Abstract
Post-concussion syndrome has been related to axonal damage in patients with mild traumatic brain injury, but little is known about the consequences of injury on brain networks. In the present study, our aim was to characterize changes in functional brain networks following mild traumatic brain injury in patients with post-concussion syndrome using resting-state functional magnetic resonance imaging data. We investigated 17 injured patients with persistent post-concussion syndrome (under the DSM-IV criteria) at 6 months post-injury compared with 38 mild traumatic brain injury patients with no post-concussion syndrome and 34 healthy controls. All patients underwent magnetic resonance imaging examinations at the subacute (1–3 weeks) and late (6 months) phases after injury. Group-wise differences in functional brain networks were analyzed using graph theory measures. Patterns of long-range functional networks alterations were found in all mild traumatic brain injury patients. Mild traumatic brain injury patients with post-concussion syndrome had greater alterations than patients without post-concussion syndrome. In patients with post-concussion syndrome, changes specifically affected temporal and thalamic regions predominantly at the subacute stage and frontal regions at the late phase. Our results suggest that the post-concussion syndrome is associated with specific abnormalities in functional brain network that may contribute to explain deficits typically observed in PCS patients.
Highlights
Post-concussion syndrome (PCS) following mild traumatic brain injury remains one of the most elusive and challenging pathological conditions
PCS is characterized by the presence of subjective complaints such as fatigue, headaches, sleep disturbance or poor concentration [1,2,3], and induces substantial socioprofessional troubles that may last from several months to years [4,5,6]
The Glasgow Coma Scale (GCS) did not differ between PCS+ and PCS– patients: all patients had a GCS of 15, except for one PCS+ patient ad one PCS– patient who both presented a GCS of 14
Summary
Post-concussion syndrome (PCS) following mild traumatic brain injury (mTBI) remains one of the most elusive and challenging pathological conditions. Brain networks are thought to form an essential substrate for the performance of most cognitive functions [12] They can be explored using resting-state fMRI, i.e. in the absence of any explicit task. Graph theory studies have allowed neuroscientists to show that neural networks had efficient small-world properties [18,19,20,21] and rich-club organization [22]. Such architecture is suggested to satisfy the competitive demands of brain networks in local and global information processing [23,24]
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