Resting-State Network Plasticity Induced by Music Therapy after Traumatic Brain Injury.

Noelia Martínez-Molina,Aarne Ylinen,Katja Ala-Kauhaluoma,Antoni Rodríguez-Fornells,Matti Laine,Johanna Pekkola,Benjamin Ultan Cowley,Päivi Jordan-Kilkki,Mirja Ahlfors,Sini-Tuuli Siponkoski,Susanna Melkas,Linda Kuusela,Milla Holma,Sari Laitinen,Pekka Rantanen,Sanna Koskinen,Teppo Särkämö,Preston E Garraghty

doi:10.1155/2021/6682471

Abstract

Traumatic brain injury (TBI) is characterized by a complex pattern of abnormalities in resting-state functional connectivity (rsFC) and network dysfunction, which can potentially be ameliorated by rehabilitation. In our previous randomized controlled trial, we found that a 3-month neurological music therapy intervention enhanced executive function (EF) and increased grey matter volume in the right inferior frontal gyrus (IFG) in patients with moderate-to-severe TBI (N = 40). Extending this study, we performed longitudinal rsFC analyses of resting-state fMRI data using a ROI-to-ROI approach assessing within-network and between-network rsFC in the frontoparietal (FPN), dorsal attention (DAN), default mode (DMN), and salience (SAL) networks, which all have been associated with cognitive impairment after TBI. We also performed a seed-based connectivity analysis between the right IFG and whole-brain rsFC. The results showed that neurological music therapy increased the coupling between the FPN and DAN as well as between these networks and primary sensory networks. By contrast, the DMN was less connected with sensory networks after the intervention. Similarly, there was a shift towards a less connected state within the FPN and SAL networks, which are typically hyperconnected following TBI. Improvements in EF were correlated with rsFC within the FPN and between the DMN and sensorimotor networks. Finally, in the seed-based connectivity analysis, the right IFG showed increased rsFC with the right inferior parietal and left frontoparietal (Rolandic operculum) regions. Together, these results indicate that the rehabilitative effects of neurological music therapy after TBI are underpinned by a pattern of within- and between-network connectivity changes in cognitive networks as well as increased connectivity between frontal and parietal regions associated with music processing.

Highlights

Each year, there are over 50 million cases of traumatic brain injury (TBI), and it has been estimated that approximately half of the world’s population will sustain at least minor TBIs during their lifetime [1]
For the between-network analysis, we examined the connectivity between the regions of interests (ROIs) of each of these resting-state networks (RSNs) (DMN, SAL, frontoparietal network (FPN), and dorsal attention (DAN)) with every other RSN included in the CONN toolbox
Our results lend support to the idea that the music intervention facilitated the integration of primary sensory information, by increasing the resting-state functional connectivity (rsFC) between multimodal and higher-level cognitive networks (FPN, DAN)

Summary

Introduction

There are over 50 million cases of traumatic brain injury (TBI), and it has been estimated that approximately half of the world’s population will sustain at least minor TBIs during their lifetime [1]. Despite the broad variety of symptoms that can follow after TBI, the most prominent cognitive impairments affect attention, memory, and executive function (EF) [1, 3,4,5,6]. These high-level cognitive functions require the integration of information across spatially distinct brain regions, which make them vulnerable to connectivity problems. Deficits in EF are deemed to be the core symptoms of TBI [7, 8], in moderateto-severe cases that are at focus here. Given the heterogeneous and complex nature of TBI and the major burden imposed upon individuals and society, there is an urgent need to develop novel and motivating rehabilitation strategies that target multiple deficits simultaneously, yet with a primary focus on EF

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Conclusion