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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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Arabshahi S, Chung S, Alivar A, Amorapanth PX, Flanagan SR, Foo FYA, Laine AF, Lui YW. A Comprehensive and Broad Approach to Resting-State Functional Connectivity in Adult Patients with Mild Traumatic Brain Injury. AJNR Am J Neuroradiol 2024; 45:637-646. [PMID: 38604737 DOI: 10.3174/ajnr.a8193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/12/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND AND PURPOSE Several recent works using resting-state fMRI suggest possible alterations of resting-state functional connectivity after mild traumatic brain injury. However, the literature is plagued by various analysis approaches and small study cohorts, resulting in an inconsistent array of reported findings. In this study, we aimed to investigate differences in whole-brain resting-state functional connectivity between adult patients with mild traumatic brain injury within 1 month of injury and healthy control subjects using several comprehensive resting-state functional connectivity measurement methods and analyses. MATERIALS AND METHODS A total of 123 subjects (72 patients with mild traumatic brain injury and 51 healthy controls) were included. A standard fMRI preprocessing pipeline was used. ROI/seed-based analyses were conducted using 4 standard brain parcellation methods, and the independent component analysis method was applied to measure resting-state functional connectivity. The fractional amplitude of low-frequency fluctuations was also measured. Group comparisons were performed on all measurements with appropriate whole-brain multilevel statistical analysis and correction. RESULTS There were no significant differences in age, sex, education, and hand preference between groups as well as no significant correlation between all measurements and these potential confounders. We found that each resting-state functional connectivity measurement revealed various regions or connections that were different between groups. However, after we corrected for multiple comparisons, the results showed no statistically significant differences between groups in terms of resting-state functional connectivity across methods and analyses. CONCLUSIONS Although previous studies point to multiple regions and networks as possible mild traumatic brain injury biomarkers, this study shows that the effect of mild injury on brain resting-state functional connectivity has not survived after rigorous statistical correction. A further study using subject-level connectivity analyses may be necessary due to both subtle and variable effects of mild traumatic brain injury on brain functional connectivity across individuals.
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Affiliation(s)
- Soroush Arabshahi
- From Biomedical Engineering Department (S.A., A.F.L.), Columbia University, New York, New York
| | - Sohae Chung
- Departments of Radiology (S.C., A.A., Y.W.L.), NYU Grossman School of Medicine, New York, New York
| | - Alaleh Alivar
- Departments of Radiology (S.C., A.A., Y.W.L.), NYU Grossman School of Medicine, New York, New York
| | - Prin X Amorapanth
- Rehabilitation Medicine (P.X.A., S.R.F.), NYU Grossman School of Medicine, New York, New York
| | - Steven R Flanagan
- Rehabilitation Medicine (P.X.A., S.R.F.), NYU Grossman School of Medicine, New York, New York
| | - Farng-Yang A Foo
- Department of Neurology (F.-Y.A.F.), NYU Grossman School of Medicine, New York, New York
| | - Andrew F Laine
- From Biomedical Engineering Department (S.A., A.F.L.), Columbia University, New York, New York
| | - Yvonne W Lui
- Departments of Radiology (S.C., A.A., Y.W.L.), NYU Grossman School of Medicine, New York, New York
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van der Horn HJ, Ling JM, Wick TV, Dodd AB, Robertson-Benta CR, McQuaid JR, Zotev V, Vakhtin AA, Ryman SG, Cabral J, Phillips JP, Campbell RA, Sapien RE, Mayer AR. Dynamic Functional Connectivity in Pediatric Mild Traumatic Brain Injury. Neuroimage 2024; 285:120470. [PMID: 38016527 PMCID: PMC10815936 DOI: 10.1016/j.neuroimage.2023.120470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 11/30/2023] Open
Abstract
Resting-state fMRI can be used to identify recurrent oscillatory patterns of functional connectivity within the human brain, also known as dynamic brain states. Alterations in dynamic brain states are highly likely to occur following pediatric mild traumatic brain injury (pmTBI) due to the active developmental changes. The current study used resting-state fMRI to investigate dynamic brain states in 200 patients with pmTBI (ages 8-18 years, median = 14 years) at the subacute (∼1-week post-injury) and early chronic (∼ 4 months post-injury) stages, and in 179 age- and sex-matched healthy controls (HC). A k-means clustering analysis was applied to the dominant time-varying phase coherence patterns to obtain dynamic brain states. In addition, correlations between brain signals were computed as measures of static functional connectivity. Dynamic connectivity analyses showed that patients with pmTBI spend less time in a frontotemporal default mode/limbic brain state, with no evidence of change as a function of recovery post-injury. Consistent with models showing traumatic strain convergence in deep grey matter and midline regions, static interhemispheric connectivity was affected between the left and right precuneus and thalamus, and between the right supplementary motor area and contralateral cerebellum. Changes in static or dynamic connectivity were not related to symptom burden or injury severity measures, such as loss of consciousness and post-traumatic amnesia. In aggregate, our study shows that brain dynamics are altered up to 4 months after pmTBI, in brain areas that are known to be vulnerable to TBI. Future longitudinal studies are warranted to examine the significance of our findings in terms of long-term neurodevelopment.
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Affiliation(s)
| | - Josef M Ling
- The Mind Research Network/LBERI, Albuquerque, NM 87106
| | - Tracey V Wick
- The Mind Research Network/LBERI, Albuquerque, NM 87106
| | - Andrew B Dodd
- The Mind Research Network/LBERI, Albuquerque, NM 87106
| | | | | | - Vadim Zotev
- The Mind Research Network/LBERI, Albuquerque, NM 87106
| | | | | | - Joana Cabral
- Life and Health Sciences Research Institute, University of Minho, Braga, Portugal
| | | | - Richard A Campbell
- Department of Psychiatry & Behavioral Sciences, University of New Mexico, Albuquerque, NM 87131
| | - Robert E Sapien
- Department of Emergency Medicine, University of New Mexico, Albuquerque, NM 87131
| | - Andrew R Mayer
- The Mind Research Network/LBERI, Albuquerque, NM 87106; Department of Psychiatry & Behavioral Sciences, University of New Mexico, Albuquerque, NM 87131; Department of Psychology, University of New Mexico, Albuquerque, NM 87131; Department of Neurology, University of New Mexico, Albuquerque, NM 87131
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Karavallil Achuthan S, Stavrinos D, Argueta P, Vanderburgh C, Holm HB, Kana RK. Thalamic functional connectivity and sensorimotor processing in neurodevelopmental disorders. Front Neurosci 2023; 17:1279909. [PMID: 38161799 PMCID: PMC10755010 DOI: 10.3389/fnins.2023.1279909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/08/2023] [Indexed: 01/03/2024] Open
Abstract
One of the earliest neurobiological findings in autism has been the differences in the thalamocortical pathway connectivity, suggesting the vital role thalamus plays in human experience. The present functional MRI study investigated resting-state functional connectivity of the thalamus in 49 (autistic, ADHD, and neurotypical) young adults. All participants underwent structural MRI and eyes-open resting state functional MRI scans. After preprocessing the imaging data using Conn's connectivity toolbox, a seed-based functional connectivity analysis was conducted using bilateral thalamus as primary seeds. Autistic participants showed stronger thalamic connectivity, relative to ADHD and neurotypical participants, between the right thalamus and right precentral gyrus, right pars opercularis-BA44, right postcentral gyrus, and the right superior parietal lobule (RSPL). Autistic participants also showed significantly increased connectivity between the left thalamus and the right precentral gyrus. Furthermore, regression analyses revealed a significant relationship between autistic traits and left thalamic-precentral connectivity (R2 = 0.1113), as well as between autistic traits and right postcentral gyrus and RSPL connectivity (R2 = 0.1204) in autistic participants compared to ADHD. These findings provide significant insights into the role of thalamus in coordinating neural information processing and its alterations in neurodevelopmental disorders.
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Affiliation(s)
- Smitha Karavallil Achuthan
- Department of Psychology and the Center for Innovative Research in Autism, The University of Alabama, Tuscaloosa, AL, United States
| | - Despina Stavrinos
- Department of Psychology and the Institute of Social Science Research, The University of Alabama, Tuscaloosa, AL, United States
| | - Paula Argueta
- Department of Psychology and the Center for Innovative Research in Autism, The University of Alabama, Tuscaloosa, AL, United States
| | - Caroline Vanderburgh
- Department of Psychology and the Center for Innovative Research in Autism, The University of Alabama, Tuscaloosa, AL, United States
| | - Haley B. Holm
- Children’s Hospital of Atlanta, Atlanta, GA, United States
| | - Rajesh K. Kana
- Department of Psychology and the Center for Innovative Research in Autism, The University of Alabama, Tuscaloosa, AL, United States
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Shida AF, Massett RJ, Imms P, Vegesna RV, Amgalan A, Irimia A. Significant Acceleration of Regional Brain Aging and Atrophy After Mild Traumatic Brain Injury. J Gerontol A Biol Sci Med Sci 2023; 78:1328-1338. [PMID: 36879433 PMCID: PMC10395568 DOI: 10.1093/gerona/glad079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Indexed: 03/08/2023] Open
Abstract
Brain regions' rates of age-related volumetric change after traumatic brain injury (TBI) are unknown. Here, we quantify these rates cross-sectionally in 113 persons with recent mild TBI (mTBI), whom we compare against 3 418 healthy controls (HCs). Regional gray matter (GM) volumes were extracted from magnetic resonance images. Linear regression yielded regional brain ages and the annualized average rates of regional GM volume loss. These results were compared across groups after accounting for sex and intracranial volume. In HCs, the steepest rates of volume loss were recorded in the nucleus accumbens, amygdala, and lateral orbital sulcus. In mTBI, approximately 80% of GM structures had significantly steeper rates of annual volume loss than in HCs. The largest group differences involved the short gyri of the insula and both the long gyrus and central sulcus of the insula. No significant sex differences were found in the mTBI group, regional brain ages being the oldest in prefrontal and temporal structures. Thus, mTBI involves significantly steeper regional GM loss rates than in HCs, reflecting older-than-expected regional brain ages.
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Affiliation(s)
- Alexander F Shida
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Roy J Massett
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Phoebe Imms
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Ramanand V Vegesna
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Anar Amgalan
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
- Corwin D. Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California, USA
- Department of Quantitative & Computational Biology, Dana and David Dornsife College of Arts & Sciences, University of Southern California, Los Angeles, California, USA
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Li YT, Kuo DP, Tseng P, Chen YC, Cheng SJ, Wu CW, Hsieh LC, Chiang YH, Chung HW, Lui YW, Chen CY. Thalamocortical Coherence Predicts Persistent Postconcussive Symptoms. Prog Neurobiol 2023; 226:102464. [PMID: 37169275 DOI: 10.1016/j.pneurobio.2023.102464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/10/2023] [Accepted: 05/07/2023] [Indexed: 05/13/2023]
Abstract
The pathogenetic mechanism of persistent post-concussive symptoms (PCS) following concussion remains unclear. Thalamic damage is known to play a role in PCS prolongation while the evidence and biomarkers that trigger persistent PCS have never been elucidated. We collected longitudinal neuroimaging and behavior data from patients and rodents after concussion, complemented with rodents' histological staining data, to unravel the early biomarkers of persistent PCS. Diffusion tensor imaging (DTI) were acquired to investigated the thalamic damage, while quantitative thalamocortical coherence was derived through resting-state functional MRI for evaluating thalamocortical functioning and predicting long-term behavioral outcome. Patients with prolonged symptoms showed abnormal DTI-derived indices at the boundaries of bilateral thalami (peri-thalamic regions). Both patients and rats with persistent symptoms demonstrated enhanced thalamocortical coherence between different thalamocortical circuits, which disrupted thalamocortical multifunctionality. In rodents, the persistent DTI abnormalities were validated in thalamic reticular nucleus (TRN) through immunohistochemistry, and correlated with enhanced thalamocortical coherence. Strong predictive power of these coherence biomarkers for long-term PCS was also validated using another patient cohort. Postconcussive events may begin with persistent TRN injury, followed by disrupted thalamocortical coherence and prolonged PCS. Functional MRI-based coherence measures can be surrogate biomarkers for early prediction of long-term PCS.
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Affiliation(s)
- Yi-Tien Li
- Translational Imaging Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei 11031, Taiwan
| | - Duen-Pang Kuo
- Translational Imaging Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan; Department of Medical Imaging, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Philip Tseng
- Graduate Institute of Mind, Brain, and Consciousness, Taipei Medical University, Taipei 11031, Taiwan; Brain and Consciousness Research Center, Shuang-Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei 11031, Taiwan
| | - Yung-Chieh Chen
- Translational Imaging Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan; Department of Medical Imaging, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Sho-Jen Cheng
- Translational Imaging Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan; Department of Medical Imaging, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Changwei W Wu
- Graduate Institute of Mind, Brain, and Consciousness, Taipei Medical University, Taipei 11031, Taiwan; Brain and Consciousness Research Center, Shuang-Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan
| | - Li-Chun Hsieh
- Translational Imaging Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan; Department of Medical Imaging, Taipei Medical University Hospital, Taipei 11031, Taiwan; Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Yung-Hsiao Chiang
- Neuroscience Research Center, Taipei Medical University, Taipei 11031, Taiwan; Center for Neurotrauma and Neuroregeneration, Taipei Medical University, Taipei 11031, Taiwan; Department of Neurosurgery, Taipei Medical University Hospital, Taipei 11031, Taiwan; Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Hsiao-Wen Chung
- Graduate Institute of Biomedical Electrics and Bioinformatics, National Taiwan University, Taipei 10617, Taiwan
| | - Yvonne W Lui
- Department of Radiology, NYU Langone Health, New York University School of Medicine, New York, NY, 10016, USA; Department of Radiology, NYU Grossman School of Medicine, New York University, New York, NY, 10016, USA
| | - Cheng-Yu Chen
- Translational Imaging Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan; Department of Medical Imaging, Taipei Medical University Hospital, Taipei 11031, Taiwan; Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei 11031, Taiwan.
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7
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Chen AM, Gerhalter T, Dehkharghani S, Peralta R, Gajdošík M, Gajdošík M, Tordjman M, Zabludovsky J, Sheriff S, Ahn S, Babb JS, Bushnik T, Zarate A, Silver JM, Im BS, Wall SP, Madelin G, Kirov II. Replicability of proton MR spectroscopic imaging findings in mild traumatic brain injury: Implications for clinical applications. Neuroimage Clin 2023; 37:103325. [PMID: 36724732 PMCID: PMC9898311 DOI: 10.1016/j.nicl.2023.103325] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/06/2022] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
PURPOSE Proton magnetic resonance spectroscopy (1H MRS) offers biomarkers of metabolic damage after mild traumatic brain injury (mTBI), but a lack of replicability studies hampers clinical translation. In a conceptual replication study design, the results reported in four previous publications were used as the hypotheses (H1-H7), specifically: abnormalities in patients are diffuse (H1), confined to white matter (WM) (H2), comprise low N-acetyl-aspartate (NAA) levels and normal choline (Cho), creatine (Cr) and myo-inositol (mI) (H3), and correlate with clinical outcome (H4); additionally, a lack of findings in regional subcortical WM (H5) and deep gray matter (GM) structures (H6), except for higher mI in patients' putamen (H7). METHODS 26 mTBI patients (20 female, age 36.5 ± 12.5 [mean ± standard deviation] years), within two months from injury and 21 age-, sex-, and education-matched healthy controls were scanned at 3 Tesla with 3D echo-planar spectroscopic imaging. To test H1-H3, global analysis using linear regression was used to obtain metabolite levels of GM and WM in each brain lobe. For H4, patients were stratified into non-recovered and recovered subgroups using the Glasgow Outcome Scale Extended. To test H5-H7, regional analysis using spectral averaging estimated metabolite levels in four GM and six WM structures segmented from T1-weighted MRI. The Mann-Whitney U test and weighted least squares analysis of covariance were used to examine mean group differences in metabolite levels between all patients and all controls (H1-H3, H5-H7), and between recovered and non-recovered patients and their respectively matched controls (H4). Replicability was defined as the support or failure to support the null hypotheses in accordance with the content of H1-H7, and was further evaluated using percent differences, coefficients of variation, and effect size (Cohen's d). RESULTS Patients' occipital lobe WM Cho and Cr levels were 6.0% and 4.6% higher than controls', respectively (Cho, d = 0.37, p = 0.04; Cr, d = 0.63, p = 0.03). The same findings, i.e., higher patients' occipital lobe WM Cho and Cr (both p = 0.01), but with larger percent differences (Cho, 8.6%; Cr, 6.3%) and effect sizes (Cho, d = 0.52; Cr, d = 0.88) were found in the comparison of non-recovered patients to their matched controls. For the lobar WM Cho and Cr comparisons without statistical significance (frontal, parietal, temporal), unidirectional effect sizes were observed (Cho, d = 0.07 - 0.37; Cr, d = 0.27 - 0.63). No differences were found in any metabolite in any lobe in the comparison between recovered patients and their matched controls. In the regional analyses, no differences in metabolite levels were found in any GM or WM region, but all WM regions (posterior, frontal, corona radiata, and the genu, body, and splenium of the corpus callosum) exhibited unidirectional effect sizes for Cho and Cr (Cho, d = 0.03 - 0.34; Cr, d = 0.16 - 0.51). CONCLUSIONS We replicated findings of diffuse WM injury, which correlated with clinical outcome (supporting H1-H2, H4). These findings, however, were among the glial markers Cho and Cr, not the neuronal marker NAA (not supporting H3). No differences were found in regional GM and WM metabolite levels (supporting H5-H6), nor in putaminal mI (not supporting H7). Unidirectional effect sizes of higher patients' Cho and Cr within all WM analyses suggest widespread injury, and are in line with the conclusion from the previous publications, i.e., that detection of WM injury may be more dependent upon sensitivity of the 1H MRS technique than on the selection of specific regions. The findings lend further support to the corollary that clinic-ready 1H MRS biomarkers for mTBI may best be achieved by using high signal-to-noise-ratio single-voxels placed anywhere within WM. The biochemical signature of the injury, however, may differ and therefore absolute levels, rather than ratios may be preferred. Future replication efforts should further test the generalizability of these findings.
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Affiliation(s)
- Anna M Chen
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Teresa Gerhalter
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Seena Dehkharghani
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA; Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Rosemary Peralta
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Mia Gajdošík
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Martin Gajdošík
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Mickael Tordjman
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA; Department of Radiology, Hôpital Cochin, Paris, France
| | - Julia Zabludovsky
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Sulaiman Sheriff
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sinyeob Ahn
- Siemens Medical Solutions USA Inc., Malvern, PA, USA
| | - James S Babb
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Tamara Bushnik
- Department of Rehabilitation Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Alejandro Zarate
- Department of Rehabilitation Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Jonathan M Silver
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Brian S Im
- Department of Rehabilitation Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Stephen P Wall
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Guillaume Madelin
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Ivan I Kirov
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA; Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA; Center for Advanced Imaging Innovation and Research, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA.
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Evidence of Chronic Complement Activation in Asymptomatic Pediatric Brain Injury Patients: A Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010045. [PMID: 36670596 PMCID: PMC9856304 DOI: 10.3390/children10010045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/16/2022] [Accepted: 12/18/2022] [Indexed: 12/28/2022]
Abstract
Physical insult from a mild Traumatic Brain Injury (mTBI) leads to changes in blood flow in the brain and measurable changes in white matter, suggesting a physiological basis for chronic symptom presentation. Post-traumatic headache (PTH) is frequently reported by persons after an mTBI that may persist beyond the acute period (>3 months). It remains unclear whether ongoing inflammation may contribute to the clinical trajectory of PTH. We recruited a cohort of pediatric subjects with PTH who had an acute or a persistent clinical trajectory, each around the 3-month post-injury time point, as well as a group of age and sex-matched healthy controls. We collected salivary markers of mRNA expression as well as brain imaging and psychological testing. The persistent PTH group showed the highest levels of psychological burden and pain symptom reporting. Our data suggest that the acute and persistent PTH cohort had elevated levels of complement factors relative to healthy controls. The greatest change in mRNA expression was found in the acute-PTH cohort wherein the complement cascade and markers of vascular health showed a prominent role for C1Q in PTH pathophysiology. These findings (1) underscore a prolonged engagement of what is normally a healthy response and (2) show that a persistent PTH symptom trajectory may parallel a poorly regulated inflammatory response.
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Joyce JM, La PL, Walker R, Harris A. Magnetic resonance spectroscopy of traumatic brain injury and subconcussive hits: A systematic review and meta-analysis. J Neurotrauma 2022; 39:1455-1476. [PMID: 35838132 DOI: 10.1089/neu.2022.0125] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Magnetic resonance spectroscopy (MRS) is a non-invasive technique used to study metabolites in the brain. MRS findings in traumatic brain injury (TBI) and subconcussive hit literature have been mixed. The most common observation is a decrease in N-acetyl-aspartate (NAA), traditionally considered a marker of neuronal integrity. Other metabolites, however, such as creatine (Cr), choline (Cho), glutamate+glutamine (Glx) and myo-inositol (mI) have shown inconsistent changes in these populations. The objective of this systematic review and meta-analysis was to synthesize MRS literature in head injury and explore factors (brain region, injury severity, time since injury, demographic, technical imaging factors, etc.) that may contribute to differential findings. One hundred and thirty-eight studies met inclusion criteria for the systematic review and of those, 62 NAA, 24 Cr, 49 Cho, 18 Glx and 21 mI studies met inclusion criteria for meta-analysis. A random effects model was used for meta-analyses with brain region as a subgroup for each of the five metabolites studied. Meta-regression was used to examine the influence of potential moderators including injury severity, time since injury, age, sex, tissue composition and methodological factors. In this analysis of 1428 unique head-injured subjects and 1132 controls, the corpus callosum was identified as a brain region highly susceptible to metabolite alteration. NAA was consistently decreased in TBI of all severity, but not in subconcussive hits. Cho and mI were found to be increased in moderate-to-severe TBI but not mild TBI. Glx and Cr were largely unaffected, however did show alterations in certain conditions.
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Affiliation(s)
- Julie Michele Joyce
- University of Calgary, 2129, Radiology, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, 157742, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, 157744, Calgary, Alberta, Canada.,Integrated Concussion Research Program, Calgary, Alberta, Canada;
| | - Parker L La
- University of Calgary, 2129, Radiology, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, 157742, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, 157744, Calgary, Alberta, Canada.,Integrated Concussion Research Program, Calgary, Alberta, Canada;
| | - Robyn Walker
- University of Calgary, 2129, Radiology, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, 157742, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, 157744, Calgary, Alberta, Canada.,Integrated Concussion Research Program, Calgary, Alberta, Canada;
| | - Ashley Harris
- University of Calgary, Radiology, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, 157742, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, 157744, Calgary, Alberta, Canada.,Integrated Concussion Research Program, Calgary, Alberta, Canada;
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10
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Abdul Rahman MR, Abd Hamid AI, Noh NA, Omar H, Chai WJ, Idris Z, Ahmad AH, Fitzrol DN, Ab. Ghani ARIG, Wan Mohamad WNA, Mohamed Mustafar MF, Hanafi MH, Reza MF, Umar H, Mohd Zulkifly MF, Ang SY, Zakaria Z, Musa KI, Othman A, Embong Z, Sapiai NA, Kandasamy R, Ibrahim H, Abdullah MZ, Amaruchkul K, Valdes-Sosa P, Luisa-Bringas M, Biswal B, Songsiri J, Yaacob HS, Sumari P, Jamir Singh PS, Azman A, Abdullah JM. Alteration in the Functional Organization of the Default Mode Network Following Closed Non-severe Traumatic Brain Injury. Front Neurosci 2022; 16:833320. [PMID: 35418832 PMCID: PMC8995774 DOI: 10.3389/fnins.2022.833320] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 02/04/2022] [Indexed: 02/05/2023] Open
Abstract
The debilitating effect of traumatic brain injury (TBI) extends years after the initial injury and hampers the recovery process and quality of life. In this study, we explore the functional reorganization of the default mode network (DMN) of those affected with non-severe TBI. Traumatic brain injury (TBI) is a wide-spectrum disease that has heterogeneous effects on its victims and impacts everyday functioning. The functional disruption of the default mode network (DMN) after TBI has been established, but its link to causal effective connectivity remains to be explored. This study investigated the differences in the DMN between healthy participants and mild and moderate TBI, in terms of functional and effective connectivity using resting-state functional magnetic resonance imaging (fMRI). Nineteen non-severe TBI (mean age 30.84 ± 14.56) and twenty-two healthy (HC; mean age 27.23 ± 6.32) participants were recruited for this study. Resting-state fMRI data were obtained at the subacute phase (mean days 40.63 ± 10.14) and analyzed for functional activation and connectivity, independent component analysis, and effective connectivity within and between the DMN. Neuropsychological tests were also performed to assess the cognitive and memory domains. Compared to the HC, the TBI group exhibited lower activation in the thalamus, as well as significant functional hypoconnectivity between DMN and LN. Within the DMN nodes, decreased activations were detected in the left inferior parietal lobule, precuneus, and right superior frontal gyrus. Altered effective connectivities were also observed in the TBI group and were linked to the diminished activation in the left parietal region and precuneus. With regard to intra-DMN connectivity within the TBI group, positive correlations were found in verbal and visual memory with the language network, while a negative correlation was found in the cognitive domain with the visual network. Our results suggested that aberrant activities and functional connectivities within the DMN and with other RSNs were accompanied by the altered effective connectivities in the TBI group. These alterations were associated with impaired cognitive and memory domains in the TBI group, in particular within the language domain. These findings may provide insight for future TBI observational and interventional research.
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Affiliation(s)
- Muhammad Riddha Abdul Rahman
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- School of Medical Imaging, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Nerus, Malaysia
- Brain and Behavior Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Aini Ismafairus Abd Hamid
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Brain and Behavior Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
- *Correspondence: Aini Ismafairus Abd Hamid,
| | - Nor Azila Noh
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Hazim Omar
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Brain and Behavior Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Wen Jia Chai
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Brain and Behavior Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Zamzuri Idris
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Brain and Behavior Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Asma Hayati Ahmad
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Diana Noma Fitzrol
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Brain and Behavior Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Ab. Rahman Izaini Ghani Ab. Ghani
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Brain and Behavior Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Wan Nor Azlen Wan Mohamad
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Brain and Behavior Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Mohamed Faiz Mohamed Mustafar
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Brain and Behavior Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Muhammad Hafiz Hanafi
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Brain and Behavior Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Mohamed Faruque Reza
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Brain and Behavior Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Hafidah Umar
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Brain and Behavior Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Mohd Faizal Mohd Zulkifly
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Brain and Behavior Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Song Yee Ang
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Brain and Behavior Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Zaitun Zakaria
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Brain and Behavior Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Azizah Othman
- Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Zunaina Embong
- Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Nur Asma Sapiai
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | | | - Haidi Ibrahim
- School of Electrical and Electronic Engineering, Universiti Sains Malaysia, Nibong Tebal, Malaysia
| | - Mohd Zaid Abdullah
- School of Electrical and Electronic Engineering, Universiti Sains Malaysia, Nibong Tebal, Malaysia
| | - Kannapha Amaruchkul
- Graduate School of Applied Statistics, National Institute of Development Administration (NIDA), Bangkok, Thailand
| | - Pedro Valdes-Sosa
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- The Cuban Neurosciences Center, Havana, Cuba
| | - Maria Luisa-Bringas
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- The Cuban Neurosciences Center, Havana, Cuba
| | - Bharat Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States
| | - Jitkomut Songsiri
- EE410 Control Systems Laboratory, Department of Electrical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
| | - Hamwira Sakti Yaacob
- Department of Computer Science, Kulliyah of Information and Communication Technology, International Islamic University Malaysia, Kuala Lumpur, Malaysia
| | - Putra Sumari
- School of Computer Sciences, Universiti Sains Malaysia, Gelugor, Malaysia
| | | | - Azlinda Azman
- School of Social Sciences, Universiti Sains Malaysia, Gelugor, Malaysia
| | - Jafri Malin Abdullah
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Brain and Behavior Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
- Jafri Malin Abdullah,
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11
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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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12
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Schumm SN, Gabrieli D, Meaney DF. Plasticity impairment exposes CA3 vulnerability in a hippocampal network model of mild traumatic brain injury. Hippocampus 2022; 32:231-250. [PMID: 34978378 DOI: 10.1002/hipo.23402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/08/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022]
Abstract
Proper function of the hippocampus is critical for executing cognitive tasks such as learning and memory. Traumatic brain injury (TBI) and other neurological disorders are commonly associated with cognitive deficits and hippocampal dysfunction. Although there are many existing models of individual subregions of the hippocampus, few models attempt to integrate the primary areas into one system. In this work, we developed a computational model of the hippocampus, including the dentate gyrus, CA3, and CA1. The subregions are represented as an interconnected neuronal network, incorporating well-characterized ex vivo slice electrophysiology into the functional neuron models and well-documented anatomical connections into the network structure. In addition, since plasticity is foundational to the role of the hippocampus in learning and memory as well as necessary for studying adaptation to injury, we implemented spike-timing-dependent plasticity among the synaptic connections. Our model mimics key features of hippocampal activity, including signal frequencies in the theta and gamma bands and phase-amplitude coupling in area CA1. We also studied the effects of spike-timing-dependent plasticity impairment, a potential consequence of TBI, in our model and found that impairment decreases broadband power in CA3 and CA1 and reduces phase coherence between these two subregions, yet phase-amplitude coupling in CA1 remains intact. Altogether, our work demonstrates characteristic hippocampal activity with a scaled network model of spiking neurons and reveals the sensitive balance of plasticity mechanisms in the circuit through one manifestation of mild traumatic injury.
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Affiliation(s)
- Samantha N Schumm
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David Gabrieli
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David F Meaney
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Penn Center for Brain Injury and Repair, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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13
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Mortaheb S, Filippini MM, Kaux JF, Annen J, Lejeune N, Martens G, Calderón MAF, Laureys S, Thibaut A. Neurophysiological Biomarkers of Persistent Post-concussive Symptoms: A Scoping Review. Front Neurol 2021; 12:687197. [PMID: 34566837 PMCID: PMC8459021 DOI: 10.3389/fneur.2021.687197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/28/2021] [Indexed: 11/25/2022] Open
Abstract
Background and Objectives: Persistent post-concussive symptoms (PCS) consist of neurologic and psychological complaints persisting after a mild traumatic brain injury (mTBI). It affects up to 50% of mTBI patients, may cause long-term disability, and reduce patients' quality of life. The aim of this review was to examine the possible use of different neuroimaging modalities in PCS. Methods: Articles from Pubmed database were screened to extract studies that investigated the relationship between any neuroimaging features and symptoms of PCS. Descriptive statistics were applied to report the results. Results: A total of 80 out of 939 papers were included in the final review. Ten examined conventional MRI (30% positive finding), 24 examined diffusion weighted imaging (54.17% positive finding), 23 examined functional MRI (82.61% positive finding), nine examined electro(magneto)encephalography (77.78% positive finding), and 14 examined other techniques (71% positive finding). Conclusion: MRI was the most widely used technique, while functional techniques seem to be the most sensitive tools to evaluate PCS. The common functional patterns associated with symptoms of PCS were a decreased anti-correlation between the default mode network and the task positive network and reduced brain activity in specific areas (most often in the prefrontal cortex). Significance: Our findings highlight the importance to use functional approaches which demonstrated a functional alteration in brain connectivity and activity in most studies assessing PCS.
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Affiliation(s)
- Sepehr Mortaheb
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Brain Clinic, University Hospital of Liège, Liège, Belgium.,Physiology of Cognition Lab., GIGA-Consciousness, University of Liège, Liège, Belgium
| | - Maria Maddalena Filippini
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Brain Clinic, University Hospital of Liège, Liège, Belgium.,Neuromotor and Rehabilitation Department, Azienda Unita Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico (USL-IRCSS) di Reggio Emilia, Reggio Emilia, Italy
| | - Jean-François Kaux
- Physical Medicine and Sport Traumatology Department, Sports, FIFA Medical Centre of Excellence, IOC Research Centre for Prevention of Injury and Protection of Athletes Health, FIMS Collaborative Centre of Sport Medicine, University and University Hospital of Liège, Liège, Belgium
| | - Jitka Annen
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Brain Clinic, University Hospital of Liège, Liège, Belgium
| | - Nicolas Lejeune
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Brain Clinic, University Hospital of Liège, Liège, Belgium.,Institute of NeuroScience, University of Louvain, Brussels, Belgium
| | - Géraldine Martens
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Physical Medicine and Sport Traumatology Department, Sports, FIFA Medical Centre of Excellence, IOC Research Centre for Prevention of Injury and Protection of Athletes Health, FIMS Collaborative Centre of Sport Medicine, University and University Hospital of Liège, Liège, Belgium
| | | | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Brain Clinic, University Hospital of Liège, Liège, Belgium
| | - Aurore Thibaut
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Brain Clinic, University Hospital of Liège, Liège, Belgium
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14
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Amir J, Nair JKR, Del Carpio-O'Donovan R, Ptito A, Chen JK, Chankowsky J, Tinawi S, Lunkova E, Saluja RS. Atypical resting state functional connectivity in mild traumatic brain injury. Brain Behav 2021; 11:e2261. [PMID: 34152089 PMCID: PMC8413771 DOI: 10.1002/brb3.2261] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES This study aimed to investigate changes in three intrinsic functional connectivity networks (IFCNs; default mode network [DMN], salience network [SN], and task-positive network [TPN]) in individuals who had sustained a mild traumatic brain injury (mTBI). METHODS Resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired from 27 mTBI patients with persistent postconcussive symptoms, along with 26 age- and sex-matched controls. These individuals were recruited from a Level-1 trauma center, at least 3 months after a traumatic episode. IFCNs were established based on seed-to-voxel, region-of-interest (ROI) to ROI, and independent component analyses (ICA). Subsequently, we analyzed the relationship between functional connectivity and postconcussive symptoms. RESULTS Seed-to-voxel analysis of rs-fMRI demonstrated decreased functional connectivity in the right lateral parietal lobe, part of the DMN, and increased functional connectivity in the supramarginal gyrus, part of the SN. Our TPN showed both hypo- and hyperconnectivity dependent on seed location. Within network hypoconnectivity was observed in the visual network also using group comparison. Using an ICA, we identified altered network functional connectivity in regions within four IFCNs (sensorimotor, visual, DMN, and dorsal attentional). A significant negative correlation between dorsal attentional network connectivity and behavioral symptoms score was also found. CONCLUSIONS Our findings indicate that rs-fMRI may be of use clinically in order to assess disrupted functional connectivity among IFCNs in mTBI patients. Improved mTBI diagnostic and prognostic information could be especially relevant for athletes looking to safely return to play, as well for individuals from the general population with persistent postconcussive symptoms months after injury, who hope to resume activity.
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Affiliation(s)
- Joelle Amir
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | | | | | - Alain Ptito
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Jen-Kai Chen
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Jeffrey Chankowsky
- Department of Radiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Simon Tinawi
- Department of Rehabilitation Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Ekaterina Lunkova
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Rajeet Singh Saluja
- Department of Radiology, McGill University Health Centre, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
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15
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Zhuo J, Jiang L, Rhodes CS, Roys S, Shanmuganathan K, Chen H, Prince JL, Badjatia N, Gullapalli RP. Early Stage Longitudinal Subcortical Volumetric Changes following Mild Traumatic Brain Injury. Brain Inj 2021; 35:725-733. [PMID: 33822686 PMCID: PMC8207827 DOI: 10.1080/02699052.2021.1906445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/15/2021] [Accepted: 03/17/2021] [Indexed: 01/07/2023]
Abstract
Objective: To investigate early brain volumetric changes from acute to 6 months following mild traumatic brain injury (mTBI) in deep gray matter regions and their association with patient 6-month outcome.Methods: Fifty-six patients with mTBI underwent MRI and behavioral evaluation at acute (<10 days) and approximately 1 and 6 months post injury. Regional volume changes were investigated in key gray matter regions: thalamus, hippocampus, putamen, caudate, pallidum, and amygdala, and compared with volumes from 34 healthy control subjects. In patients with mTBI, we further assessed associations between longitudinal regional volume changes with patient outcome measures at 6 months including post-concussive symptoms, cognitive performance, and overall satisfaction with life.Results: Reduction in thalamic and hippocampal volumes was observed at 1 month among patients with mTBI. Such volume reduction persisted in the thalamus until 6 months. Changes in thalamic volumes also correlated with multiple symptom and functional outcome measures in patients at 6 months.Conclusion: Our results indicate that the thalamus may be differentially affected among patients with mTBI, resulting in both structural and functional deficits with subsequent post-concussive sequelae and may serve as a biomarker for the assessment of efficacy of novel therapeutic interventions.
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Affiliation(s)
- Jiachen Zhuo
- Center for Advanced Imaging Research, Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Li Jiang
- Center for Advanced Imaging Research, Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Chandler Sours Rhodes
- Center for Advanced Imaging Research, Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
| | - Steven Roys
- Center for Advanced Imaging Research, Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Karthikamanthan Shanmuganathan
- Center for Advanced Imaging Research, Department of Diagnostic Radiology & 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
| | - Jerry L. Prince
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD
| | - Neeraj Badjatia
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD
| | - Rao P. Gullapalli
- Center for Advanced Imaging Research, Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
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16
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Bartnik-Olson BL, Alger JR, Babikian T, Harris AD, Holshouser B, Kirov II, Maudsley AA, Thompson PM, Dennis EL, Tate DF, Wilde EA, Lin A. The clinical utility of proton magnetic resonance spectroscopy in traumatic brain injury: recommendations from the ENIGMA MRS working group. Brain Imaging Behav 2021; 15:504-525. [PMID: 32797399 PMCID: PMC7882010 DOI: 10.1007/s11682-020-00330-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Proton (1H) magnetic resonance spectroscopy provides a non-invasive and quantitative measure of brain metabolites. Traumatic brain injury impacts cerebral metabolism and a number of research groups have successfully used this technique as a biomarker of injury and/or outcome in both pediatric and adult TBI populations. However, this technique is underutilized, with studies being performed primarily at centers with access to MR research support. In this paper we present a technical introduction to the acquisition and analysis of in vivo 1H magnetic resonance spectroscopy and review 1H magnetic resonance spectroscopy findings in different injury populations. In addition, we propose a basic 1H magnetic resonance spectroscopy data acquisition scheme (Supplemental Information) that can be added to any imaging protocol, regardless of clinical magnetic resonance platform. We outline a number of considerations for study design as a way of encouraging the use of 1H magnetic resonance spectroscopy in the study of traumatic brain injury, as well as recommendations to improve data harmonization across groups already using this technique.
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Affiliation(s)
| | - Jeffry R Alger
- Departments of Neurology and Radiology, University of California Los Angeles, Los Angeles, CA, USA
- NeuroSpectroScopics LLC, Sherman Oaks, Los Angeles, CA, USA
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Talin Babikian
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA
| | - Ashley D Harris
- Department of Radiology, University of Calgary, Calgary, Canada
- Child and Adolescent Imaging Research Program, Alberta Children's Hospital Research Institute and the Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Barbara Holshouser
- Department of Radiology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Ivan I Kirov
- Bernard and Irene Schwartz Center for Biomedical Imaging, Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Andrew A Maudsley
- Department of Radiology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, Los Angeles, CA, USA
- Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology, USC, Los Angeles, CA, USA
| | - Emily L Dennis
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, Los Angeles, CA, USA
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
- Psychiatry Neuroimaging Laboratory, Brigham & Women's Hospital, Boston, MA, USA
| | - David F Tate
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Elisabeth A Wilde
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
| | - Alexander Lin
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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17
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Albayram O, Albayram S, Mannix R. Chronic traumatic encephalopathy-a blueprint for the bridge between neurological and psychiatric disorders. Transl Psychiatry 2020; 10:424. [PMID: 33293571 PMCID: PMC7723988 DOI: 10.1038/s41398-020-01111-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 10/21/2020] [Accepted: 11/09/2020] [Indexed: 12/14/2022] Open
Abstract
Chronic traumatic encephalopathy (CTE) is a perplexing condition characterized by a broad and diverse range of neuropathology and psychopathology. While there are no agreed upon or validated clinical criteria for CTE, case series of CTE have described a wide range of neuropsychiatric symptoms that have been attributed to repetitive traumatic brain injuries (rTBI). However, the direct links between the psychopathology of psychiatric and neurological conditions from rTBI to CTE remains poorly understood. Prior studies suggest that repetitive cerebral injuries are associated with damage to neural circuitry involved in emotional and memory processes, but these studies do not offer longitudinal assessments that prove causation. More recent studies on novel targets, such as transmission of misfolded proteins, as well as newly advanced non-invasive imaging techniques may offer more direct evidence of the pathogenesis of CTE by tracing the progression of pathology and display of related behavioral impairments. Understanding this interface in the context of rTBI can play an important role in future approaches to the definition, assessment, prevention, and treatment of CTE and mental illnesses.
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Affiliation(s)
- Onder Albayram
- Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, 29425, USA.
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, 29425, USA.
| | - Sait Albayram
- Department of Radiology, University of Florida College of Medicine, Gainesville, FL, 32610, USA
| | - Rebekkah Mannix
- Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115, USA
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18
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Stone JR, Avants BB, Tustison NJ, Wassermann EM, Gill J, Polejaeva E, Dell KC, Carr W, Yarnell AM, LoPresti ML, Walker P, O'Brien M, Domeisen N, Quick A, Modica CM, Hughes JD, Haran FJ, Goforth C, Ahlers ST. Functional and Structural Neuroimaging Correlates of Repetitive Low-Level Blast Exposure in Career Breachers. J Neurotrauma 2020; 37:2468-2481. [PMID: 32928028 PMCID: PMC7703399 DOI: 10.1089/neu.2020.7141] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Combat military and civilian law enforcement personnel may be exposed to repetitive low-intensity blast events during training and operations. Persons who use explosives to gain entry (i.e., breach) into buildings are known as “breachers” or dynamic entry personnel. Breachers operate under the guidance of established safety protocols, but despite these precautions, breachers who are exposed to low-level blast throughout their careers frequently report performance deficits and symptoms to healthcare providers. Although little is known about the etiology linking blast exposure to clinical symptoms in humans, animal studies demonstrate network-level changes in brain function, alterations in brain morphology, vascular and inflammatory changes, hearing loss, and even alterations in gene expression after repeated blast exposure. To explore whether similar effects occur in humans, we collected a comprehensive data battery from 20 experienced breachers exposed to blast throughout their careers and 14 military and law enforcement controls. This battery included neuropsychological assessments, blood biomarkers, and magnetic resonance imaging measures, including cortical thickness, diffusion tensor imaging of white matter, functional connectivity, and perfusion. To better understand the relationship between repetitive low-level blast exposure and behavioral and imaging differences in humans, we analyzed the data using similarity-driven multi-view linear reconstruction (SiMLR). SiMLR is specifically designed for multiple modality statistical integration using dimensionality-reduction techniques for studies with high-dimensional, yet sparse, data (i.e., low number of subjects and many data per subject). We identify significant group effects in these data spanning brain structure, function, and blood biomarkers.
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Affiliation(s)
- James R Stone
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - Brian B Avants
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - Nicholas J Tustison
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - Eric M Wassermann
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Jessica Gill
- Tissue Injury Branch, National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Elena Polejaeva
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Kristine C Dell
- Department of Psychology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Walter Carr
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA.,Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Angela M Yarnell
- Military Emergency Medicine, Uniformed Services University, Bethesda, Maryland, USA
| | - Matthew L LoPresti
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Peter Walker
- Health Mission Initiative, DoD Joint Artificial Intelligence Center, Washington, DC, USA
| | - Meghan O'Brien
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - Natalie Domeisen
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - Alycia Quick
- School of Psychology, University of Glasgow, Glasgow, United Kingdom
| | - Claire M Modica
- Neurotrauma Department, Naval Medical Research Center, Silver Spring, Maryland, USA
| | - John D Hughes
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Francis J Haran
- Operational and Undersea Medicine Directorate, Naval Medical Research Center, Silver Spring, Maryland, USA
| | - Carl Goforth
- Operational and Undersea Medicine Directorate, Naval Medical Research Center, Silver Spring, Maryland, USA
| | - Stephen T Ahlers
- Operational and Undersea Medicine Directorate, Naval Medical Research Center, Silver Spring, Maryland, USA
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19
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Boshra R, Ruiter KI, Dhindsa K, Sonnadara R, Reilly JP, Connolly JF. On the time-course of functional connectivity: theory of a dynamic progression of concussion effects. Brain Commun 2020; 2:fcaa063. [PMID: 32954320 PMCID: PMC7491441 DOI: 10.1093/braincomms/fcaa063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/15/2020] [Accepted: 04/24/2020] [Indexed: 12/27/2022] Open
Abstract
The current literature presents a discordant view of mild traumatic brain injury and its effects on the human brain. This dissonance has often been attributed to heterogeneities in study populations, aetiology, acuteness, experimental paradigms and/or testing modalities. To investigate the progression of mild traumatic brain injury in the human brain, the present study employed data from 93 subjects (48 healthy controls) representing both acute and chronic stages of mild traumatic brain injury. The effects of concussion across different stages of injury were measured using two metrics of functional connectivity in segments of electroencephalography time-locked to an active oddball task. Coherence and weighted phase-lag index were calculated separately for individual frequency bands (delta, theta, alpha and beta) to measure the functional connectivity between six electrode clusters distributed from frontal to parietal regions across both hemispheres. Results show an increase in functional connectivity in the acute stage after mild traumatic brain injury, contrasted with significantly reduced functional connectivity in chronic stages of injury. This finding indicates a non-linear time-dependent effect of injury. To understand this pattern of changing functional connectivity in relation to prior evidence, we propose a new model of the time-course of the effects of mild traumatic brain injury on the brain that brings together research from multiple neuroimaging modalities and unifies the various lines of evidence that at first appear to be in conflict.
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Affiliation(s)
- Rober Boshra
- ARiEAL Research Centre, McMaster University, Hamilton, ON L8S 4K1, Canada.,School of Biomedical Engineering, McMaster University, Hamilton, ON L8S 4K1, Canada.,Vector Institute, Toronto, ON M5G 1M1, Canada
| | - Kyle I Ruiter
- ARiEAL Research Centre, McMaster University, Hamilton, ON L8S 4K1, Canada.,Linguistics and Languages, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Kiret Dhindsa
- ARiEAL Research Centre, McMaster University, Hamilton, ON L8S 4K1, Canada.,Vector Institute, Toronto, ON M5G 1M1, Canada.,Department of Surgery, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Ranil Sonnadara
- ARiEAL Research Centre, McMaster University, Hamilton, ON L8S 4K1, Canada.,Vector Institute, Toronto, ON M5G 1M1, Canada.,Department of Surgery, McMaster University, Hamilton, ON L8S 4K1, Canada.,Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - James P Reilly
- ARiEAL Research Centre, McMaster University, Hamilton, ON L8S 4K1, Canada.,School of Biomedical Engineering, McMaster University, Hamilton, ON L8S 4K1, Canada.,Vector Institute, Toronto, ON M5G 1M1, Canada.,Department of Electrical & Computer Engineering, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - John F Connolly
- ARiEAL Research Centre, McMaster University, Hamilton, ON L8S 4K1, Canada.,School of Biomedical Engineering, McMaster University, Hamilton, ON L8S 4K1, Canada.,Vector Institute, Toronto, ON M5G 1M1, Canada.,Linguistics and Languages, McMaster University, Hamilton, ON L8S 4K1, Canada.,Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON L8S 4K1, Canada
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20
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Huang M, Lewine JD, Lee RR. Magnetoencephalography for Mild Traumatic Brain Injury and Posttraumatic Stress Disorder. Neuroimaging Clin N Am 2020; 30:175-192. [DOI: 10.1016/j.nic.2020.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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21
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Schumm SN, Gabrieli D, Meaney DF. Neuronal Degeneration Impairs Rhythms Between Connected Microcircuits. Front Comput Neurosci 2020; 14:18. [PMID: 32194390 PMCID: PMC7063469 DOI: 10.3389/fncom.2020.00018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 02/11/2020] [Indexed: 11/23/2022] Open
Abstract
Synchronization of neural activity across brain regions is critical to processes that include perception, learning, and memory. After traumatic brain injury (TBI), neuronal degeneration is one possible effect and can alter communication between neural circuits. Consequently, synchronization between neurons may change and can contribute to both lasting changes in functional brain networks and cognitive impairment in patients. However, fundamental principles relating exactly how TBI at the cellular scale affects synchronization of mesoscale circuits are not well understood. In this work, we use computational networks of Izhikevich integrate-and-fire neurons to study synchronized, oscillatory activity between clusters of neurons, which also adapt according to spike-timing-dependent plasticity (STDP). We study how the connections within and between these neuronal clusters change as unidirectional connections form between the two neuronal populations. In turn, we examine how neuronal deletion, intended to mimic the temporary or permanent loss of neurons in the mesoscale circuit, affects these dynamics. We determine synchronization of two neuronal circuits requires very modest connectivity between these populations; approximately 10% of neurons projecting from one circuit to another circuit will result in high synchronization. In addition, we find that synchronization level inversely affects the strength of connection between neuronal microcircuits - moderately synchronized microcircuits develop stronger intercluster connections than do highly synchronized circuits. Finally, we find that highly synchronized circuits are largely protected against the effects of neuronal deletion but may display changes in frequency properties across circuits with targeted neuronal loss. Together, our results suggest that strongly and weakly connected regions differ in their inherent resilience to damage and may serve different roles in a larger network.
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Affiliation(s)
- Samantha N. Schumm
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, United States
| | - David Gabrieli
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, United States
| | - David F. Meaney
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, United States
- Penn Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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22
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Warnock A, Toomey LM, Wright AJ, Fisher K, Won Y, Anyaegbu C, Fitzgerald M. Damage Mechanisms to Oligodendrocytes and White Matter in Central Nervous System Injury: The Australian Context. J Neurotrauma 2020; 37:739-769. [DOI: 10.1089/neu.2019.6890] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Andrew Warnock
- Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
| | - Lillian M. Toomey
- Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
| | - Alexander J. Wright
- Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
| | - Katherine Fisher
- School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Yerim Won
- School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Chidozie Anyaegbu
- Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
| | - Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
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23
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Clark AL, Sorg SF, Holiday K, Bigler ED, Bangen KJ, Evangelista ND, Bondi MW, Schiehser DM, Delano-Wood L. Fatigue Is Associated With Global and Regional Thalamic Morphometry in Veterans With a History of Mild Traumatic Brain Injury. J Head Trauma Rehabil 2019; 33:382-392. [PMID: 29385016 PMCID: PMC6066453 DOI: 10.1097/htr.0000000000000377] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Fatigue is a complex, multidimensional phenomenon that commonly occurs following traumatic brain injury (TBI). The thalamus-a structure vulnerable to both primary and secondary injuries in TBI-is thought to play a pivotal role in the manifestation of fatigue. We explored how neuroimaging markers of local and global thalamic morphometry relate to the subjective experience of fatigue post-TBI. METHODS Sixty-three Veterans with a history of mild TBI underwent structural magnetic resonance imaging and completed questionnaires related to fatigue and psychiatric symptoms. FMRIB's Software (FSL) was utilized to obtain whole brain and thalamic volume estimates, as well as to perform regional thalamic morphometry analyses. RESULTS Independent of age, sex, intracranial volume, posttraumatic stress disorder, and depressive symptoms, greater levels of self-reported fatigue were significantly associated with decreased right (P = .026) and left (P = .046) thalamic volumes. Regional morphometry analyses revealed that fatigue was significantly associated with reductions in the anterior and dorsomedial aspects of the right thalamic body (P < .05). Similar trends were observed for the left thalamic body (P < .10). CONCLUSIONS Both global and regional thalamic morphometric changes are associated with the subjective experience of fatigue in Veterans with a history of mild TBI. These findings support a theory in which disruption of thalamocorticostriatal circuitry may result in the manifestation of fatigue in individuals with a history of neurotrauma.
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Affiliation(s)
- Alexandra L. Clark
- San Diego State University/University of California, San Diego
(SDSU/UCSD) Joint Doctoral Program in Clinical Psychology
- VA San Diego Healthcare System (VASDHS)
| | - Scott F. Sorg
- VA San Diego Healthcare System (VASDHS)
- University of California San Diego, School of Medicine, Department
of Psychiatry
| | - Kelsey Holiday
- San Diego State University/University of California, San Diego
(SDSU/UCSD) Joint Doctoral Program in Clinical Psychology
- VA San Diego Healthcare System (VASDHS)
| | - Erin D. Bigler
- Department of Psychology and the Neuroscience Center, Brigham and
Young University
| | - Katherine J. Bangen
- VA San Diego Healthcare System (VASDHS)
- University of California San Diego, School of Medicine, Department
of Psychiatry
| | | | - Mark W. Bondi
- VA San Diego Healthcare System (VASDHS)
- University of California San Diego, School of Medicine, Department
of Psychiatry
| | - Dawn M. Schiehser
- VA San Diego Healthcare System (VASDHS)
- Center of Excellence for Stress and Mental Health, VASDHS
- University of California San Diego, School of Medicine, Department
of Psychiatry
| | - Lisa Delano-Wood
- VA San Diego Healthcare System (VASDHS)
- Center of Excellence for Stress and Mental Health, VASDHS
- University of California San Diego, School of Medicine, Department
of Psychiatry
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24
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Walker MS, Stamper AM, Nathan DE, Riedy G. Art therapy and underlying fMRI brain patterns in military TBI: A case series. INTERNATIONAL JOURNAL OF ART THERAPY 2018. [DOI: 10.1080/17454832.2018.1473453] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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25
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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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26
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Kirov II, Whitlow CT, Zamora C. Susceptibility-Weighted Imaging and Magnetic Resonance Spectroscopy in Concussion. Neuroimaging Clin N Am 2018; 28:91-105. [DOI: 10.1016/j.nic.2017.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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27
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Muller AM, Virji-Babul N. Stuck in a State of Inattention? Functional Hyperconnectivity as an Indicator of Disturbed Intrinsic Brain Dynamics in Adolescents With Concussion: A Pilot Study. ASN Neuro 2018; 10:1759091417753802. [PMID: 29357675 PMCID: PMC5784460 DOI: 10.1177/1759091417753802] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/07/2017] [Accepted: 12/19/2017] [Indexed: 11/16/2022] Open
Abstract
Sports-related concussion in youth is a major public health issue. Evaluating the diffuse and often subtle changes in structure and function that occur in the brain, particularly in this population, remains a significant challenge. The goal of this pilot study was to evaluate the relationship between the intrinsic dynamics of the brain using resting-state functional magnetic resonance imaging (rs-fMRI) and relate these findings to structural brain correlates from diffusion tensor imaging in a group of adolescents with sports-related concussions ( n = 6) and a group of healthy adolescent athletes ( n = 6). We analyzed rs-fMRI data using a sliding windows approach and related the functional findings to structural brain correlates by applying graph theory analysis to the diffusion tensor imaging data. Within the resting-state condition, we extracted three separate brain states in both groups. Our analysis revealed that the brain dynamics in healthy adolescents was characterized by a dynamic pattern, shifting equally between three brain states; however, in adolescents with concussion, the pattern was more static with a longer time spent in one brain state. Importantly, this lack of dynamic flexibility in the concussed group was associated with increased nodal strength in the left middle frontal gyrus, suggesting reorganization in a region related to attention. This preliminary report shows that both the intrinsic brain dynamics and structural organization are altered in networks related to attention in adolescents with concussion. This first report in adolescents will be used to inform future studies in a larger cohort.
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Affiliation(s)
- Angela M. Muller
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Naznin Virji-Babul
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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28
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Vergara VM, Mayer AR, Damaraju E, Calhoun VD. The effect of preprocessing in dynamic functional network connectivity used to classify mild traumatic brain injury. Brain Behav 2017; 7:e00809. [PMID: 29075569 PMCID: PMC5651393 DOI: 10.1002/brb3.809] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 06/19/2017] [Accepted: 07/20/2017] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Dynamic functional network connectivity (dFNC), derived from magnetic resonance imaging (fMRI), is an important technique in the search for biomarkers of brain diseases such as mild traumatic brain injury (mTBI). At the individual level, mTBI can affect cognitive functions and change personality traits. Previous research aimed at detecting significant changes in the dFNC of mTBI subjects. However, one of the main concerns in dFNC analysis is the appropriateness of methods used to correct for subject movement. In this work, we focus on the effect that rearranging movement correction at different points of the processing pipeline has in dFNC analysis utilizing mTBI data. METHODS The sample cohort consists of 50 mTBI patients and matched healthy controls. A 5-min resting-state run was completed by each participant. Data were preprocessed using different pipeline alternatives varying with the place where motion-related variance was removed. In all pipelines, group-independent component analysis (gICA) followed by dFNC analysis was performed. Additional tests were performed varying the detection of temporal spikes, the number of gICA components, and the sliding-window size. A linear support vector machine was used to test how each pipeline affects classification accuracy. RESULTS Results suggest that correction for motion variance before spatial smoothing, but leaving correction for spiky time courses after gICA produced the best mean classification performance. The number of gICA components and the sliding-window size were also important in determining classification performance. Variance in spikes correction affected some pipelines more than others with fewer significant differences than the other parameters. CONCLUSION The sequence of preprocessing steps motion regression, smoothing, gICA, and despiking produced data most suitable for differentiating mTBI from healthy subjects. However, the selection of optimal preprocessing parameters strongly affected the final results.
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Affiliation(s)
| | - Andrew R Mayer
- The Mind Research Network Albuquerque NM USA.,Departments of Neurology and Psychiatry University of New Mexico Albuquerque NM USA
| | | | - Vince D Calhoun
- The Mind Research Network Albuquerque NM USA.,Department of Electrical and Computer Engineering University of New Mexico Albuquerque NM USA
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29
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Abstract
Mild traumatic brain injury (mTBI) frequently challenges the integrity of sleep function by affecting multiple brain areas implicated in controlling the switch between wakefulness and sleep and those involved in circadian and homeostatic processes; the malfunction of each causes a variety of disorders. In this review, we discuss recent data on the dynamics between disorders of sleep and mental/psychiatric disorders in persons with mTBI. This analysis sets the stage for understanding how a variety of physiological, emotional and environmental influences affect sleep and mental activities after injury to the brain. Consideration of the intricate links between sleep and mental functions in future research can increase understanding on the underlying mechanisms of sleep-related and psychiatric comorbidity in mTBI.
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30
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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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Banks SD, Coronado RA, Clemons LR, Abraham CM, Pruthi S, Conrad BN, Morgan VL, Guillamondegui OD, Archer KR. Thalamic Functional Connectivity in Mild Traumatic Brain Injury: Longitudinal Associations With Patient-Reported Outcomes and Neuropsychological Tests. Arch Phys Med Rehabil 2016; 97:1254-61. [PMID: 27085849 PMCID: PMC4990202 DOI: 10.1016/j.apmr.2016.03.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 03/18/2016] [Accepted: 03/21/2016] [Indexed: 12/27/2022]
Abstract
OBJECTIVES (1) To examine differences in patient-reported outcomes, neuropsychological tests, and thalamic functional connectivity (FC) between patients with mild traumatic brain injury (mTBI) and individuals without mTBI and (2) to determine longitudinal associations between changes in these measures. DESIGN Prospective observational case-control study. SETTING Academic medical center. PARTICIPANTS A sample (N=24) of 13 patients with mTBI (mean age, 39.3±14.0y; 4 women [31%]) and 11 age- and sex-matched controls without mTBI (mean age, 37.6±13.3y; 4 women [36%]). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Resting state FC (3T magnetic resonance imaging scanner) was examined between the thalamus and the default mode network, dorsal attention network, and frontoparietal control network. Patient-reported outcomes included pain (Brief Pain Inventory), depressive symptoms (Patient Health Questionnaire-9), posttraumatic stress disorder ([PTSD] Checklist - Civilian Version), and postconcussive symptoms (Rivermead Post-Concussion Symptoms Questionnaire). Neuropsychological tests included the Delis-Kaplan Executive Function System Tower test, Trails B, and Hotel Task. Assessments occurred at 6 weeks and 4 months after hospitalization in patients with mTBI and at a single visit for controls. RESULTS Student t tests found increased pain, depressive symptoms, PTSD symptoms, and postconcussive symptoms; decreased performance on Trails B; increased FC between the thalamus and the default mode network; and decreased FC between the thalamus and the dorsal attention network and between the thalamus and the frontoparietal control network in patients with mTBI as compared with controls. The Spearman correlation coefficient indicated that increased FC between the thalamus and the dorsal attention network from baseline to 4 months was associated with decreased pain and postconcussive symptoms (corrected P<.05). CONCLUSIONS Findings suggest that alterations in thalamic FC occur after mTBI, and improvements in pain and postconcussive symptoms are correlated with normalization of thalamic FC over time.
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Affiliation(s)
- Sarah D Banks
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Rogelio A Coronado
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Lori R Clemons
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Christine M Abraham
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN; Department of Education and Human Services, Lehigh University, Bethlehem, PA
| | - Sumit Pruthi
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Benjamin N Conrad
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN; Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN
| | - Victoria L Morgan
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN; Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN
| | - Oscar D Guillamondegui
- Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, TN
| | - Kristin R Archer
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN; Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN.
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Nathan DE, Bellgowan JF, Oakes TR, French LM, Nadar SR, Sham EB, Liu W, Riedy G. Assessing Quantitative Changes in Intrinsic Thalamic Networks in Blast and Nonblast Mild Traumatic Brain Injury: Implications for Mechanisms of Injury. Brain Connect 2016; 6:389-402. [PMID: 26956452 DOI: 10.1089/brain.2015.0403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In the global war on terror, the increased use of improvised explosive devices has resulted in increased incidence of blast-related mild traumatic brain injury (mTBI). Diagnosing mTBI is both challenging and controversial due to heterogeneity of injury location, trauma intensity, transient symptoms, and absence of focal biomarkers on standard clinical imaging modalities. The goal of this study is to identify a brain biomarker that is sensitive to mTBI injury. Research suggests the thalamus may be sensitive to changes induced by mTBI. A significant number of connections to and from various brain regions converge at the thalamus. In addition, the thalamus is involved in information processing, integration, and regulation of specific behaviors and mood. In this study, changes in task-free thalamic networks as quantified by graph theory measures in mTBI blast (N = 186), mTBI nonblast (N = 80), and controls (N = 21) were compared. Results show that the blast mTBI group had significant hyper-connectivity compared with the controls and nonblast mTBI group. However, after controlling for post-traumatic stress symptoms (PTSS), the blast mTBI group was not different from the controls, but the nonblast mTBI group showed significant hypo-connectivity. The results suggest that there are differences in the mechanisms of injury related to mTBI as reflected in the architecture of the thalamic networks. However, the effect of PTSS and its relationship to mTBI is difficult to distinguish and warrants more research.
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Affiliation(s)
- Dominic E Nathan
- 1 National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center , Bethesda, Maryland.,2 North Tide LLC , Dulles, Virginia.,3 Uniformed Services University of the Health Sciences , Bethesda, Maryland
| | - Julie F Bellgowan
- 1 National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center , Bethesda, Maryland.,2 North Tide LLC , Dulles, Virginia
| | - Terrence R Oakes
- 1 National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center , Bethesda, Maryland
| | - Louis M French
- 1 National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center , Bethesda, Maryland.,4 Center of Neuroscience and Regenerative Medicine (CNRM) , Bethesda, Maryland
| | - Sreenivasan R Nadar
- 1 National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center , Bethesda, Maryland.,5 Henry M. Jackson Foundation , Bethesda, Maryland
| | - Elyssa B Sham
- 1 National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center , Bethesda, Maryland.,2 North Tide LLC , Dulles, Virginia
| | - Wei Liu
- 1 National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center , Bethesda, Maryland.,2 North Tide LLC , Dulles, Virginia
| | - Gerard Riedy
- 1 National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center , Bethesda, Maryland.,3 Uniformed Services University of the Health Sciences , Bethesda, Maryland
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33
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The Risk of Sleep Disorder Among Persons with Mild Traumatic Brain Injury. Curr Neurol Neurosci Rep 2016; 16:55. [DOI: 10.1007/s11910-016-0657-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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34
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Girgis F, Pace J, Sweet J, Miller JP. Hippocampal Neurophysiologic Changes after Mild Traumatic Brain Injury and Potential Neuromodulation Treatment Approaches. Front Syst Neurosci 2016; 10:8. [PMID: 26903824 PMCID: PMC4746250 DOI: 10.3389/fnsys.2016.00008] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 01/25/2016] [Indexed: 12/22/2022] Open
Abstract
Traumatic brain injury (TBI) is the leading cause of death and disability in individuals below age 45, and five million Americans live with chronic disability as a result. Mild TBI (mTBI), defined as TBI in the absence of major imaging or histopathological defects, is responsible for a majority of cases. Despite the lack of overt morphological defects, victims of mTBI frequently suffer lasting cognitive deficits, memory difficulties, and behavioral disturbances. There is increasing evidence that cognitive and memory dysfunction is related to subtle physiological changes that occur in the hippocampus, and these impact both the phenotype of deficits observed and subsequent recovery. Therapeutic modulation of physiological activity by means of medications commonly used for other indications or brain stimulation may represent novel treatment approaches. This review summarizes the present body of knowledge regarding neurophysiologic changes that occur in the hippocampus after mTBI, as well as potential targets for therapeutic modulation of neurologic activity.
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Affiliation(s)
- Fady Girgis
- Department of Neurosurgery, University Hospitals Case Medical Center, Case Western Reserve University Cleveland, OH, USA
| | - Jonathan Pace
- Department of Neurosurgery, University Hospitals Case Medical Center, Case Western Reserve University Cleveland, OH, USA
| | - Jennifer Sweet
- Department of Neurosurgery, University Hospitals Case Medical Center, Case Western Reserve University Cleveland, OH, USA
| | - Jonathan P Miller
- Department of Neurosurgery, University Hospitals Case Medical Center, Case Western Reserve University Cleveland, OH, USA
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