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Multimodal imaging of mild traumatic brain injury and persistent postconcussion syndrome

Dean, PJA, Sato, JR, Vieira, G, McNamara, A and Sterr, A (2014) Multimodal imaging of mild traumatic brain injury and persistent postconcussion syndrome Brain and Behavior.

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Abstract

Background: Persistent postconcussion syndrome (PCS) occurs in around 5– 10% of individuals after mild traumatic brain injury (mTBI), but research into the underlying biology of these ongoing symptoms is limited and inconsistent. One reason for this could be the heterogeneity inherent to mTBI, with individualized injury mechanisms and psychological factors. A multimodal imaging study may be able to characterize the injury better. Aim: To look at the relationship between functional (fMRI), structural (diffusion tensor imaging), and metabolic (magnetic resonance spectroscopy) data in the same participants in the long term (>1 year) after injury. It was hypothesized that only those mTBI participants with persistent PCS would show functional changes, and that these changes would be related to reduced structural integrity and altered metabolite concentrations. Methods: Functional changes associated with persistent PCS after mTBI (>1 year postinjury) were investigated in participants with and without PCS (both n = 8) and non-head injured participants (n = 9) during performance of working memory and attention/processing speed tasks. Correlation analyses were performed to look at the relationship between the functional data and structural and metabolic alterations in the same participants. Results: There were no behavioral differences between the groups, but participants with greater PCS symptoms exhibited greater activation in attention-related areas (anterior cingulate), along with reduced activation in temporal, default mode network, and working memory areas (left prefrontal) as cognitive load was increased from the easiest to the most difficult task. Functional changes in these areas correlated with reduced structural integrity in corpus callosum and anterior white matter, and reduced creatine concentration in right dorsolateral prefrontal cortex. Conclusion: These data suggest that the top-down attentional regulation and deactivation of task-irrelevant areas may be compensating for the reduction in working memory capacity and variation in white matter transmission caused by the structural and metabolic changes after injury. This may in turn be contributing to secondary PCS symptoms such as fatigue and headache. Further research is required using multimodal data to investigate the mechanisms of injury after mTBI, but also to aid individualized diagnosis and prognosis.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Psychology
Authors :
AuthorsEmailORCID
Dean, PJAUNSPECIFIEDUNSPECIFIED
Sato, JRUNSPECIFIEDUNSPECIFIED
Vieira, GUNSPECIFIEDUNSPECIFIED
McNamara, AUNSPECIFIEDUNSPECIFIED
Sterr, AUNSPECIFIEDUNSPECIFIED
Date : 2 December 2014
Identification Number : 10.1002/brb3.292
Uncontrolled Keywords : Cognitive tasks, mild traumatic brain injury, neuroimaging
Additional Information : Copyright 2014 The Authors. Brain and Behavior, published by Wiley Periodicals, Inc. This is an open access article under the terms of the Creative Commons Attribution License, which permits use,distribution and reproduction in any medium, provided the original work is properly cited.
Depositing User : Symplectic Elements
Date Deposited : 10 Dec 2014 16:14
Last Modified : 06 Jul 2016 10:52
URI: http://epubs.surrey.ac.uk/id/eprint/806870

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