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Safar K, Zhang J, Emami Z, Gharehgazlou A, Ibrahim G, Dunkley BT. Mild traumatic brain injury is associated with dysregulated neural network functioning in children and adolescents. Brain Commun 2021; 3:fcab044. [PMID: 34095832 PMCID: PMC8176148 DOI: 10.1093/braincomms/fcab044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/10/2020] [Accepted: 01/04/2021] [Indexed: 11/23/2022] Open
Abstract
Mild traumatic brain injury is highly prevalent in paediatric populations, and can result in chronic physical, cognitive and emotional impairment, known as persistent post-concussive symptoms. Magnetoencephalography has been used to investigate neurophysiological dysregulation in mild traumatic brain injury in adults; however, whether neural dysrhythmia persists in chronic mild traumatic brain injury in children and adolescents is largely unknown. We predicted that children and adolescents would show similar dysfunction as adults, including pathological slow-wave oscillations and maladaptive, frequency-specific, alterations to neural connectivity. Using magnetoencephalography, we investigated regional oscillatory power and distributed brain-wide networks in a cross-sectional sample of children and adolescents in the chronic stages of mild traumatic brain injury. Additionally, we used a machine learning pipeline to identify the most relevant magnetoencephalography features for classifying mild traumatic brain injury and to test the relative classification performance of regional power versus functional coupling. Results revealed that the majority of participants with chronic mild traumatic brain injury reported persistent post-concussive symptoms. For neurophysiological imaging, we found increased regional power in the delta band in chronic mild traumatic brain injury, predominantly in bilateral occipital cortices and in the right inferior temporal gyrus. Those with chronic mild traumatic brain injury also showed dysregulated neuronal coupling, including decreased connectivity in the delta range, as well as hyper-connectivity in the theta, low gamma and high gamma bands, primarily involving frontal, temporal and occipital brain areas. Furthermore, our multivariate classification approach combined with functional connectivity data outperformed regional power in terms of between-group classification accuracy. For the first time, we establish that local and large-scale neural activity are altered in youth in the chronic phase of mild traumatic brain injury, with the majority presenting persistent post-concussive symptoms, and that dysregulated interregional neural communication is a reliable marker of lingering paediatric ‘mild’ traumatic brain injury.
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Affiliation(s)
- Kristina Safar
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada M5G 0A4.,Neurosciences & Mental Health, SickKids Research Institute, Toronto, ON, Canada M5G 0A4
| | - Jing Zhang
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada M5G 0A4.,Neurosciences & Mental Health, SickKids Research Institute, Toronto, ON, Canada M5G 0A4
| | - Zahra Emami
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada M5G 0A4.,Neurosciences & Mental Health, SickKids Research Institute, Toronto, ON, Canada M5G 0A4
| | - Avideh Gharehgazlou
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada M5G 0A4.,Neurosciences & Mental Health, SickKids Research Institute, Toronto, ON, Canada M5G 0A4.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada M5S 1A8
| | - George Ibrahim
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada M5G 0A4.,Neurosciences & Mental Health, SickKids Research Institute, Toronto, ON, Canada M5G 0A4.,Department of Surgery, University of Toronto, Toronto, ON, Canada M5T 1P5.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, M5S 3G9 Canada
| | - Benjamin T Dunkley
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada M5G 0A4.,Neurosciences & Mental Health, SickKids Research Institute, Toronto, ON, Canada M5G 0A4.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada M5T 1W7
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