Alteration of brain functional network at rest and in response to YMCA physical stress test in concussed athletes: RsFMRI study.
There is still controversy in the literature whether a single episode of mild traumatic brain injury (mTBI) results in short- and/or long-term functional and structural deficits in the concussed brain. With the inability of traditional brain imaging techniques to properly assess the severity of brain damage induced by a concussive blow, there is hope that more advanced applications such as resting state functional magnetic resonance imaging (rsFMRI) will be more specific in accurately diagnosing mTBI. In this rsFMRI study, we examined 17 subjects 10±2 days post-sports-related mTBI and 17 age-matched normal volunteers (NVs) to investigate the possibility that the integrity of the resting state brain network is disrupted following a single concussive blow. We hypothesized that advanced brain imaging techniques may reveal subtle alterations of functional brain connections in asymptomatic mTBI subjects. There are several findings of interest. All mTBI subjects were asymptomatic based upon clinical evaluation and neuropsychological (NP) assessments prior to the MRI session. The mTBI subjects revealed a disrupted functional network both at rest and in response to the YMCA physical stress test. Specifically, interhemispheric connectivity was significantly reduced in the primary visual cortex, hippocampal and dorsolateral prefrontal cortex networks (p<0.05). The YMCA physical stress induced nonspecific and similar changes in brain network connectivity patterns in both the mTBI and NV groups. These major findings are discussed in relation to underlying mechanisms, clinical assessment of mTBI, and current debate regarding functional brain connectivity in a clinical population. Overall, our major findings clearly indicate that functional brain alterations in the acute phase of injury are overlooked when conventional clinical and neuropsychological examinations are used.
Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA. sms18@psu.edu
S M
SM
Slobounov
M
M
Gay
K
K
Zhang
B
B
Johnson
D
D
Pennell
W
W
Sebastianelli
S
S
Horovitz
M
M
Hallett
D000222:Adaptation, Physiological; D000328:Adult; D001265:Athletic Injuries / Q000150:complications / Q000503:physiopathology*; D001921:Brain / Q000503:physiopathology*; D001924:Brain Concussion / Q000503:physiopathology*; D001931:Brain Mapping; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D009415:Nerve Net / Q000503:physiopathology*; D009473:Neuronal Plasticity; D012146:Rest
Neuroimage. 2001 Nov;14(5):1004-12
11697932
AJNR Am J Neuroradiol. 2004 May;25(5):738-45
15140712
PLoS One. 2009 Dec 14;4(12):e8220
20011533
Clin J Sport Med. 2009 May;19(3):185-200
19423971
Biol Psychiatry. 1992 Oct 1;32(7):595-606
1450286
Arch Neurol. 2011 Jan;68(1):74-84
21220676
Clin Neurophysiol. 2007 Nov;118(11):2317-31
17900977
Magn Reson Med. 1995 Oct;34(4):537-41
8524021
J Neurol Neurosurg Psychiatry. 2003 Mar;74(3):326-32
12588917
AJNR Am J Neuroradiol. 2008 Mar;29(3):514-9
18039754
NeuroRehabilitation. 2007;22(3):217-27
17917172
Clin Neurophysiol. 2011 Jul;122(7):1314-21
21216191
Neurology. 2008 Mar 18;70(12):948-55
18347317
J Neurosurg. 1977 Oct;47(4):525-31
903805
BMC Med Imaging. 2009 Jun 17;9:11
19534772
Semin Neurol. 1990 Sep;10(3):287-94
2259807
Neuroimage. 2007 Aug 1;37(1):90-101
17560126
Exp Brain Res. 2010 Jul;204(1):57-70
20496060
J Neurosurg. 2005 Aug;103(2):298-303
16175860
AJNR Am J Neuroradiol. 2002 May;23(5):794-802
12006280
Front Syst Neurosci. 2010 Jun 17;4:22
20592949
Electroencephalogr Clin Neurophysiol. 1998 Mar;106(3):220-8
9743280
Proc Natl Acad Sci U S A. 2009 Aug 4;106(31):13040-5
19620724
Clin Nucl Med. 1998 May;23(5):309-17
9596157
Alzheimers Dement. 2008 Jul;4(4):265-70
18631977
Nat Rev Neurosci. 2001 Apr;2(4):229-39
11283746
J Neurosurg. 2003 Feb;98(2):296-301
12593614
IEEE Trans Neural Syst Rehabil Eng. 2010 Feb;18(1):11-9
20064767
Front Syst Neurosci. 2010 Apr 06;4:8
20407579
Front Syst Neurosci. 2010 Jun 17;4:19
20592951
J Neurotrauma. 2006 Oct;23(10):1450-67
17020482
Front Syst Neurosci. 2010 Jun 28;4:27
20661461
Exp Brain Res. 2010 Apr;202(2):341-54
20039023