title: Disrupted structural connectome is associated with both psychometric and real-world neuropsychological impairment in diffuse traumatic brain injury.
abstract: Traumatic brain injury (TBI) is likely to disrupt structural network properties due to diffuse white matter pathology. The present study aimed to detect alterations in structural network topology in TBI and relate them to cognitive and real-world behavioral impairment. Twenty-two people with moderate to severe TBI with mostly diffuse pathology and 18 demographically matched healthy controls were included in the final analysis. Graph theoretical network analysis was applied to diffusion tensor imaging (DTI) data to characterize structural connectivity in both groups. Neuropsychological functions were assessed by a battery of psychometric tests and the Frontal Systems Behavior Scale (FrSBe). Local connection-wise analysis demonstrated reduced structural connectivity in TBI arising from subcortical areas including thalamus, caudate, and hippocampus. Global network metrics revealed that shortest path length in participants with TBI was longer compared to controls, and that this reduced network efficiency was associated with worse performance in executive function and verbal learning. The shortest path length measure was also correlated with family-reported FrSBe scores. These findings support the notion that the diffuse form of neuropathology caused by TBI results in alterations in structural connectivity that contribute to cognitive and real-world behavioral impairment.
authors.affiliation: 1Moss Rehabilitation Research Institute,Elkins Park,Pennsylvania.
authors.forename: Junghoon
authors.initials: J
authors.lastname: Kim
authors.affiliation: 2Department of Radiology,University of Pennsylvania,Philadelphia,Pennsylvania.
authors.forename: Drew
authors.initials: D
authors.lastname: Parker
authors.affiliation: 1Moss Rehabilitation Research Institute,Elkins Park,Pennsylvania.
authors.forename: John
authors.initials: J
authors.lastname: Whyte
authors.affiliation: 1Moss Rehabilitation Research Institute,Elkins Park,Pennsylvania.
authors.forename: Tessa
authors.initials: T
authors.lastname: Hart
authors.affiliation: 2Department of Radiology,University of Pennsylvania,Philadelphia,Pennsylvania.
authors.forename: John
authors.initials: J
authors.lastname: Pluta
authors.affiliation: 2Department of Radiology,University of Pennsylvania,Philadelphia,Pennsylvania.
authors.forename: Madhura
authors.initials: M
authors.lastname: Ingalhalikar
authors.affiliation: 3Department of Neurology,University of Pennsylvania,Philadelphia,Pennsylvania.
authors.forename: H B
authors.initials: HB
authors.lastname: Coslett
authors.affiliation: 2Department of Radiology,University of Pennsylvania,Philadelphia,Pennsylvania.
authors.forename: Ragini
authors.initials: R
authors.lastname: Verma
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D001930:Brain Injuries / Q000150:complications* / Q000523:psychology*; D001931:Brain Mapping; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D056324:Diffusion Tensor Imaging; D056344:Executive Function; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D009434:Neural Pathways / Q000473:pathology*; D009483:Neuropsychological Tests; D011594:Psychometrics; D011597:Psychomotor Performance; D055815:Young Adult