title: Thalamic Functional Connectivity in Mild Traumatic Brain Injury: Longitudinal Associations With Patient-Reported Outcomes and Neuropsychological Tests.
abstract: (1) To examine differences in patient-reported outcomes, neuropsychological tests, and thalamic functional connectivity (FC) between patients with mild traumatic brain injury (mTBI) and individuals without mTBI and (2) to determine longitudinal associations between changes in these measures.
  
  
  
  Prospective observational case-control study.
  
  
  
  Academic medical center.
  
  
  
  A sample (N=24) of 13 patients with mTBI (mean age, 39.3±14.0y; 4 women [31%]) and 11 age- and sex-matched controls without mTBI (mean age, 37.6±13.3y; 4 women [36%]).
  
  
  
  Not applicable.
  
  
  
  Resting state FC (3T magnetic resonance imaging scanner) was examined between the thalamus and the default mode network, dorsal attention network, and frontoparietal control network. Patient-reported outcomes included pain (Brief Pain Inventory), depressive symptoms (Patient Health Questionnaire-9), posttraumatic stress disorder ([PTSD] Checklist - Civilian Version), and postconcussive symptoms (Rivermead Post-Concussion Symptoms Questionnaire). Neuropsychological tests included the Delis-Kaplan Executive Function System Tower test, Trails B, and Hotel Task. Assessments occurred at 6 weeks and 4 months after hospitalization in patients with mTBI and at a single visit for controls.
  
  
  
  Student t tests found increased pain, depressive symptoms, PTSD symptoms, and postconcussive symptoms; decreased performance on Trails B; increased FC between the thalamus and the default mode network; and decreased FC between the thalamus and the dorsal attention network and between the thalamus and the frontoparietal control network in patients with mTBI as compared with controls. The Spearman correlation coefficient indicated that increased FC between the thalamus and the dorsal attention network from baseline to 4 months was associated with decreased pain and postconcussive symptoms (corrected P<.05).
  
  
  
  Findings suggest that alterations in thalamic FC occur after mTBI, and improvements in pain and postconcussive symptoms are correlated with normalization of thalamic FC over time.
authors.affiliation: Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Banks
authors.affiliation: Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Rogelio A
authors.initials: RA
authors.lastname: Coronado
authors.affiliation: Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Lori R
authors.initials: LR
authors.lastname: Clemons
authors.affiliation: Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN; Department of Education and Human Services, Lehigh University, Bethlehem, PA.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Abraham
authors.affiliation: Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Sumit
authors.initials: S
authors.lastname: Pruthi
authors.affiliation: Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN; Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Benjamin N
authors.initials: BN
authors.lastname: Conrad
authors.affiliation: Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN; Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Morgan
authors.affiliation: Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Oscar D
authors.initials: OD
authors.lastname: Guillamondegui
authors.affiliation: Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN; Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN. Electronic address: kristin.archer@vanderbilt.edu.
authors.forename: Kristin R
authors.initials: KR
authors.lastname: Archer
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism; D001924:Brain Concussion / Q000150:complications* / Q000503:physiopathology*; D016022:Case-Control Studies; D003863:Depression / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D000071066:Patient Reported Outcome Measures; D038223:Post-Concussion Syndrome; D011446:Prospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000503:physiopathology; D013788:Thalamus / Q000000981:diagnostic imaging / Q000378:metabolism*; D055815:Young Adult
keywords: Brain injuries; Functional neuroimaging; Magnetic resonance imaging; Neuropsychological tests; Rehabilitation; Thalamus