title: Altered functional connectivity in children with mild to moderate TBI relates to motor control.
abstract: OBJECTIVE
  Functionally relevant alterations in resting state fMRI (rs-fMRI) connectivity have been identified in adults with traumatic brain injury (TBI). We evaluated rs-fMRI connectivity in children with TBI and explored the relationship between altered connectivity and measures of neurological function.
  
  
  METHODS
  Rs-fMRI was obtained in 14 children after TBI and 14 controls matched for age, sex, and handedness. Whole-brain connectivity was evaluated separately for the default mode network (DMN) and dorsal attention network (DAN); Between-group contrasts identified regions with altered connectivity between TBI and control cohorts. In children with TBI, the relationships between regions of altered connectivity and performance on relevant functional measures were examined.
  
  
  RESULTS
  Compared to controls, children with TBI showed significantly greater connectivity between DMN and right dorsal premotor cortex (RdPM) and between DAN and bilateral sensorimotor cortex (SM1). In children with TBI, greater DMN-RdPM connectivity was associated with worse motor performance whereas greater DAN-LSM1 connectivity was associated with better motor performance; furthermore, DMN-RdPM and DAN-LSM1 connectivity were negatively correlated.
  
  
  CONCLUSIONS
  Rs-fMRI reveals significant altered connectivity in children with TBI compared to controls. After TBI in children, patterns of altered connectivity appear divergent, with increased DMN-motor network connectivity associated with worse motor control whereas increased DAN-motor network connectivity appears compensatory.
authors.affiliation: Kennedy Krieger Institute, Baltimore, MD, USA.|Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.|Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Risen
authors.affiliation: Kennedy Krieger Institute, Baltimore, MD, USA.|Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: A D
authors.initials: AD
authors.lastname: Barber
authors.affiliation: Kennedy Krieger Institute, Baltimore, MD, USA.|Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.|Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: S H
authors.initials: SH
authors.lastname: Mostofsky
authors.affiliation: Kennedy Krieger Institute, Baltimore, MD, USA.|Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.|Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Suskauer
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000503:physiopathology*; D002648:Child; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008279:Magnetic Resonance Imaging; D008297:Male; D009415:Nerve Net / Q000503:physiopathology
keywords: TBI; fMRI; pediatric; resting-state networks