Abstract
TBI results in significant cognitive impairments and in altered brain functional connectivity. However, no studies explored so far, the relationship between global functional connectivity and cognitive outcome in chronic moderate-severe TBI. This proof of principle study employed the intrinsic connectivity contrast, an objective voxel-based metric of global functional connectivity, in a small sample of chronic moderate-severe TBI participants and a group of healthy controls matched on gender (males), age, and education. Cognitive tests assessing executive functions, verbal memory, visual memory, attention/organization, and cognitive reserve were administered. Group differences in terms of global functional connectivity maps were assessed and the association between performance on the cognitive measures and global functional connectivity was examined. Next, we investigated the spatial extent of functional connectivity in the brain regions found to be associated with cognitive performance, using traditional seed-based analyses. Global functional connectivity of the TBI group was altered, compared to the controls. Moreover, the strength of global functional connectivity in affected brain areas was associated with cognitive outcome. These findings indicate that impaired global functional connectivity is a significant consequence of TBI suggesting that cognitive impairments following TBI may be partly attributed to altered functional connectivity between brain areas involved in the specific cognitive functions.
Highlights
Traumatic brain injury (TBI) represents a major medical, public health and socioeconomic problem worldwide [1,2,3]
Two-tailed, two-sample t-tests revealed that the groups with TBI and healthy control (HC) participants were very similar in terms of age and education
The right Caudate nucleus showed functional magnetic resonance imaging (fMRI) activity related to the attended condition in a selective attention task of car experts [96]. These findings demonstrate that impaired global functional connectivity is associated with cognitive outcome and it constitutes an important consequence of brain injury
Summary
Traumatic brain injury (TBI) represents a major medical, public health and socioeconomic problem worldwide [1,2,3]. It has been estimated that globally at least 10 million people per year sustain a TBI that is serious enough to result in death or hospitalization. The number of people who have been hospitalized with at least one TBI has been estimated at 57 million, but the proportion of those living with TBI-related disability is still unknown [2]. TBI results in the greatest number of years lived with a disability due to trauma in Europe [5, 6]; the annual cost of traumatic brain injuries is estimated at approximately US$400 billion [7]
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