Changes in Structural Connectivity Following a Cognitive Intervention in Children With Traumatic Brain Injury

Yuan, Weihong; Treble‐Barna, Amery; Sohlberg, McKay Moore; Harn, Beth; Wade, Shari L.

doi:10.1177/1545968316675430

Cited by 40 publications

(53 citation statements)

References 53 publications

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“…First, we found a reduced density and an increased normalized characteristic path length in TBI patients compared with healthy controls. This finding concurs with previous research reporting reduced density and/or increased path length in both children with TBI (Caeyenberghs et al, ; Konigs et al, 2017; Yuan, Treble‐Barna, Sohlberg, Harn, & Wade, ) and adults with TBI (Caeyenberghs et al, ; Kim et al, ) in the chronic stage of recovery. Furthermore, our findings suggest an increase in normalized clustering coefficient in children with TBI.…”

Section: Discussionsupporting

confidence: 92%

Impaired rich club and increased local connectivity in children with traumatic brain injury: Local support for the rich?

Verhelst

Linden

Pauw

et al. 2018

Human Brain Mapping

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Recent evidence has shown the presence of a "rich club" in the brain, which constitutes a core network of highly interconnected and spatially distributed brain regions, important for high-order cognitive processes. This study aimed to map the rich club organization in 17 young patients with moderate to severe TBI (15.71 ± 1.75 years) in the chronic stage of recovery and 17 age- and gender-matched controls. Probabilistic tractography was performed on diffusion weighted imaging data to construct the edges of the structural connectomes using number of streamlines as edge weight. In addition, the whole-brain network was divided into a rich club network, a local network and a feeder network connecting the latter two. Functional outcome was measured with a parent questionnaire for executive functioning. Our results revealed a significantly decreased rich club organization (p values < .05) and impaired executive functioning (p < .001) in young patients with TBI compared with controls. Specifically, we observed reduced density values in all three subnetworks (p values < .005) and a reduced mean strength in the rich club network (p = .013) together with an increased mean strength in the local network (p = .002) in patients with TBI. This study provides new insights into the nature of TBI-induced brain network alterations and supports the hypothesis that the local subnetwork tries to compensate for the biologically costly subnetwork of rich club nodes after TBI.

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Section: Discussionsupporting

confidence: 92%

Impaired rich club and increased local connectivity in children with traumatic brain injury: Local support for the rich?

Verhelst

Linden

Pauw

et al. 2018

Human Brain Mapping

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“…8 Improved structural brain connectivity was found to be associated with better recovery of attention problems after a 10-week attention training intervention in children with more severe brain injury. 9 Studies have also reported white matter changes and associated outcomes improvement following other cognitive or motor trainings of various lengths. 17,18 In the present study, the aerobic training or stretching protocol lasted 6 to 8 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…The specific work flow has been described in our previous studies. 8,9 A detailed description and the corresponding mathematical definition of the network measures can be found in Rubinov and Sporns’ work in 2010. 6 …”

Section: Methodsmentioning

confidence: 99%

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Structural Connectivity Related to Persistent Symptoms After Mild TBI in Adolescents and Response to Aerobic Training: Preliminary Investigation

Yuan

Wade

Quatman‐Yates

et al. 2017

Journal of Head Trauma Rehabilitation

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OBJECTIVE To quantify structural connectivity abnormalities in adolescents with mild traumatic brain injury (mTBI) and to investigate connectivity changes following aerobic training using graph theory and diffusion tensor imaging (DTI) tractography. SETTING Outpatient research setting. PARTICIPANTS Twenty two children (age: 15.83±1.77 years, 10 F) with 4–16 weeks of persistent symptoms after mTBI and a matched healthy comparison group. DESIGN Randomized clinical trial of aerobic training and stretching comparison combined with case-control comparison. MAIN MEASURES (1) Five global network measures: global efficiency (Eglob), mean local efficiency, modularity, normalized clustering coefficient (γ), normalized characteristic path length (λ), small-worldness (σ). (2) The self-reported Post-Concussion Symptom Inventory (PCSI) score. RESULTS At initial enrollment, adolescents with mTBI had significantly lower Eglob and higher γ, λ, and σ (all p<0.05) when compared to healthy peers. After the intervention, significant increased Eglob and decreased λ (both p<0.05) were found in the aerobic training group. Improvement in PCSI scores were significantly correlated with the Eglob increase and λ decrease in the aerobic training and λ decrease in the stretching comparison group (all p<0.05). CONCLUSION This pilot study showed initial evidence that structural connectivity analysis was sensitive to brain network abnormalities and may serve as an imaging biomarker in children with persistent symptoms after mTBI.

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“…Higher FA and lower MD/ADC predict improved scores on tests of reading [28], executive function [27], and a global measure spanning nine cognitive domains [45]. Using a graph theory approach, Yuan et al found higher small-worldness in the TBI group at time 1, which decreased over time [31]. Small-worldness is a ratio of clustering to path length, factors that individually show non-significant effects at time 1, but decreases in clustering appear to underlie the longitudinal changes in small-worldness.…”

Section: Moderate-severe Brain Injurymentioning

confidence: 99%

Diffusion MRI in pediatric brain injury

Dennis

Babikian²,

Giza

et al. 2017

Childs Nerv Syst

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Traumatic brain injury (TBI) is a major public health issue around the world and can be especially devastating in children as TBI can derail cognitive and social development. White matter (WM) is particularly vulnerable to disruption post-TBI, as myelination is ongoing during this period. Diffusion magnetic resonance imaging (dMRI) is a versatile modality for identifying and quantifying WM disruption and can detect diffuse axonal injury (DAI or TAI (traumatic axonal injury)). This review covers dMRI studies of pediatric TBI, including mild to severe injuries, and covering all periods post-injury. While there have been considerable advances in our understanding of pediatric TBI through the use of dMRI, there are still large gaps in our knowledge, which will be filled in by larger studies and more longitudinal studies. Heterogeneity post-injury is an obstacle in all TBI studies, but we expect that larger better-characterized samples will aid in identifying clinically meaningful subgroups within the pediatric TBI patient population.

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Changes in Structural Connectivity Following a Cognitive Intervention in Children With Traumatic Brain Injury

Cited by 40 publications

References 53 publications

Impaired rich club and increased local connectivity in children with traumatic brain injury: Local support for the rich?

Impaired rich club and increased local connectivity in children with traumatic brain injury: Local support for the rich?

Structural Connectivity Related to Persistent Symptoms After Mild TBI in Adolescents and Response to Aerobic Training: Preliminary Investigation

Diffusion MRI in pediatric brain injury

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