1
|
Dogra S, Arabshahi S, Wei J, Saidenberg L, Kang SK, Chung S, Laine A, Lui YW. Functional Connectivity Changes on Resting-State fMRI after Mild Traumatic Brain Injury: A Systematic Review. AJNR Am J Neuroradiol 2024; 45:795-801. [PMID: 38637022 PMCID: PMC11288594 DOI: 10.3174/ajnr.a8204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/22/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Mild traumatic brain injury is theorized to cause widespread functional changes to the brain. Resting-state fMRI may be able to measure functional connectivity changes after traumatic brain injury, but resting-state fMRI studies are heterogeneous, using numerous techniques to study ROIs across various resting-state networks. PURPOSE We systematically reviewed the literature to ascertain whether adult patients who have experienced mild traumatic brain injury show consistent functional connectivity changes on resting-state -fMRI, compared with healthy patients. DATA SOURCES We used 5 databases (PubMed, EMBASE, Cochrane Central, Scopus, Web of Science). STUDY SELECTION Five databases (PubMed, EMBASE, Cochrane Central, Scopus, and Web of Science) were searched for research published since 2010. Search strategies used keywords of "functional MR imaging" and "mild traumatic brain injury" as well as related terms. All results were screened at the abstract and title levels by 4 reviewers according to predefined inclusion and exclusion criteria. For full-text inclusion, each study was evaluated independently by 2 reviewers, with discordant screening settled by consensus. DATA ANALYSIS Data regarding article characteristics, cohort demographics, fMRI scan parameters, data analysis processing software, atlas used, data characteristics, and statistical analysis information were extracted. DATA SYNTHESIS Across 66 studies, 80 areas were analyzed 239 times for at least 1 time point, most commonly using independent component analysis. The most analyzed areas and networks were the whole brain, the default mode network, and the salience network. Reported functional connectivity changes varied, though there may be a slight trend toward decreased whole-brain functional connectivity within 1 month of traumatic brain injury and there may be differences based on the time since injury. LIMITATIONS Studies of military, sports-related traumatic brain injury, and pediatric patients were excluded. Due to the high number of relevant studies and data heterogeneity, we could not be as granular in the analysis as we would have liked. CONCLUSIONS Reported functional connectivity changes varied, even within the same region and network, at least partially reflecting differences in technical parameters, preprocessing software, and analysis methods as well as probable differences in individual injury. There is a need for novel rs-fMRI techniques that better capture subject-specific functional connectivity changes.
Collapse
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
| |
Collapse
|
2
|
Danielli E, Simard N, DeMatteo CA, Kumbhare D, Ulmer S, Noseworthy MD. A review of brain regions and associated post-concussion symptoms. Front Neurol 2023; 14:1136367. [PMID: 37602240 PMCID: PMC10435092 DOI: 10.3389/fneur.2023.1136367] [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: 01/03/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023] Open
Abstract
The human brain is an exceptionally complex organ that is comprised of billions of neurons. Therefore, when a traumatic event such as a concussion occurs, somatic, cognitive, behavioral, and sleep impairments are the common outcome. Each concussion is unique in the sense that the magnitude of biomechanical forces and the direction, rotation, and source of those forces are different for each concussive event. This helps to explain the unpredictable nature of post-concussion symptoms that can arise and resolve. The purpose of this narrative review is to connect the anatomical location, healthy function, and associated post-concussion symptoms of some major cerebral gray and white matter brain regions and the cerebellum. As a non-exhaustive description of post-concussion symptoms nor comprehensive inclusion of all brain regions, we have aimed to amalgamate the research performed for specific brain regions into a single article to clarify and enhance clinical and research concussion assessment. The current status of concussion diagnosis is highly subjective and primarily based on self-report of symptoms, so this review may be able to provide a connection between brain anatomy and the clinical presentation of concussions to enhance medical imaging assessments. By explaining anatomical relevance in terms of clinical concussion symptom presentation, an increased understanding of concussions may also be achieved to improve concussion recognition and diagnosis.
Collapse
Affiliation(s)
- Ethan Danielli
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Nicholas Simard
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, ON, Canada
| | - Carol A. DeMatteo
- ARiEAL Research Centre, McMaster University, Hamilton, ON, Canada
- Department of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Dinesh Kumbhare
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Stephan Ulmer
- Neurorad.ch, Zurich, Switzerland
- Department of Radiology and Neuroradiology, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Michael D. Noseworthy
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, ON, Canada
- ARiEAL Research Centre, McMaster University, Hamilton, ON, Canada
- Department of Radiology, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
3
|
Ryan D, Mirbagheri S, Yahyavi-Firouz-Abadi N. The Current State of Functional MR Imaging for Trauma Prognostication. Neuroimaging Clin N Am 2023; 33:299-313. [PMID: 36965947 DOI: 10.1016/j.nic.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
In this review, we discuss the basics of functional MRI (fMRI) techniques including task-based and resting state fMRI, and overview the major findings in patients with traumatic brain injury. We summarize the studies that have longitudinally evaluated the changes in brain connectivity and task-related activation in trauma patients during different phases of trauma. We discuss how these data may potentially be used for prognostication, treatment planning, or monitoring and management of trauma patients.
Collapse
Affiliation(s)
- Daniel Ryan
- Southern Illinois University School of Medicine, 401 East Carpenter Street, Springfield, IL, USA
| | - Saeedeh Mirbagheri
- University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT 05401, USA
| | | |
Collapse
|
4
|
Lempke LB, Hoch MC, Call JA, Schmidt JD, Lynall RC. Lower Extremity Somatosensory Function Throughout Concussion Recovery: A Prospective Cohort Study. J Head Trauma Rehabil 2023; 38:E156-E166. [PMID: 35687895 DOI: 10.1097/htr.0000000000000805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Balance impairments may suggest somatosensory disruption beyond concussion clinical recovery, but somatosensory subsystems have never been directly assessed. Our objective was to examine somatosensory function between individuals with a concussion and healthy matched-controls at acute (<7 days) and asymptomatic (<72 hours of being symptom-free) time points. SETTING Laboratory. PARTICIPANTS Participants with a concussion and matched controls ( n = 24; 58% male, age: 19.3 ± 1.1 years, mass: 70.3 ± 16.4 kg, height: 177.3 ± 12.7 cm). DESIGN Prospective cohort. MAIN MEASURES Somatosensory assessments on the dominant limb at both time points included: (1) plantar touch sensation threshold via Semmes-Weinstein monofilaments, (2) plantar pressure pain threshold via algometry, and (3) knee absolute passive joint repositioning (PJR) error via Biodex across 3 arcs (105°-75°, 30°-60°, 90°-45° knee-flexion). We used mixed-model analyses of variance, post hoc Tukey honestly significant difference t tests with mean difference, 95% CI, and Hedges' g effect sizes to examine outcomes. RESULTS Touch sensation had a group effect with the concussion cohort needing 0.95 grams of force (gf) more relative to controls (95% CI: 0.03 to 1.87; P = .043). No touch sensation interaction was present, but medium and large effects were observed for greater gf needed among the concussed cohort at the acute (1.11 gf; 95% CI: 0.17 to 2.05; g = 0.96) and asymptomatic time points (0.79 gf; 95% CI: -0.15 to 1.73; g = 0.73). No plantar pressure pain threshold effects were observed ( P ≥ .311), with negligible pressure difference magnitudes at the acute (0.26 pound force [lbf]/cm 2 ; 95% CI: -1.54 to 2.06; g = 0.13) and medium magnitudes at the asymptomatic time points (0.99 lbf/cm 2 ; 95% CI: -0.81 to 2.80; g = 0.42) for the concussed cohort needing more pressure to detect pain. The 30° to 60° PJR had a time effect, with asymptomatic time point having 3.12° better accuracy (95% CI: 1.23° to 5.02; P = .002). The concussed cohort had small-to-medium magnitude differences relative to controls at the acute time point for PJR during 105° to 75° (0.89°; g = 0.30) and 90° to 45° (0.62°; g = 0.17), but not 30° to 60° (-1.75°; g = -0.40). CONCLUSIONS Individuals with a concussion exhibited large effects for diminished plantar touch sensation and small to medium effects for inhibited plantar pressure pain sensation compared with controls, which may indicate altered somatosensory function. Negligible PJR differences suggest knee joint position sense is not altered post-concussion. Pre- and postconcussion examination is warranted to understand causal somatosensory mechanisms.
Collapse
Affiliation(s)
- Landon B Lempke
- UGA Concussion Research Laboratory, University of Georgia, Athens (Drs Lempke, Schmidt, and Lynall); Department of Kinesiology, University of Georgia, Athens (Drs Lempke, Call, Schmidt, and Lynall); Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, and Micheli Center for Sports Injury Prevention, Waltham, Massachusetts (Dr Lempke); Sports Medicine Research Institute, University of Kentucky, Lexington (Dr Hoch); and Skeletal Muscle Dysfunction Laboratory, University of Georgia, Athens (Dr Call)
| | | | | | | | | |
Collapse
|
5
|
Raizman R, Itzhaki N, Sirkin J, Meningher I, Tsarfaty G, Keren O, Zibli Z, Silberg T, Pick CG, Livny A. Decreased homotopic functional connectivity in traumatic brain injury. Cereb Cortex 2023; 33:1207-1216. [PMID: 35353131 DOI: 10.1093/cercor/bhac130] [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: 12/29/2021] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Homotopic functional connectivity (HoFC), the synchrony in activity patterns between homologous brain regions, is a fundamental characteristic of resting-state functional connectivity (RsFC). METHODS We examined the difference in HoFC, computed as the correlation between atlas-based regions and their counterpart on the opposite hemisphere, in 16 moderate-severe traumatic brain injury patients (msTBI) and 36 healthy controls. Regions of decreased HoFC in msTBI patients were further used as seeds for examining differences between groups in correlations with other brain regions. Finally, we computed logistic regression models of regional HoFC and fractional anisotropy (FA) of the corpus callosum (CC). RESULTS TBI patients exhibited decreased HoFC in the middle and posterior cingulate cortex, thalamus, superior temporal pole, and cerebellum III. Furthermore, decreased RsFC was found between left cerebellum III and right parahippocampal cortex and vermis, between superior temporal pole and left caudate and medial left and right frontal orbital gyri. Thalamic HoFC and FA of the CC discriminate patients as msTBI with a high accuracy of 96%. CONCLUSION TBI is associated with regionally decreased HoFC. Moreover, a multimodality model of interhemispheric connectivity allowed for a high degree of accuracy in disease discrimination and enabled a deeper understanding of TBI effects on brain interhemispheric reorganization post-TBI.
Collapse
Affiliation(s)
- Reut Raizman
- Division of Diagnostic Imaging, Sheba Medical Center, 5262000 Tel-Hashomer, Israel.,Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, 69979 Tel-Aviv, Israel
| | - Nofar Itzhaki
- Division of Diagnostic Imaging, Sheba Medical Center, 5262000 Tel-Hashomer, Israel
| | - Johanna Sirkin
- Department of Psychology, Reichman University, Herzelia, Israel
| | - Inbar Meningher
- Division of Diagnostic Imaging, Sheba Medical Center, 5262000 Tel-Hashomer, Israel
| | - Galia Tsarfaty
- Division of Diagnostic Imaging, Sheba Medical Center, 5262000 Tel-Hashomer, Israel.,Department of imaging, Sackler Faculty of Medicine, Tel-Aviv University, 69979 Tel-Aviv, Israel
| | - Ofer Keren
- Department of Brain Injury Rehabilitation, Sheba Medical Center, 5262000 Tel-Hashomer, Israel
| | - Zion Zibli
- Department of Neurosurgery, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, 69979 Ramat Gan, Israel
| | - Tamar Silberg
- Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.,Department of Psychology, Bar Ilan University, 5290002 Ramat Gan, Israel
| | - Chaim G Pick
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, 69979 Tel-Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, 69979 Tel Aviv, Israel.,The Dr. Miriam and Sheldon G. Adelson, Chair and Center for the Biology of Addictive Diseases, Tel-Aviv University, 69979 Tel-Aviv, Israel.,Sylvan Adams Sports Institute, Tel Aviv University, 69979 Tel Aviv, Israel
| | - Abigail Livny
- Division of Diagnostic Imaging, Sheba Medical Center, 5262000 Tel-Hashomer, Israel.,Department of imaging, Sackler Faculty of Medicine, Tel-Aviv University, 69979 Tel-Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, 69979 Tel Aviv, Israel
| |
Collapse
|
6
|
Tajima T, Ota O, Nagayama M, Takahashi M, Yamada M, Ishiyama N, Yoshida I, Takemura M, Hara K, Akama T, Mitsumori N, Higashihara J, Toyama Y, Furuya M, Chosa E, Nakamura A. Head Injury Assessment in the Elite Level Rugby Union in Japan: Review of 3 Seasons. Int J Sports Med 2022; 43:889-894. [PMID: 35672000 DOI: 10.1055/a-1810-6509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Head Injury Assessment (HIA) is the screening tool for head injury during a rugby game. The purpose of this study was to investigate the epidemiology of HIA in the Japan Rugby Top League (JRTL). The incidences of HIA, defined concussion (per 1,000 player-hours) and repeated concussions were evaluated in three seasons (2016-17, 2017-18, 2018-19; total 360 games). The HIA incidence rates were 12.7 (95% confidence interval 9.5-15.9), 20.8 (16.8-24.9), and 25.0 (20.5-29.5) in each season. HIA-1 criteria 2, which is applied for suspected concussion cases, was performed for 46 cases in the 2016-17 season, 81 cases in the 2017-18 season, and 88 cases in the 2018-19 season. The concussion incidence rates were significantly greater in the 2017-18 season (9.6/1000 player-hours, 95% confidence interval 6.8-12.4) and the 2018-19 season (14.4, 11-17.8) compared to the 2016-17 season (4.8, 2.8-6.8). The number of repeated concussion cases in the same season was 1 in the 2016-17 season and 4 in both the 2017-18 and 2018-19 seasons. This study confirmed significantly higher HIA and concussion incidence rates over time. Although the HIA system might have been established in the three seasons in JRTL, comprehensive management needs to be improved to prevent repeated concussions.
Collapse
Affiliation(s)
- Takuya Tajima
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.,Medical control committee, Japan Rugby Top League, Tokyo, Japan
| | - Osamu Ota
- Japan Rugby Top League, Japan Rugby Football Union, Tokyo, Japan
| | - Masataka Nagayama
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Medical control committee, Japan Rugby Top League, Tokyo, Japan
| | - Masayasu Takahashi
- Department of Orthopaedic Surgery, Konan Medical center, Kobe, Japan.,Medical control committee, Japan Rugby Top League, Tokyo, Japan
| | - Mutsuo Yamada
- Injury prevention & Research unit, Japan Rugby Football Union, Tokyo, Japan.,Faculty of Health and Sports Sciences, Ryutsu Keizai University, Ryugasaki, Japan
| | - Nobuo Ishiyama
- Faculty of Medical Science, Nippon Sport Science University, Setagaya-ku, Japan.,Medical control committee, Japan Rugby Top League, Tokyo, Japan
| | - Ichiro Yoshida
- Medical control committee, Japan Rugby Top League, Tokyo, Japan
| | - Masahiro Takemura
- Faculty of Health and Sports Sciences, University of Tsukuba, Tsukuba, Japan.,Medical control committee, Japan Rugby Top League, Tokyo, Japan
| | - Kenji Hara
- Department of Sports Medicine and Science, Faculty of Human Health, Kurume University, Kurume, Japan.,Medical control committee, Japan Rugby Top League, Tokyo, Japan
| | - Takao Akama
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan.,Medical control committee, Japan Rugby Top League, Tokyo, Japan
| | - Norio Mitsumori
- Department of Surgery, Jikei University School of Medicine, Minato-ku, Japan.,Medical control committee, Japan Rugby Top League, Tokyo, Japan
| | - Junichiro Higashihara
- Gynecology, Higashihara clinic, Fukuoka, Japan.,Medical control committee, Japan Rugby Top League, Tokyo, Japan
| | - Yukimasa Toyama
- Orthopaedic surgery, Toyama Orthopaedic clinic, Osaka, Japan.,Medical control committee, Japan Rugby Top League, Tokyo, Japan
| | - Masahiro Furuya
- Orthopaedic Surgery, Furuya Orhopaedic clinic, Yokohama, Japan.,Medical control committee, Japan Rugby Top League, Tokyo, Japan
| | - Etsuo Chosa
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Akihiko Nakamura
- Department of Surgery, Nakamura Surgery and Pediatrics clinic, Tokyo, Japan.,Medical control committee, Japan Rugby Top League, Tokyo, Japan
| |
Collapse
|
7
|
Gumus M, Mack ML, Green R, Khodadadi M, Wennberg R, Crawley A, Colella B, Tarazi A, Mikulis DJ, Tator CH, Tartaglia MC. Brain Connectivity Changes in Post-Concussion Syndrome as the Neural Substrate of a Heterogeneous Syndrome. Brain Connect 2022; 12:711-724. [PMID: 35018791 DOI: 10.1089/brain.2021.0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Post-concussion syndrome (PCS) or persistent symptoms of concussion refers to a constellation of symptoms that persist for weeks and months after a concussion. To better capture the heterogeneity of the symptoms of patients with post-concussion syndrome, we aimed to separate patients into clinical subtypes based on brain connectivity changes. METHODS Subject-specific structural and functional connectomes were created based on Diffusion Weighted and Resting State Functional Magnetic Resonance Imaging, respectively. Following an informed dimensionality reduction, a gaussian mixture model was used on patient specific structural and functional connectivity matrices to find potential patient clusters. For validation, the resulting patient subtypes were compared in terms of cognitive, neuropsychiatric, and post-concussive symptom differences. RESULTS Multimodal analyses of brain connectivity were predictive of behavioural outcomes. Our modelling revealed 2 patient subtypes; mild and severe. The severe group showed significantly higher levels of depression, anxiety, aggression, and a greater number of symptoms than the mild patient subgroup. CONCLUSION This study suggests that structural and functional connectivity changes together can help us better understand the symptom severity and neuropsychiatric profiles of patients with post-concussion syndrome. This work allows us to move towards precision medicine in concussions and provides a novel machine learning approach that can be applicable to other heterogeneous conditions.
Collapse
Affiliation(s)
- Melisa Gumus
- University of Toronto, 7938, 60 Leonard Avenue, Krembil Discovery Tower, Toronto, Toronto, Ontario, Canada, M5S 1A1;
| | | | - Robin Green
- University of Toronto, 7938, Toronto, Ontario, Canada;
| | | | | | | | - Brenda Colella
- University Health Network, 7989, Toronto, Ontario, Canada;
| | - Apameh Tarazi
- University Health Network, 7989, Toronto, Ontario, Canada;
| | - David J Mikulis
- Toronto Western Hospital, 26625, Joint Department of Medical Imaging, 399 Bathurst St., Toronto, Ontario, Canada, m5t2s8;
| | | | | |
Collapse
|
8
|
Wang L, Schwedt TJ, Chong CD, Wu T, Li J. Discriminant Subgraph Learning from Functional Brain Sensory Data. IISE TRANSACTIONS 2021; 54:1084-1097. [PMID: 37860108 PMCID: PMC10586061 DOI: 10.1080/24725854.2021.1987592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 07/21/2021] [Accepted: 09/03/2021] [Indexed: 10/21/2023]
Abstract
The human brain is a complex system with many functional units interacting with each other. This interacting relationship, known as the functional connectivity network (FCN), is critical for brain functions. To learn the FCN, machine learning algorithms can be built based on brain signals captured by sensing technologies such as EEG and fMRI. In neurological diseases, past research has revealed that the FCN is altered. Also, focusing on a specific disease, some part of the FCN, i.e., a sub-network, can be more susceptible than other parts. However, the current knowledge about disease-specific sub-networks is limited. We propose a novel Discriminant Subgraph Learner (DSL) to identify a functional sub-network that best differentiates patients with a specific disease from healthy controls based on brain sensory data. We develop an integrated optimization framework for DSL to simultaneously learn the FCN of each class and identify the discriminant sub-network. Further, we develop tractable and converging algorithms to solve the optimization. We apply DSL to identify a functional sub-network that best differentiates patients with episodic migraine (EM) from healthy controls based on a fMRI dataset. DSL achieved the best accuracy compared to five state-of-the-art competing algorithms.
Collapse
Affiliation(s)
- Lujia Wang
- School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA
| | - Todd J Schwedt
- Department of Neurology, Mayo Clinic Arizona, Scottsdale, AZ
| | | | - Teresa Wu
- Industrial Engineering, Arizona State University, Tempe, AZ
| | - Jing Li
- School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA
| |
Collapse
|
9
|
Gumus M, Santos A, Tartaglia MC. Diffusion and functional MRI findings and their relationship to behaviour in postconcussion syndrome: a scoping review. J Neurol Neurosurg Psychiatry 2021; 92:1259-1270. [PMID: 34635568 DOI: 10.1136/jnnp-2021-326604] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/22/2021] [Indexed: 11/04/2022]
Abstract
Postconcussion syndrome (PCS) is a term attributed to the constellation of symptoms that fail to recover after a concussion. PCS is associated with a variety of symptoms such as headaches, concentration deficits, fatigue, depression and anxiety that have an enormous impact on patients' lives. There is currently no diagnostic biomarker for PCS. There have been attempts at identifying structural and functional brain changes in patients with PCS, using diffusion tensor imaging (DTI) and functional MRI (fMRI), respectively, and relate them to specific PCS symptoms. In this scoping review, we appraised, synthesised and summarised all empirical studies that (1) investigated structural or functional brain changes in PCS using DTI or fMRI, respectively, and (2) assessed behavioural alterations in patients with PCS. We performed a literature search in MEDLINE (Ovid), Embase (Ovid) and PsycINFO (Ovid) for primary research articles published up to February 2020. We identified 8306 articles and included 45 articles that investigated the relationship between DTI and fMRI parameters and behavioural changes in patients with PCS: 20 diffusion, 20 fMRI studies and 5 papers with both modalities. Most frequently studied structures were the corpus callosum, superior longitudinal fasciculus in diffusion and the dorsolateral prefrontal cortex and default mode network in the fMRI literature. Although some white matter and fMRI changes were correlated with cognitive or neuropsychiatric symptoms, there were no consistent, converging findings on the relationship between neuroimaging abnormalities and behavioural changes which could be largely due to the complex and heterogeneous presentation of PCS. Furthermore, the heterogeneity of symptoms in PCS may preclude discovery of one biomarker for all patients. Further research should take advantage of multimodal neuroimaging to better understand the brain-behaviour relationship, with a focus on individual differences rather than on group comparisons.
Collapse
Affiliation(s)
- Melisa Gumus
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Alexandra Santos
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Maria Carmela Tartaglia
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada .,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada.,Canadian Concussion Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Thompson XD, Erdman NK, Walton SR, Broshek DK, Resch JE. Reevaluating clinical assessment outcomes after unrestricted return to play following sport-related concussion. Brain Inj 2021; 35:1577-1584. [PMID: 34543089 DOI: 10.1080/02699052.2021.1975818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PRIMARY OBJECTIVE The objective of this study was to examine neurocognition, postural control, and symptomology at multiple timepoints following concussion. We hypothesized that collegiate athletes would perform similar to or better than their baseline in terms of each outcome at both timepoints. RESEARCH DESIGN This was a retrospective study of 71 collegiate athletes (18.3 ± 0.89 years old; 182.2 ± 10.05 cm; 84.2 ± 20.07 kg) to observe changes in outcomes from a previously established clinical protocol. METHODS AND PROCEDURES Participants were administered ImPACT™, the Sensory Organization Test (SOT), and the revised head injury scale (HIS-r) prior to their seasons (baseline); upon reporting symptom-free following concussion (post-injury); and approximately 8-months after return-to-play to establish a new baseline. MAIN OUTCOMES AND RESULTS There were no changes in ImPACT scores or HIS-r reporting over time. ImPACT total symptom score (TSS) decreased over time (p = .002, ηp2 = 0.08). Significant main effects occurred for the SOT equilibrium score (p < .01, ηp2 = 0.34) and Vestibular sensory ratio (p < .001, ηp2 = 0.22). CONCLUSIONS Our data suggest no decline in neurocognition, balance, or symptom burden approximately eight months post-injury. As clinicians continue to explore "best practices" for concussion management and potential long-term implications of these injuries it is important to monitor outcome measures longitudinally.
Collapse
Affiliation(s)
- Xavier D Thompson
- UVA Department of Kinesiology, The University of Virginia, Charlottesville, Virginia, USA
| | - Nicholas K Erdman
- Postdoctoral Research Fellow, George Mason University Sports Medicine, Research and Testing Lab, Fairfax, Virginia, USA
| | - Samuel R Walton
- Postdoctoral Research Associate, UNC Center for the Study of Retired Athletes & Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Chapel Hill, North Carolina, USA
| | - Donna K Broshek
- UVA Department of Psychiatry and Neurobehavioral Sciences, UVA Health, Charlottesville, Virginia, USA
| | - Jacob E Resch
- UVA Department of Kinesiology, The University of Virginia, Charlottesville, Virginia, USA
| |
Collapse
|