Brain Networks Subserving Emotion Regulation and Adaptation after Mild Traumatic Brain Injury

Abstract

The majority of patients with traumatic brain injury (TBI) sustain a mild injury (mTBI). One out of 4 patients experiences persistent complaints, despite their often normal neuropsychological test results and the absence of structural brain damage on conventional neuroimaging. Susceptibility to develop persistent complaints is thought to be affected by interindividual differences in adaptation, which can also be influenced by preinjury psychological factors. Coping is a key construct of adaptation and refers to strategies to deal with new situations and serious life events. An important element of coping is the ability to regulate emotions and stress. The prefrontal cortex is a crucial area in this regulation process, given that it exerts a top-down influence on the amygdala and other subcortical structures involved in emotion processing. However, little is known about the role of the prefrontal cortex and associated brain networks in emotion regulation and adaptation post-mTBI. Especially, the influence of prefrontal dysfunction on development of persistent postconcussive complaints is poorly understood. In this article, we aim to integrate findings from functional and structural MRI studies on this topic. Alterations within the default mode, executive and salience network have been found in relation to complaints post-mTBI. Dysfunction of the medial prefrontal cortex may impair network dynamics for emotion regulation and adaptation post-mTBI, resulting in persistent post-concussive complaints.

Validation and calibration of HeadCount, a self-report measure for quantifying heading exposure in soccer players

“…Other self-report instruments, such as those developed by Kerr et al (2015) or Montenigro (2016), utilize a structured interview approach that may provide increased accuracy, but is not as easily scaled to large populations or remote (online) participation. Additionally, although these two studies resembled our study most closely in their technique for estimation of cumulative heading, they both relied on differences in player position to augment exposure estimation.…”

“…Subject self-report questionnaires are a proven method used for quantifying physical activity across a range of recall periods (Atienza & King, 2005; Ekelund et al, 2006; Friedenreich et al, 2006; Johnson-Kozlow, Rock, Gilpin, Hollenbach, & Pierce, 2007). Additionally, self-report measures have been successfully used to quantify repeated head impacts in football players (Kerr et al, 2015; Montenigro et al, 2016). Montenigro et al calculated a cumulative head impact index score based on the players' self report of number of seasons of play at different levels (youth, high school, college) play, weighted by estimates of the frequency of head impacts by position and level of play drawn from published helmet accelerometer studies.…”

Blood biomarkers for brain injury: What are we measuring?

“…Furthermore, evidence indicates that serum levels of neurotoxic C-terminal Tau fragments (c-Tau: Fig. 5B) are significantly elevated after mTBI (Shahim et al, 2015). …”

“…Shahim et al reported that serum levels of these species were elevated in professional hockey players after concussion, and furthermore found that A-Tau levels were associated with the duration of post-concussion symptoms (Shahim et al, 2014, 2015). Enzyme-linked immunosorbent assays (ELISA) with cut-off values of 12 pg/ml were initially used to investigate serum Tau levels.…”

“…Additional Tau fragments have also been found to be significantly elevated in the serum of athletes after concussion compared to preseason baseline values. And while serum A-Tau levels remained constant after concussion, A-Tau levels have been shown to positively correlate with persistent symptoms lasting more than 10 days (Shahim et al, 2015). …”