RT Journal Article
SR Electronic
T1 Abnormal whole-brain functional networks in homogeneous acute mild traumatic brain injury
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 175
OP 182
DO 10.1212/WNL.0b013e31825f04fb
VO 79
IS 2
A1 Shumskaya, Elena
A1 Andriessen, Teuntje M.J.C.
A1 Norris, David G.
A1 Vos, Pieter E.
YR 2012
UL http://n.neurology.org/content/79/2/175.abstract
AB Objectives: To evaluate the whole-brain resting-state networks in a homogeneous group of patients with acute mild traumatic brain injury (MTBI) and to identify alterations in functional connectivity induced by MTBI. Methods: Thirty-five patients with acute MTBI and 35 healthy control subjects, matched in age, gender, handedness, and education, underwent resting-state fMRI, susceptibility weighted imaging, neuropsychological, and postconcussive symptom assessments. We ensured the homogeneity of the patient group by limiting the injury mechanism to fronto-occipital impacts. Alterations in functional connectivity were analyzed by using data-driven independent component analysis, which is not biased by a priori region selection. Results: We found a decrease in functional connectivity within the motor-striatal network in the MTBI group. At the same time, patients showed deficits in psychomotor speed as well as in speed of information processing. We propose that although disorders in motor function after MTBI are rarely reported, injury still has an effect on motor functioning, which in its turn may also explain the reduction in speed of information processing. Further, we found a cluster of increased functional connectivity in the right frontoparietal network in the MTBI group. We suggest that this abnormal increased connectivity might reflect increased awareness to external environment and explain excessive cognitive fatigue reported by patients with MTBI. It might also underlie the physical postconcussive symptoms, such as headache and increased sensitivity to noise/light. Conclusions: We proved that whole-brain functional connectivity is altered early (within 4 weeks) after MTBI, suggesting that changes in functional networks underlie the cognitive deficits and postconcussive complaints reported by patients with MTBI. BOLD=blood oxygen level−dependent; DNC=dynamic network connectivity; FTT=Finger Tapping Test; GCS=Glasgow Coma Scale; GOSE=Glasgow Outcome Scale Extended; ICA=independent component analysis; LOC=loss of consciousness; MTBI=mild traumatic brain injury; PCS=postconcussion syndrome; PTA=posttraumatic amnesia; rs-fMRI=resting state fMRI; RSN=resting-state network; SWI=susceptibility weighted imaging; TBI=traumatic brain injury; TE=echo time; TFCE=threshold-free cluster enhancement; TOMM=Test of Memory Malingering; TR=repetition time.