Thalamic Functional Connectivity in Mild Traumatic Brain Injury: Longitudinal Associations With Patient-Reported Outcomes and Neuropsychological Tests

Sarah D. Banks, Rogelio A. Coronado, Lori R. Clemons, Christine M. Abraham, Sumit Pruthi, Benjamin N. Conrad, Victoria L. Morgan, Oscar D. Guillamondegui, Kristin R. Archer

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives (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. Design Prospective observational case-control study. Setting Academic medical center. Participants 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%]). Interventions Not applicable. Main Outcome Measures 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. Results 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). Conclusions 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.

Original languageEnglish (US)
Pages (from-to)1254-1261
Number of pages8
JournalArchives of Physical Medicine and Rehabilitation
Volume97
Issue number8
DOIs
StatePublished - 2016
Externally publishedYes

Fingerprint

Brain Concussion
Thalamus
Wounds and Injuries
Pain
Neuropsychological Tests
Post-Traumatic Stress Disorders
Post-Concussion Syndrome
Depression
Executive Function
Checklist
Case-Control Studies
Hospitalization
Magnetic Resonance Imaging
Outcome Assessment (Health Care)
Students
Equipment and Supplies
Health

Keywords

  • Brain injuries
  • Functional neuroimaging
  • Magnetic resonance imaging
  • Neuropsychological tests
  • Rehabilitation
  • Thalamus

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

Thalamic Functional Connectivity in Mild Traumatic Brain Injury : Longitudinal Associations With Patient-Reported Outcomes and Neuropsychological Tests. / Banks, Sarah D.; Coronado, Rogelio A.; Clemons, Lori R.; Abraham, Christine M.; Pruthi, Sumit; Conrad, Benjamin N.; Morgan, Victoria L.; Guillamondegui, Oscar D.; Archer, Kristin R.

In: Archives of Physical Medicine and Rehabilitation, Vol. 97, No. 8, 2016, p. 1254-1261.

Research output: Contribution to journalArticle

Banks, Sarah D. ; Coronado, Rogelio A. ; Clemons, Lori R. ; Abraham, Christine M. ; Pruthi, Sumit ; Conrad, Benjamin N. ; Morgan, Victoria L. ; Guillamondegui, Oscar D. ; Archer, Kristin R. / Thalamic Functional Connectivity in Mild Traumatic Brain Injury : Longitudinal Associations With Patient-Reported Outcomes and Neuropsychological Tests. In: Archives of Physical Medicine and Rehabilitation. 2016 ; Vol. 97, No. 8. pp. 1254-1261.
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abstract = "Objectives (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. Design Prospective observational case-control study. Setting Academic medical center. Participants 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{\%}]). Interventions Not applicable. Main Outcome Measures 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. Results 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). Conclusions 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.",
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author = "Banks, {Sarah D.} and Coronado, {Rogelio A.} and Clemons, {Lori R.} and Abraham, {Christine M.} and Sumit Pruthi and Conrad, {Benjamin N.} and Morgan, {Victoria L.} and Guillamondegui, {Oscar D.} and Archer, {Kristin R.}",
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AU - Clemons, Lori R.

AU - Abraham, Christine M.

AU - Pruthi, Sumit

AU - Conrad, Benjamin N.

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N2 - Objectives (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. Design Prospective observational case-control study. Setting Academic medical center. Participants 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%]). Interventions Not applicable. Main Outcome Measures 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. Results 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). Conclusions 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.

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