Default-Mode Network Disruption in Mild Traumatic Brain Injury

• Published in: Radiology Vol. 265; no. 3; pp. 882 - 892
• Main Authors: Zhou, Yongxia, Milham, Michael P., Lui, Yvonne W., Miles, Laura, Reaume, Joseph, Sodickson, Daniel K., Grossman, Robert I., Ge, Yulin
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL Radiological Society of North America 01.12.2012; Radiological Society of North America, Inc
• Subjects: Adult; Adult and adolescent clinical studies; Biological and medical sciences; Brain Injuries - pathology; Brain Injuries - physiopathology; Brain Injuries - psychology; Brain Mapping - methods; Case-Control Studies; Female; Frontal Lobe - pathology; Frontal Lobe - physiopathology; Gyrus Cinguli - pathology; Gyrus Cinguli - physiopathology; Humans; Image Interpretation, Computer-Assisted; Injuries of the nervous system and the skull. Diseases due to physical agents; Investigative techniques, diagnostic techniques (general aspects); Least-Squares Analysis; Magnetic Resonance Imaging - methods; Male; Medical sciences; Neural Pathways - pathology; Neural Pathways - physiopathology; Neuropsychological Tests; Organic mental disorders. Neuropsychology; Original Research; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Traumas. Diseases due to physical agents; Human; Nervous system diseases; Pathophysiology; Radiology; Medical imagery; Neural network; Head trauma; Nuclear magnetic resonance imaging
• ISSN: 0033-8419; 1527-1315; 1527-1315
• DOI: 10.1148/radiol.12120748

To investigate the integrity of the default-mode network (DMN) by using independent component analysis (ICA) methods in patients shortly after mild traumatic brain injury (MTBI) and healthy control subjects, and to correlate DMN connectivity changes with neurocognitive tests and clinical symptoms. This study was approved by the institutional review board and complied with HIPAA regulations. Twenty-three patients with MTBI who had posttraumatic symptoms shortly after injury (<2 months) and 18 age-matched healthy control subjects were included in this study. Resting-state functional magnetic resonance imaging was performed at 3 T to characterize the DMN by using ICA methods, including a single-participant ICA on the basis of a comprehensive template from core seeds in the posterior cingulate cortex (PCC) and medial prefrontal cortex (MPFC) nodes. ICA z images of DMN components were compared between the two groups and correlated with neurocognitive tests and clinical performance in patients by using Pearson and Spearman rank correlation. When compared with the control subjects, there was significantly reduced connectivity in the PCC and parietal regions and increased frontal connectivity around the MPFC in patients with MTBI (P < .01). These frontoposterior opposing changes within the DMN were significantly correlated (r = -0.44, P = .03). The reduced posterior connectivity correlated positively with neurocognitive dysfunction (eg, cognitive flexibility), while the increased frontal connectivity correlated negatively with posttraumatic symptoms (ie, depression, anxiety, fatigue, and postconcussion syndrome). These results showed abnormal DMN connectivity patterns in patients with MTBI, which may provide insight into how neuronal communication and information integration are disrupted among DMN key structures after mild head injury.