title: Changes in Structural Connectivity Following a Cognitive Intervention in Children With Traumatic Brain Injury.
abstract: Structural connectivity analysis based on graph theory and diffusion tensor imaging tractography is a novel method that quantifies the topological characteristics in the brain network. This study aimed to examine structural connectivity changes following the Attention Intervention and Management (AIM) program designed to improve attention and executive function (EF) in children with traumatic brain injury (TBI).
  
  
  
  Seventeen children with complicated mild to severe TBI (13.66 ± 2.68 years; >12 months postinjury) completed magnetic resonance imaging (MRI) and neurobehavioral measures at time 1, 10 of whom completed AIM and assessment at time 2. Eleven matched healthy comparison (HC) children (13.37 ± 2.08 years) completed MRI and neurobehavioral assessment at both time points, but did not complete AIM. Network characteristics were analyzed to quantify the structural connectivity before and after the intervention.
  
  
  
  Mixed model analyses showed that small-worldness was significantly higher in the TBI group than the HC group at time 1, and both small-worldness and normalized clustering coefficient decreased significantly at time 2 in the TBI group whereas the HC group remained relatively unchanged. Reductions in mean local efficiency were significantly correlated with improvements in verbal inhibition and both parent- and child-reported EF. Increased normalized characteristic path length was significantly correlated with improved sustained attention.
  
  
  
  The results provide preliminary evidence suggesting that graph theoretical analysis may be a sensitive tool in pediatric TBI for detecting ( a) abnormalities of structural connectivity in brain network and ( b) structural neuroplasticity associated with neurobehavioral improvement following a short-term intervention for attention and EF.
authors: 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.|2 University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors: Weihong
authors: W
authors: Yuan
authors: 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors: Amery
authors: A
authors: Treble-Barna
authors: 3 University of Oregon, Eugene, OR, USA.
authors: McKay M
authors: MM
authors: Sohlberg
authors: 3 University of Oregon, Eugene, OR, USA.
authors: Beth
authors: B
authors: Harn
authors: 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.|2 University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors: Shari L
authors: SL
authors: Wade
mesh_terms: D000293:Adolescent; D001921:Brain / Q000000981:diagnostic imaging*; D000070642:Brain Injuries, Traumatic / Q000000981:diagnostic imaging* / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009434:Neural Pathways / Q000000981:diagnostic imaging; D009473:Neuronal Plasticity; D009483:Neuropsychological Tests; D016896:Treatment Outcome
keywords: behavioral assessment; cognitive intervention; diffusion tensor imaging; graph theoretical analysis; neuroplasticity; structural connectivity; traumatic brain injury