.3389/fneur.2020.00247] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 03/13/2020] [Indexed: 12/21/2022] Open
Abstract
Since late stage dementia, including Alzheimer's disease (AD), cannot be reversed by any available drugs, there is increasing research interest in the preclinical stage of AD, i.e., subjective cognitive decline (SCD). SCD is characterized by self-perceptive cognitive decline but is difficult to detect using objective tests. At SCD stage, the cognitive deficits can be more easily reversed compared to that of mild cognitive impairment (MCI) and AD only if accurate diagnosis of SCD and early intervention can be developed. In this paper, we review the recent progress of SCD research including current assessment tools, biomarkers, neuroimaging, intervention and expected prognosis, and the potential relevance to traumatic brain injury (TBI)-induced cognitive deficits.
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Affiliation(s)
- Tong Si
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Guoqiang Xing
- The Affiliated Hospital and the Second Clinical Medical College of North Sichuan Medical University, Nanchong Central Hospital, Nanchong, China
| | - Ying Han
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China
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14
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Hou W, Sours Rhodes C, Jiang L, Roys S, Zhuo J, JaJa J, Gullapalli RP. Dynamic Functional Network Analysis in Mild Traumatic Brain Injury. Brain Connect 2020; 9:475-487. [PMID: 30982332 DOI: 10.1089/brain.2018.0629] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Mild traumatic brain injury (mTBI) is one of the most common neurological disorders for which a subset of patients develops persistent postconcussive symptoms. Previous studies discovered abnormalities and disruptions in the brain functional networks of mTBI patients principally using static functional connectivity measures which assume that neural communication across the brain is static during resting state conditions. In this study, we examine the differences in dynamic neural communication between mTBI and control participants through the application of a combination of dynamic functional analysis and graph theoretic algorithms. Resting state functional magnetic resonance imaging data was obtained on 47 mTBI patients at the acute stage of injury and 30 demographically matched healthy control participants. Results show unique alterations in both the static and dynamic functional connectivity at the acute stage in mTBI patients who suffer persistent symptoms (≥6 months after injury). In addition, mTBI patients with postconcussion syndrome demonstrated a unique allocation of time in various brain states compared to both control participants and mTBI patients with favorable outcomes. These findings suggest that global damage to the overall communication across the brain in the acute stage may contribute to chronic mTBI symptoms. Dynamic functional analysis is a powerful tool that provides insights into the brain states and the innovative analysis methodology utilized may hold the potential to delineate patients predisposed to poor outcomes upon early presentation following injury.
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Affiliation(s)
- Wenshuai Hou
- 1 Department of Electrical and Computer Engineering, University of Maryland Institute for Advanced Computer Services (UMIACS), College Park, Maryland
| | - Chandler Sours Rhodes
- 2 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Li Jiang
- 2 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Steven Roys
- 2 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jiachen Zhuo
- 2 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Joseph JaJa
- 1 Department of Electrical and Computer Engineering, University of Maryland Institute for Advanced Computer Services (UMIACS), College Park, Maryland
| | - Rao P Gullapalli
- 2 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland
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15
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Chong CD, Wang L, Wang K, Traub S, Li J. Homotopic region connectivity during concussion recovery: A longitudinal fMRI study. PLoS One 2019; 14:e0221892. [PMID: 31577811 PMCID: PMC6774501 DOI: 10.1371/journal.pone.0221892] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 08/16/2019] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES To (i) investigate alterations in homotopic functional connectivity (hfc) in concussed patients relative to healthy controls (HC) and to (ii) interrogate whether hfc in concussed patients normalized during the recovery process. The relationship between symptom recovery and change in hfc was assessed using post-hoc analyses. METHODS This study included 15 concussed patients (mean age = 39.1, SD = 10.1; sex: 13 females, 2 males) and 15 HC (mean age = 39.1, SD = 11.7; sex: 13 females, 2 males). Hfc patterns were interrogated using resting-state magnetic resonance imaging (rs-MRI) for 29 a priori selected pain-processing regions. Concussed patients underwent imaging at two time-points; at 1-month post-concussion (mean time following concussion: 28 days, SD = 9.5) and again at 5-months post-concussion (mean time following concussion: 121 days, SD = 13). At both time-points, symptoms associated with concussion were assessed using the Sports Concussion Assessment Tool (SCAT-3). RESULTS Concussed patients had significantly weaker hfc in the following six regions 1-month post-concussion compared to HC: middle cingulate, posterior insula, middle occipital, spinal trigeminal nucleus, precentral and the pulvinar. There were no regions of significantly stronger hfc in concussed patients relative to HC. Longitudinally, patients showed significant symptom recovery 5-months post-concussion and had significant strengthening of hfc patterns in seven homotopic ROIs: middle cingulate, posterior insula, middle occipital, secondary somatosensory area, spinal trigeminal nucleus, precentral, and the pulvinar. Post-hoc analyses indicated a significant negative correlation between somatosensory functional connectivity strengthening and symptom severity. CONCLUSION At 1-month post-concussion, patients had significantly weaker hfc in a number of pain-processing regions relative to HC. However, over a period of 5-months, region-pair connectivity showed significant recovery and normalization. Those patients with more successful symptom recovery at 5-months post-concussion had more functional somatosensory strengthening, suggesting an association between functional strengthening and post-concussion symptom recovery.
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Affiliation(s)
| | - Lujia Wang
- School of Computing, Informatics and Decision Systems Engineering, Arizona State University, Tempe, AZ, United States of America
| | - Kun Wang
- School of Computing, Informatics and Decision Systems Engineering, Arizona State University, Tempe, AZ, United States of America
| | - Stephen Traub
- Mayo Clinic Arizona, Phoenix, AZ, United States of America
| | - Jing Li
- School of Computing, Informatics and Decision Systems Engineering, Arizona State University, Tempe, AZ, United States of America
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16
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Relationships Between Subcortical Shape Measures and Subjective Symptom Reporting in US Service Members With Mild Traumatic Brain Injury. J Head Trauma Rehabil 2019. [PMID: 29517591 DOI: 10.1097/htr.0000000000000379] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To assess interactions of subcortical structure with subjective symptom reporting associated with mild traumatic brain injury (mTBI), using advanced shape analysis derived from volumetric MRI. PARTICIPANTS Seventy-six cognitively symptomatic individuals with mTBI and 59 service members sustaining only orthopedic injury. DESIGN Descriptive cross-sectional study. MAIN MEASURES Self-report symptom measures included the PTSD Checklist-Military, Neurobehavioral Symptom Inventory, and Symptom Checklist-90-Revised. High-dimensional measures of shape characteristics were generated from volumetric MRI for 7 subcortical structures in addition to standard volume measures. RESULTS Several significant interactions between group status and symptom measures were observed across the various shape measures. These interactions were revealed in the right thalamus and globus pallidus for each of the shape measures, indicating differences in structure thickness and expansion/contraction for these regions. No relationships with volume were observed. CONCLUSION Results provide evidence for the sensitivity of shape measures in differentiating symptomatic mTBI individuals from controls, while volumetric measures did not exhibit this same sensitivity. Disruptions to thalamic nuclei identified here highlight the role of the thalamus in the spectrum of symptoms associated with mTBI. Additional work is needed to prospectively, and longitudinally, assess these measures along with cognitive performance and advanced multimodal imaging methods to extend the utility of shape analysis in relation to functional outcomes in this population.
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17
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D'Souza A, Mollayeva S, Pacheco N, Javed F, Colantonio A, Mollayeva T. Measuring Change Over Time: A Systematic Review of Evaluative Measures of Cognitive Functioning in Traumatic Brain Injury. Front Neurol 2019; 10:353. [PMID: 31133955 PMCID: PMC6517520 DOI: 10.3389/fneur.2019.00353] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 03/22/2019] [Indexed: 12/19/2022] Open
Abstract
Objectives: The purpose of evaluative instruments is to measure the magnitude of change in a construct of interest over time. The measurement properties of these instruments, as they relate to the instrument's ability to fulfill its purpose, determine the degree of certainty with which the results yielded can be viewed. This work systematically reviews all instruments that have been used to evaluate cognitive functioning in persons with traumatic brain injury (TBI), and critically assesses their evaluative measurement properties: construct validity, test-retest reliability, and responsiveness. Data Sources: MEDLINE, Central, EMBASE, Scopus, PsycINFO were searched from inception to December 2016 to identify longitudinal studies focused on cognitive evaluation of persons with TBI, from which instruments used for measuring cognitive functioning were abstracted. MEDLINE, instrument manuals, and citations of articles identified in the primary search were then screened for studies on measurement properties of instruments utilized at least twice within the longitudinal studies. Study Selection: All English-language, peer-reviewed studies of longitudinal design that measured cognition in adults with a TBI diagnosis over any period of time, identified in the primary search, were used to identify instruments. A secondary search was carried out to identify all studies that assessed the evaluative measurement properties of the instruments abstracted in the primary search. Data Extraction: Data on psychometric properties, cognitive domains covered and clinical utility were extracted for all instruments. Results: In total, 38 longitudinal studies from the primary search, utilizing 15 instruments, met inclusion and quality criteria. Following review of studies identified in the secondary search, it was determined that none of the instruments utilized had been assessed for all the relevant measurement properties in the TBI population. The most frequently assessed property was construct validity. Conclusions: There is insufficient evidence for the validity and reliability of instruments measuring cognitive functioning, longitudinally, in persons with TBI. Several instruments with well-defined construct validity in TBI samples warrant further assessment for test-retest reliability and responsiveness. Registration Number: www.crd.york.ac.uk/PROSPERO/, identifier CRD42017055309.
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Affiliation(s)
- Andrea D'Souza
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
| | - Shirin Mollayeva
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
| | - Nicole Pacheco
- Faculty of Life Sciences, McMaster University, Hamilton, ON, Canada
| | - Fiza Javed
- Department of Biology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
| | - Tatyana Mollayeva
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
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18
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Mollayeva T, Mollayeva S, Pacheco N, D'Souza A, Colantonio A. The course and prognostic factors of cognitive outcomes after traumatic brain injury: A systematic review and meta-analysis. Neurosci Biobehav Rev 2019; 99:198-250. [PMID: 30641116 DOI: 10.1016/j.neubiorev.2019.01.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 08/16/2018] [Accepted: 01/10/2019] [Indexed: 12/18/2022]
Abstract
Despite indications that TBI may be a precursor of cognitive decline and subsequent development of Alzheimer's disease, little is known about the time course of this relationship and the factors involved. This systematic review summarizes the evidence pertinent to this subject matter. All English language studies of longitudinal design, and works cited within them, found in six literature databases, were considered, and their quality assessed. Of 65 articles appraised, 44 studies were selected. Results were organized by timing of assessments, injury severity, and cognitive domains assessed. Differences in the course of cognitive performance were observed across injury severity groups and cognitive domains, with differential proportions of reports of improvement, decline, or no change over time. The evidence for genetic, sex-, age-, and injury-related factors as determinants of cognitive outcome was inconsistent. The non-uniform trajectory of cognitive performance post-TBI supports the notion that this construct is non-homogeneous, and that different factors influence its course. Agreement on a core set of predictors and consideration of psychometric properties of outcome measures is needed.
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Affiliation(s)
- Tatyana Mollayeva
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Canada; Toronto Rehabilitation Institute-University Health Network, Ontario, Canada; Acquired Brain Injury Research Lab, University of Toronto, Canada.
| | - Shirin Mollayeva
- Toronto Rehabilitation Institute-University Health Network, Ontario, Canada.
| | - Nicole Pacheco
- Acquired Brain Injury Research Lab, University of Toronto, Canada; Faculty of Health Sciences, McMaster University, Canada.
| | - Andrea D'Souza
- Acquired Brain Injury Research Lab, University of Toronto, Canada.
| | - Angela Colantonio
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Canada; Toronto Rehabilitation Institute-University Health Network, Ontario, Canada; Acquired Brain Injury Research Lab, University of Toronto, Canada.
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19
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Rosenthal S, Gray M, Fatima H, Sair HI, Whitlow CT. Functional MR Imaging: Blood Oxygen Level-Dependent and Resting State Techniques in Mild Traumatic Brain Injury. Neuroimaging Clin N Am 2018; 28:107-115. [PMID: 29157847 DOI: 10.1016/j.nic.2017.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This article discusses mild traumatic brain injury (mTBI)-associated effects on brain functional connectivity assessed via resting-state functional MR (fMR) imaging. Several studies have reported acute post-injury default mode network hyperconnectivity, followed by a period of decreased connectivity before later connectivity normalization in some patients. Other studies have reported mTBI associated effects on connectivity that remain evident for up to 5-years or more. Discordance in the published literature regarding the direction of network connectivity changes (eg, increased versus decreased connectivity) may reflect differences in timing of data collection post-injury, as well as the need to standardize MR imaging acquisition protocols and processing methods.
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Affiliation(s)
- Scott Rosenthal
- Radiology Informatics and Image Processing Laboratory (RIIPL), Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA; Division of Neuroradiology, Department of Radiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Matthew Gray
- Radiology Informatics and Image Processing Laboratory (RIIPL), Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA; Division of Neuroradiology, Department of Radiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Hudaisa Fatima
- Radiology Informatics and Image Processing Laboratory (RIIPL), Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA; Division of Neuroradiology, Department of Radiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Haris I Sair
- Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21205, USA
| | - Christopher T Whitlow
- Radiology Informatics and Image Processing Laboratory (RIIPL), Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA; Division of Neuroradiology, Department of Radiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA; Department of Biomedical Engineering, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA; Clinical Translational Sciences Institute (CTSI), Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
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20
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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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21
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Structural imaging of mild traumatic brain injury may not be enough: overview of functional and metabolic imaging of mild traumatic brain injury. Brain Imaging Behav 2018; 11:591-610. [PMID: 28194558 DOI: 10.1007/s11682-017-9684-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A majority of patients with traumatic brain injury (TBI) present as mild injury with no findings on conventional clinical imaging methods. Due to this difficulty of imaging assessment on mild TBI patients, there has been much emphasis on the development of diffusion imaging modalities such as diffusion tensor imaging (DTI). However, basic science research in TBI shows that many of the functional and metabolic abnormalities in TBI may be present even in the absence of structural damage. Moreover, structural damage may be present at a microscopic and molecular level that is not detectable by structural imaging modality. The use of functional and metabolic imaging modalities can provide information on pathological changes in mild TBI patients that may not be detected by structural imaging. Although there are various differences in protocols of positron emission tomography (PET), single photon emission computed tomography (SPECT), functional magnetic resonance imaging (fMRI), electroencephalography (EEG), and magnetoencephalography (MEG) methods, these may be important modalities to be used in conjunction with structural imaging in the future in order to detect and understand the pathophysiology of mild TBI. In this review, studies of mild TBI patients using these modalities that detect functional and metabolic state of the brain are discussed. Each modality's advantages and disadvantages are compared, and potential future applications of using combined modalities are explored.
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22
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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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23
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Post-concussive complaints after mild traumatic brain injury associated with altered brain networks during working memory performance. Brain Imaging Behav 2017; 10:1243-1253. [PMID: 26667033 PMCID: PMC5167217 DOI: 10.1007/s11682-015-9489-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The aim was to investigate brain network function during working memory (WM) task performance in patients with uncomplicated mild traumatic brain injury (mTBI) in the sub-acute phase post-injury. We were particularly interested in differences between patients with (PCC-present) and without post-concussive complaints (PCC-absent). Fifty-two patients and twenty healthy controls (HCs) (matched for age, sex, education and handedness) were included. Two patient groups were created based on reported post-concussive complaints at two weeks post-injury: PCC-present (n = 32) and PCC-absent (n = 20). Functional MRI scans were made at approximately four weeks post-injury. Participants performed an n-back task consisting of three conditions (0-, 1- and 2-back) with increasing difficulty. General linear model analysis was performed to investigate activation patterns. Independent component analysis was used to identify brain networks. The frontal executive network (FEN), frontoparietal network (FPN) and default mode network (DMN) were selected for further analyses based on their highest task-relatedness. Task accuracy and reaction times were similar for patients with mTBI and HCs. During high WM load (2-vs.0-back contrast), mTBI patients exhibited lower activation within the medial prefrontal cortex compared to HCs. No differences were found between PCC-present and PCC-absent patients. Regarding network function, PCC-absent patients showed stronger deactivation of the DMN compared to PCC-present patients and HCs, especially during difficult task conditions. Furthermore, functional connectivity between the DMN and FEN was lower in PCC-absent patients compared to PCC-present patients. Interestingly, network function did not differ between PCC-present patients and HCs, suggesting that non-injury related factors may underlie post-concussive complaints after mTBI.
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Vincent AS, Roebuck-Spencer TM, Cox-Fuenzalida LE, Block C, Scott JG, Kane R. Validation of ANAM for cognitive screening in a mixed clinical sample. APPLIED NEUROPSYCHOLOGY-ADULT 2017; 25:366-375. [PMID: 28448160 DOI: 10.1080/23279095.2017.1314967] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The Automated Neuropsychological Assessment Metrics (ANAM) is a library of computer based tests designed to measure cognitive function at a single time-point or longitudinally for detection of cognitive change. This study sought to validate ANAM as a cognitive screening tool for presence of confirmed neuropsychological diagnosis in an outpatient setting. Retrospective data analysis was conducted for 139 patients referred for outpatient neuropsychological assessment. Clinical diagnosis was made independent of ANAM test results and resulted in a diagnostic mix of both neurologic and psychologic etiologies. ANAM scores predictive of presence of confirmed diagnosis were identified using multiple logistic regression and the predictive ability of the resulting model was quantified using receiver operator characteristic analysis. Sensitivity and specificity for the ANAM when combined with anger and depressive symptom scores were 71% and 91%, respectively, with a positive predictive value of 97.5 and negative predictive value of 40.4. This combined approach provided the greatest accuracy for individual tests as well as the composite score of the ANAM in identifying those who received a subsequent clinical diagnosis. Although data should be replicated in larger samples, these results suggest that ANAM may have predictive value and may be a useful screening tool for identifying those who would likely benefit from neuropsychological services.
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Affiliation(s)
- Andrea S Vincent
- a Cognitive Science Research Center , University of Oklahoma , Norman , Okalahoma
| | | | | | - Cady Block
- b Department of Psychiatry and Behavioral Sciences , University of Oklahoma Health Sciences Center , Oklahoma City , Oklahoma
| | - James G Scott
- b Department of Psychiatry and Behavioral Sciences , University of Oklahoma Health Sciences Center , Oklahoma City , Oklahoma
| | - Robert Kane
- c Department of Neurology , Georgetown University , Washington , District of Columbia
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Sours C, Raghavan P, Medina AE, Roys S, Jiang L, Zhuo J, Gullapalli RP. Structural and Functional Integrity of the Intraparietal Sulcus in Moderate and Severe Traumatic Brain Injury. J Neurotrauma 2017; 34:1473-1481. [PMID: 27931179 DOI: 10.1089/neu.2016.4570] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Severe and moderate traumatic brain injury (sTBI) often results in long-term cognitive deficits such as reduced processing speed and attention. The intraparietal sulcus (IPS) is a neocortical structure that plays a crucial role in the deeply interrelated processes of multi-sensory processing and top down attention. Therefore, we hypothesized that disruptions in the functional and structural connections of the IPS may play a role in the development of such deficits. To examine these connections, we used resting state magnetic resonance imaging (rsfMRI and diffusion kurtosis imaging (DKI) in a cohort of 27 patients with sTBI (29.3 ± 8.9 years) and 27 control participants (29.8 ± 10.3 years). Participants were prospectively recruited and received rsfMRI and neuropsychological assessments including the Automated Neuropsychological Assessment Metrics (ANAM) at greater than 6 months post-injury. A subset of participants received a DKI scan. Results suggest that patients with sTBI performed worse than control participants on multiple subtests of the ANAM suggesting reduced cognitive performance. Reduced resting state functional connectivity between the IPS and cortical regions associated with multi-sensory processing and the dorsal attention network was observed in the patients with sTBI. The patients also showed reduced structural integrity of the superior longitudinal fasciculus (SLF), a key white matter tract connecting the IPS to anterior frontal areas, as measured by reduced mean kurtosis (MK) and fractional anisotropy (FA) and increased mean diffusivity (MD). Further, this reduced structural integrity of the SLF was associated with a reduction in overall cognitive performance. These findings suggest that disruptions in the structural and functional connectivity of the IPS may contribute to chronic cognitive deficits experienced by these patients.
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Affiliation(s)
- Chandler Sours
- 1 Magnetic Resonance Research Center, University of Maryland School of Medicine , Baltimore, Maryland.,2 Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine , Baltimore, Maryland
| | - Prashant Raghavan
- 2 Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine , Baltimore, Maryland
| | - Alexandre E Medina
- 3 Department of Pediatrics, University of Maryland School of Medicine , Baltimore, Maryland
| | | | - Li Jiang
- 1 Magnetic Resonance Research Center, University of Maryland School of Medicine , Baltimore, Maryland.,2 Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine , Baltimore, Maryland
| | - Jiachen Zhuo
- 1 Magnetic Resonance Research Center, University of Maryland School of Medicine , Baltimore, Maryland.,2 Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine , Baltimore, Maryland
| | - Rao P Gullapalli
- 1 Magnetic Resonance Research Center, University of Maryland School of Medicine , Baltimore, Maryland.,2 Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine , Baltimore, Maryland
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26
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Womack KB, Paliotta C, Strain JF, Ho JS, Skolnick Y, Lytton WW, Turtzo LC, McColl R, Diaz-Arrastia R, Bergold PJ. Measurement of Peripheral Vision Reaction Time Identifies White Matter Disruption in Patients with Mild Traumatic Brain Injury. J Neurotrauma 2017; 34:1539-1545. [PMID: 27927083 DOI: 10.1089/neu.2016.4670] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
This study examined whether peripheral vision reaction time (PVRT) in patients with mild traumatic brain injury (mTBI) correlated with white matter abnormalities in centroaxial structures and impairments in neuropsychological testing. Within 24 h after mTBI, crossed reaction times (CRT), uncrossed reaction times (URT), and crossed-uncrossed difference (CUD) were measured in 23 patients using a laptop computer that displayed visual stimuli predominantly to either the left or the right visual field of the retina. The CUD is a surrogate marker of the interhemispheric transfer time (ITT). Within 7 days after the injury, patients received a diffusion tensor-MRI (DTI) scan and a battery of neuropsychological tests. Nine uninjured control subjects received similar testing. Patients 18-50 years of age were included if they had a post-resuscitation Glasgow Coma Scale >13 and an injury mechanism compatible with mTBI. Healthy controls were either age- and gender-matched family members of the TBI patients or healthy volunteers. CUD deficits >2 standard deviations (SD) were seen in 40.9% of patients. The CUD of injured patients correlated with mean diffusivity (MD) (p < 0.001, ρ = -0.811) in the posterior corpus callosum. Patients could be stratified on the basis of CUD on the Stroop 1, Controlled Oral Word Association Test (COWAT), and the obsessive-compulsive component of the Basic Symptom Inventory tests. These studies suggest that the PVRT indirectly measures white matter integrity in the posterior corpus callosum, a brain region frequently damaged by mTBI.
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Affiliation(s)
- Kyle B Womack
- 1 Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center , Dallas, Texas.,2 Department of Psychiatry, University of Texas Southwestern Medical Center , Dallas, Texas.,3 Berman Laboratory for Learning and Memory, Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas , Dallas, Texas
| | - Christopher Paliotta
- 1 Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center , Dallas, Texas
| | - Jeremy F Strain
- 3 Berman Laboratory for Learning and Memory, Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas , Dallas, Texas.,4 Department of Neurology, Washington University , St. Louis, Missouri
| | - Johnson S Ho
- 5 Department of Physiology and Pharmacology, State University of New York-Downstate Medical Center , Brooklyn, New York
| | - Yosef Skolnick
- 5 Department of Physiology and Pharmacology, State University of New York-Downstate Medical Center , Brooklyn, New York
| | - William W Lytton
- 5 Department of Physiology and Pharmacology, State University of New York-Downstate Medical Center , Brooklyn, New York
| | - L Christine Turtzo
- 6 National Institute of Neurological Disorders and Stroke, National Institutes of Health , Bethesda, Maryland
| | - Roderick McColl
- 7 Department of Radiology, University of Texas Southwestern Medical Center , Dallas, Texas
| | - Ramon Diaz-Arrastia
- 6 National Institute of Neurological Disorders and Stroke, National Institutes of Health , Bethesda, Maryland.,8 Center for Neuroscience and Regenerative Medicine, Department of Neurology, Uniformed Services University of the Health Sciences , Bethesda, Maryland
| | - Peter J Bergold
- 5 Department of Physiology and Pharmacology, State University of New York-Downstate Medical Center , Brooklyn, New York
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Mild traumatic brain injury and suicide risk among a clinical sample of deployed military personnel: Evidence for a serial mediation model of anger and depression. J Psychiatr Res 2017; 84:161-168. [PMID: 27743528 DOI: 10.1016/j.jpsychires.2016.10.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 09/29/2016] [Accepted: 10/06/2016] [Indexed: 11/20/2022]
Abstract
Research has demonstrated a robust link between traumatic brain injuries (TBIs) and suicide risk. Yet, few studies have investigated factors that account for this link. Utilizing a clinical sample of deployed military personnel, this study aimed to examine a serial meditation model of anger and depression in the association of mild TBI and suicide risk. A total of 149 military service members referred for evaluation/treatment of a suspected head injury at a military hospital participated in the present study (92.6% male; Mage = 27.9y). Self-report measures included the Suicidal Behaviors Questionnaire-Revised (SBQ-R), Automated Neuropsychological Assessment Metrics (ANAM) anger and depression subscales, and Behavioral Health Measure-20 depression subscale. A current mild TBI diagnosis was confirmed by a licensed clinical psychologist/physician. Overall, 84.6% (126/149) of participants met diagnostic criteria for a current mild TBI. Bootstrapped serial mediation analyses indicated that the association of mild TBI and suicide risk is serially mediated by anger and depression symptoms (bias-corrected 95% confidence interval [CI] for the indirect effect = 0.044, 0.576). An alternate serial mediation model in which depression symptoms precede anger was not statistically significant (bias-corrected 95% CI for the indirect effect = -0.405, 0.050). Among a clinical sample of military personnel, increased anger and depression statistically mediated the association of mild TBI and suicide risk, and anger appears to precede depression in this pathway. Findings suggest that therapeutically targeting anger may serve to thwart the trajectory to suicide risk among military personnel who experience a mild TBI. Future research should investigate this conjecture within a prospective design to establish temporality.
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28
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Wu X, Kirov II, Gonen O, Ge Y, Grossman RI, Lui YW. MR Imaging Applications in Mild Traumatic Brain Injury: An Imaging Update. Radiology 2016; 279:693-707. [PMID: 27183405 DOI: 10.1148/radiol.16142535] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Mild traumatic brain injury (mTBI), also commonly referred to as concussion, affects millions of Americans annually. Although computed tomography is the first-line imaging technique for all traumatic brain injury, it is incapable of providing long-term prognostic information in mTBI. In the past decade, the amount of research related to magnetic resonance (MR) imaging of mTBI has grown exponentially, partly due to development of novel analytical methods, which are applied to a variety of MR techniques. Here, evidence of subtle brain changes in mTBI as revealed by these techniques, which are not demonstrable by conventional imaging, will be reviewed. These changes can be considered in three main categories of brain structure, function, and metabolism. Macrostructural and microstructural changes have been revealed with three-dimensional MR imaging, susceptibility-weighted imaging, diffusion-weighted imaging, and higher order diffusion imaging. Functional abnormalities have been described with both task-mediated and resting-state blood oxygen level-dependent functional MR imaging. Metabolic changes suggesting neuronal injury have been demonstrated with MR spectroscopy. These findings improve understanding of the true impact of mTBI and its pathogenesis. Further investigation may eventually lead to improved diagnosis, prognosis, and management of this common and costly condition. (©) RSNA, 2016.
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Affiliation(s)
- Xin Wu
- From the Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, 660 First Ave, 4th Floor, New York, NY 10016
| | - Ivan I Kirov
- From the Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, 660 First Ave, 4th Floor, New York, NY 10016
| | - Oded Gonen
- From the Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, 660 First Ave, 4th Floor, New York, NY 10016
| | - Yulin Ge
- From the Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, 660 First Ave, 4th Floor, New York, NY 10016
| | - Robert I Grossman
- From the Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, 660 First Ave, 4th Floor, New York, NY 10016
| | - Yvonne W Lui
- From the Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, 660 First Ave, 4th Floor, New York, NY 10016
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29
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Relationship between individual differences in functional connectivity and facial-emotion recognition abilities in adults with traumatic brain injury. NEUROIMAGE-CLINICAL 2016; 13:370-377. [PMID: 28123948 PMCID: PMC5222957 DOI: 10.1016/j.nicl.2016.12.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 11/14/2016] [Accepted: 12/10/2016] [Indexed: 12/15/2022]
Abstract
Although several studies have demonstrated that facial-affect recognition impairment is common following moderate-severe traumatic brain injury (TBI), and that there are diffuse alterations in large-scale functional brain networks in TBI populations, little is known about the relationship between the two. Here, in a sample of 26 participants with TBI and 20 healthy comparison participants (HC) we measured facial-affect recognition abilities and resting-state functional connectivity (rs-FC) using fMRI. We then used network-based statistics to examine (A) the presence of rs-FC differences between individuals with TBI and HC within the facial-affect processing network, and (B) the association between inter-individual differences in emotion recognition skills and rs-FC within the facial-affect processing network. We found that participants with TBI showed significantly lower rs-FC in a component comprising homotopic and within-hemisphere, anterior-posterior connections within the facial-affect processing network. In addition, within the TBI group, participants with higher emotion-labeling skills showed stronger rs-FC within a network comprised of intra- and inter-hemispheric bilateral connections. Findings indicate that the ability to successfully recognize facial-affect after TBI is related to rs-FC within components of facial-affective networks, and provide new evidence that further our understanding of the mechanisms underlying emotion recognition impairment in TBI. Emotion recognition deficits are common following severe TBI. TBI patients show reduced rs-FC within affect processing network. Affect processing network rs-FC correlates with emotion recognition skills. Rs-FC disruption as possible mechanism of emotion recognition deficit
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Huang MX, Harrington DL, Robb Swan A, Angeles Quinto A, Nichols S, Drake A, Song T, Diwakar M, Huang CW, Risbrough VB, Dale A, Bartsch H, Matthews S, Huang JW, Lee RR, Baker DG. Resting-State Magnetoencephalography Reveals Different Patterns of Aberrant Functional Connectivity in Combat-Related Mild Traumatic Brain Injury. J Neurotrauma 2016; 34:1412-1426. [PMID: 27762653 DOI: 10.1089/neu.2016.4581] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Blast mild traumatic brain injury (mTBI) is a leading cause of sustained impairment in military service members and veterans. However, the mechanism of persistent disability is not fully understood. The present study investigated disturbances in brain functioning in mTBI participants using a source-imaging-based approach to analyze functional connectivity (FC) from resting-state magnetoencephalography (rs-MEG). Study participants included 26 active-duty service members or veterans who had blast mTBI with persistent post-concussive symptoms, and 22 healthy control active-duty service members or veterans. The source time courses from regions of interest (ROIs) were used to compute ROI to whole-brain (ROI-global) FC for different frequency bands using two different measures: 1) time-lagged cross-correlation and 2) phase-lock synchrony. Compared with the controls, blast mTBI participants showed increased ROI-global FC in beta, gamma, and low-frequency bands, but not in the alpha band. Sources of abnormally increased FC included the: 1) prefrontal cortex (right ventromedial prefrontal cortex [vmPFC], right rostral anterior cingulate cortex [rACC]), and left ventrolateral and dorsolateral prefrontal cortex; 2) medial temporal lobe (bilateral parahippocampus, hippocampus, and amygdala); and 3) right putamen and cerebellum. In contrast, the blast mTBI group also showed decreased FC of the right frontal pole. Group differences were highly consistent across the two different FC measures. FC of the left ventrolateral prefrontal cortex correlated with executive functioning and processing speed in mTBI participants. Altogether, our findings of increased and decreased regionalpatterns of FC suggest that disturbances in intrinsic brain connectivity may be the result of multiple mechanisms, and are associated with cognitive sequelae of the injury.
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Affiliation(s)
- Ming-Xiong Huang
- 1 Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System , San Diego, California.,2 Department of Radiology, University of California , San Diego, California
| | - Deborah L Harrington
- 1 Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System , San Diego, California.,2 Department of Radiology, University of California , San Diego, California
| | - Ashley Robb Swan
- 1 Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System , San Diego, California.,2 Department of Radiology, University of California , San Diego, California
| | - Annemarie Angeles Quinto
- 1 Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System , San Diego, California.,2 Department of Radiology, University of California , San Diego, California
| | - Sharon Nichols
- 3 Department of Neuroscience, University of California , San Diego, California
| | | | - Tao Song
- 2 Department of Radiology, University of California , San Diego, California
| | - Mithun Diwakar
- 2 Department of Radiology, University of California , San Diego, California
| | - Charles W Huang
- 5 Department of Bioengineering, University of California , San Diego, California
| | - Victoria B Risbrough
- 6 Department of Psychiatry, University of California , San Diego, California.,7 VA Center of Excellence for Stress and Mental Health , San Diego, California
| | - Anders Dale
- 2 Department of Radiology, University of California , San Diego, California
| | - Hauke Bartsch
- 2 Department of Radiology, University of California , San Diego, California
| | - Scott Matthews
- 1 Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System , San Diego, California.,6 Department of Psychiatry, University of California , San Diego, California.,8 Aspire Center , VASDHS Residential Rehabilitation Treatment Program, San Diego, California
| | | | - Roland R Lee
- 1 Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System , San Diego, California.,2 Department of Radiology, University of California , San Diego, California
| | - Dewleen G Baker
- 1 Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System , San Diego, California.,6 Department of Psychiatry, University of California , San Diego, California.,7 VA Center of Excellence for Stress and Mental Health , San Diego, California
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31
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Hyper-connectivity of the thalamus during early stages following mild traumatic brain injury. Brain Imaging Behav 2016; 9:550-63. [PMID: 26153468 DOI: 10.1007/s11682-015-9424-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The thalamo-cortical resting state functional connectivity of seven sub-thalamic regions were examined in a prospectively recruited population of 77 acute mild TBI (mTBI) patients within the first 10 days (mean 6 ± 3 days) of injury and 35 neurologically intact control subjects using the Oxford thalamic connectivity atlas. Neuropsychological assessments were conducted using the Automated Neuropsychological Assessment Metrics (ANAM). A subset of participants received a magentic resonance spectroscopy (MRS) exam to determine metabolite concentrations in the thalamus and the posterior cingulate cortex. Results show that patients performed worse than the control group on various subtests of ANAM and the weighted throughput score, suggesting reduced cognitive performance at this early stage of injury. Both voxel and region of interest based analysis of the resting state fMRI data demonstrated that acute mTBI patients have increased functional connectivity between the various sub-thalamic regions and cortical regions associated with sensory processing and the default mode network (DMN). In addition, a significant reduction in NAA/Cr was observed in the thalamus in the mTBI patients. Furthermore, an increase in Cho/Cr ratio specific to mTBI patients with self-reported sensory symptoms was observed compared to those without self-reported sensory symptoms. These results provide novel insights into the neural mechanisms of the brain state related to internal rumination and arousal, which have implications for new interventions for mTBI patients with persistent symptoms. Furthermore, an understanding of heightened sensitivity to sensory related inputs during early stages of injury may facilitate enhanced prediction of safe return to work.
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Tobyne SM, Boratyn D, Johnson JA, Greve DN, Mainero C, Klawiter EC. A surface-based technique for mapping homotopic interhemispheric connectivity: Development, characterization, and clinical application. Hum Brain Mapp 2016; 37:2849-68. [PMID: 27219660 DOI: 10.1002/hbm.23214] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 03/29/2016] [Accepted: 04/01/2016] [Indexed: 02/01/2023] Open
Abstract
The functional organization of the human brain consists of a high degree of connectivity between interhemispheric homologous regions. The degree of homotopic organization is known to vary across the cortex and homotopic connectivity is high in regions that share cross-hemisphere structural connections or are activated by common input streams (e.g., the visual system). Damage to one or both regions, as well as damage to the connections between homotopic regions, could disrupt this functional organization. Here were introduce and test a computationally efficient technique, surface-based homotopic interhermispheric connectivity (sHIC), that leverages surface-based registration and processing techniques in an attempt to improve the spatial specificity and accuracy of cortical interhemispheric connectivity estimated with resting state functional connectivity. This technique is shown to be reliable both within and across subjects. sHIC is also characterized in a dataset of nearly 1000 subjects. We confirm previous results showing increased interhemispheric connectivity in primary sensory regions, and reveal a novel rostro-caudal functionally defined network level pattern of sHIC across the brain. In addition, we demonstrate a structural-functional relationship between sHIC and atrophy of the corpus callosum in multiple sclerosis (r = 0.2979, p = 0.0461). sHIC presents as a sensitive and reliable measure of cortical homotopy that may prove useful as a biomarker in neurologic disease. Hum Brain Mapp 37:2849-2868, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Sean M Tobyne
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Daria Boratyn
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Douglas N Greve
- Athinoula a. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Caterina Mainero
- Athinoula a. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Eric C Klawiter
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
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Rigon A, Duff MC, McAuley E, Kramer AF, Voss MW. Is Traumatic Brain Injury Associated with Reduced Inter-Hemispheric Functional Connectivity? A Study of Large-Scale Resting State Networks following Traumatic Brain Injury. J Neurotrauma 2016; 33:977-89. [PMID: 25719433 DOI: 10.1089/neu.2014.3847] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Traumatic brain injury (TBI) often has long-term debilitating sequelae in cognitive and behavioral domains. Understanding how TBI impacts functional integrity of brain networks that underlie these domains is key to guiding future approaches to TBI rehabilitation. In the current study, we investigated the differences in inter-hemispheric functional connectivity (FC) of resting state networks (RSNs) between chronic mild-to-severe TBI patients and normal comparisons (NC), focusing on two externally oriented networks (i.e., the fronto-parietal network [FPN] and the executive control network [ECN]), one internally oriented network (i.e., the default mode network [DMN]), and one somato-motor network (SMN). Seed voxel correlation analysis revealed that TBI patients displayed significantly less FC between lateralized seeds and both homologous and non-homologous regions in the opposite hemisphere for externally oriented networks but not for DMN or SMN; conversely, TBI patients showed increased FC within regions of the DMN, especially precuneus and parahippocampal gyrus. Region of interest correlation analyses confirmed the presence of significantly higher inter-hemispheric FC in NC for the FPN (p < 0.01), and ECN (p < 0.05), but not for the DMN (p > 0.05) or SMN (p > 0.05). Further analysis revealed that performance on a neuropsychological test measuring organizational skills and visuo-spatial abilities administered to the TBI group, the Rey-Osterrieth Complex Figure Test, positively correlated with FC between the right FPN and homologous regions. Our findings suggest that distinct RSNs display specific patterns of aberrant FC following TBI; this represents a step forward in the search for biomarkers useful for early diagnosis and treatment of TBI-related cognitive impairment.
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Affiliation(s)
- Arianna Rigon
- 1 Neuroscience Graduate Program, University of Iowa , Iowa City, Iowa
| | - Melissa C Duff
- 1 Neuroscience Graduate Program, University of Iowa , Iowa City, Iowa.,2 Department of Communication Sciences and Disorders, University of Iowa , Iowa City, Iowa.,3 Department of Neurology, University of Iowa , Iowa City, Iowa
| | - Edward McAuley
- 5 The Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign , Illinois.,6 Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign , Illinois
| | - Arthur F Kramer
- 5 The Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign , Illinois
| | - Michelle W Voss
- 1 Neuroscience Graduate Program, University of Iowa , Iowa City, Iowa.,4 Department of Psychological and Brain Sciences, University of Iowa , Iowa City, Iowa
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34
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Disrupted Intrinsic Connectivity among Default, Dorsal Attention, and Frontoparietal Control Networks in Individuals with Chronic Traumatic Brain Injury. J Int Neuropsychol Soc 2016; 22:263-79. [PMID: 26888622 PMCID: PMC4763346 DOI: 10.1017/s1355617715001393] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Individuals with chronic traumatic brain injury (TBI) often show detrimental deficits in higher order cognitive functions requiring coordination of multiple brain networks. Although assessing TBI-related deficits in higher order cognition in the context of network dysfunction is promising, few studies have systematically investigated altered interactions among multiple networks in chronic TBI. METHOD We characterized disrupted resting-state functional connectivity of the default mode network (DMN), dorsal attention network (DAN), and frontoparietal control network (FPCN) whose interactions are required for internally and externally focused goal-directed cognition in chronic TBI. Specifically, we compared the network interactions of 40 chronic TBI individuals (8 years post-injury on average) with those of 17 healthy individuals matched for gender, age, and years of education. RESULTS The network-based statistic (NBS) on DMN-DAN-FPCN connectivity of these groups revealed statistically significant (p NBS2.58) reductions in within-DMN, within-FPCN, DMN-DAN, and DMN-FPCN connectivity of the TBI group over healthy controls. Importantly, such disruptions occurred prominently in between-network connectivity. Subsequent analyses further exhibited the disrupted connectivity patterns of the chronic TBI group occurring preferentially in long-range and inter-hemispheric connectivity of DMN-DAN-FPCN. Most importantly, graph-theoretic analysis demonstrated relative reductions in global, local and cost efficiency (p<.05) as a consequence of the network disruption patterns in the TBI group. CONCLUSION Our findings suggest that assessing multiple networks-of-interest simultaneously will allow us to better understand deficits in goal-directed cognition and other higher order cognitive phenomena in chronic TBI. Future research will be needed to better understand the behavioral consequences related to these network disruptions.
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van der Horn HJ, Liemburg EJ, Aleman A, Spikman JM, van der Naalt J. Brain Networks Subserving Emotion Regulation and Adaptation after Mild Traumatic Brain Injury. J Neurotrauma 2016; 33:1-9. [DOI: 10.1089/neu.2015.3905] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Harm J. van der Horn
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Edith J. Liemburg
- BCN NeuroImaging Center of the Department of Neuroscience, University of Groningen, Groningen, The Netherlands
| | - André Aleman
- BCN NeuroImaging Center of the Department of Neuroscience, University of Groningen, Groningen, The Netherlands
| | - Jacoba M. Spikman
- Department of Neuropsychology, University of Groningen, 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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Sours C, Zhuo J, Roys S, Shanmuganathan K, Gullapalli RP. Disruptions in Resting State Functional Connectivity and Cerebral Blood Flow in Mild Traumatic Brain Injury Patients. PLoS One 2015; 10:e0134019. [PMID: 26241476 PMCID: PMC4524606 DOI: 10.1371/journal.pone.0134019] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 07/03/2015] [Indexed: 12/27/2022] Open
Abstract
Mild traumatic brain injury (mTBI) is often occult to conventional imaging techniques. However, there is growing evidence that mTBI patients who lack evidence of structural intracranial injury may develop post-concussive syndrome (PCS). We investigated longitudinal alterations in resting state functional connectivity (rs-FC) in brain networks in a population of 28 patients compared to 28 matched control participants. Rs-FC and cerebral blood flow (CBF) within the nodes of the Default Mode Network (DMN) and Task Positive Network (TPN) were assessed at three time points including acute, sub-acute, and chronic stages following mTBI. Participants received the Automated Neuropsychological Assessment Metrics (ANAM) to assess cognitive performance. Main findings indicate that despite normalized cognitive performance, chronic mTBI patients demonstrate increased rs-FC between the DMN and regions associated with the salience network (SN) and TPN compared to the control populations, as well as reduced strength of rs-FC within the DMN at the acute stage of injury. In addition, chronic mTBI patients demonstrate an imbalance in the ratio of CBF between nodes of the DMN and TPN. Furthermore, preliminary exploratory analysis suggests that compared to those without chronic PCS, patients with chronic PCS reveal an imbalance in the ratio of CBF between the DMN nodes and TPN nodes across multiple stages of recovery. Findings suggest that the altered network perfusion with the associated changes in rs-FC may be a possible predictor of which mTBI patients will develop chronic PCS.
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Affiliation(s)
- Chandler Sours
- Magnetic Resonance Research Center, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Jiachen Zhuo
- Magnetic Resonance Research Center, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Steven Roys
- Magnetic Resonance Research Center, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Kathirkamanthan Shanmuganathan
- Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Rao P. Gullapalli
- Magnetic Resonance Research Center, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
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Sours C, Chen H, Roys S, Zhuo J, Varshney A, Gullapalli RP. Investigation of Multiple Frequency Ranges Using Discrete Wavelet Decomposition of Resting-State Functional Connectivity in Mild Traumatic Brain Injury Patients. Brain Connect 2015; 5:442-50. [PMID: 25808612 DOI: 10.1089/brain.2014.0333] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of this study was to investigate if discrete wavelet decomposition provides additional insight into resting-state processes through the analysis of functional connectivity within specific frequency ranges within the default mode network (DMN) that may be affected by mild traumatic brain injury (mTBI). Participants included 32 mTBI patients (15 with postconcussive syndrome [PCS+] and 17 without [PCS-]). mTBI patients received resting-state functional magnetic resonance imaging (rs-fMRI) at acute (within 10 days of injury) and chronic (6 months postinjury) time points and were compared with 31 controls (healthy control [HC]). The wavelet decomposition divides the time series into multiple frequency ranges based on four scaling factors (SF1: 0.125-0.250 Hz, SF2: 0.060-0.125 Hz, SF3: 0.030-0.060 Hz, SF4: 0.015-0.030 Hz). Within each SF, wavelet connectivity matrices for nodes of the DMN were created for each group (HC, PCS+, PCS-), and bivariate measures of strength and diversity were calculated. The results demonstrate reduced strength of connectivity in PCS+ patients compared with PCS- patients within SF1 during both the acute and chronic stages of injury, as well as recovery of connectivity within SF1 across the two time points. Furthermore, the PCS- group demonstrated greater network strength compared with controls at both time points, suggesting a potential compensatory or protective mechanism in these patients. These findings stress the importance of investigating resting-state connectivity within multiple frequency ranges; however, many of our findings are within SF1, which may overlap with frequencies associated with cardiac and respiratory activities.
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Affiliation(s)
- Chandler Sours
- 1 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine , Baltimore, Maryland.,2 Magnetic Resonance Research Center (MRRC) , Baltimore, Maryland
| | - Haoxing Chen
- 3 University of Maryland School of Medicine , Baltimore, Maryland
| | - Steven Roys
- 1 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine , Baltimore, Maryland.,2 Magnetic Resonance Research Center (MRRC) , Baltimore, Maryland
| | - Jiachen Zhuo
- 1 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine , Baltimore, Maryland.,2 Magnetic Resonance Research Center (MRRC) , Baltimore, Maryland
| | - Amitabh Varshney
- 4 Department of Computer Science, Institute for Advanced Computer Studies, University of Maryland College Park , College Park, Maryland
| | - Rao P Gullapalli
- 1 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine , Baltimore, Maryland.,2 Magnetic Resonance Research Center (MRRC) , Baltimore, Maryland
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