Abstract
Traumatic brain injury (TBI) can result in acute cognitive deficits and diffuse axonal injury reflected in white matter brain network alterations, which may, or may not, later recover. Our objective is to first characterize the ways in which brain networks change after TBI and, second, investigate if those changes are associated with recovery of cognitive deficits. We aim to make initial progress in discerning the relationships between brain network changes, and their (dys)functional correlates. We analyze longitudinally acquired MRI from 23 TBI patients (two time points: 6 days, 12 months post-injury) and cross-sectional data from 28 controls to construct white matter brain networks. Cognitive assessment was also performed. Graph theory and regression analysis were applied to identify changed brain network metrics after injury that are associated with subsequent improvements in cognitive function. Sixteen brain network metrics were found to be discriminative of different post-injury phases. Eleven of those explain 90% (adjusted R2) of the variability observed in cognitive recovery following TBI. Brain network metrics that had a high contribution to the explained variance were found in frontal and temporal cortex, additional to the anterior cingulate cortex. Our preliminary study suggests that network reorganization may be related to recovery of impaired cognitive function in the first year after a TBI.
Highlights
Traumatic brain injury (TBI), which frequently involves white matter connectivity damage, is the leading cause of morbidity, death among children, and individuals under the age of 45 [1, 2]
Longitudinal Analysis After identifying network metrics discriminating between different TBI phases, we investigated their association with cognitive score
The genetic algorithm random forest (GARF) model selected a total of 16 network metrics involving 12 brain regions and showed a 5-fold cross-validation accuracy of 83.3%, confirming robust discrimination between early and late post-injury time phases
Summary
Traumatic brain injury (TBI), which frequently involves white matter connectivity damage, is the leading cause of morbidity, death among children, and individuals under the age of 45 [1, 2]. Diffuse axonal injury (DAI), one of the most common pathologies in TBI [5, 6], is triggered by mechanical disruption of axons, resulting in complex, and diverse effects on brain function. Network Reorganization in Traumatic Brain Injury [7]. Diffusion tensor imaging (DTI) is suited to the study of DAI and has been used to investigate white matter brain connectivity changes after TBI [8, 9]. To understand how widespread DAI lesions affect brain function, it may be necessary to analyze the global impact of these lesions on the whole-brain network [9]
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