Default Mode Network Connectivity Predicts Sustained Attention Deficits after Traumatic Brain Injury
Default Mode Network Connectivity Predicts Sustained Attention Deficits after Traumatic Brain Injury
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DOI：
10.1523/jneurosci.1163-11.2011
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发表时间：
2011-09-21
影响因子：
5.3
通讯作者：
Sharp, David J.
中科院分区：
文献类型：
--
作者：
Bonnelle, Valerie;Leech, Robert;Sharp, David J.
创伤性脑损伤（TBI）经常导致人类注意力障碍。这些可能导致无法保持一致的目标导向行为。一个主要是右侧化的额顶叶网络经常参与注意力要求高的任务。然而，注意力的丧失也与默认模式网络（DMN）内的激活增加有关。在这里，我们研究了持续注意力障碍的TBI患者，根据他们的行为表现随时间的一致性来定义。我们表明，患者持续的注意力障碍与DMN激活的增加有关，特别是在楔前叶和后扣带皮质内。此外，在任务开始时，楔前叶与DMN其余部分的相互作用，即，它的功能连接，预测哪些病人会继续表现出注意力障碍。重要的是，这种预测信息在持续注意力障碍的任何行为证据之前就存在，并且这种关系也在没有局灶性脑损伤的患者亚组中发现。TBI通常导致弥漫性轴索损伤，其通过断开分布式脑网络中的节点而产生认知障碍。使用扩散张量成像，我们证明了DMN内的结构断开也与持续注意力水平相关。这些结果表明，DMN功能异常是注意力障碍的敏感标志，并表明DMN内连接的变化是TBI后注意力障碍发展的核心。
Traumatic brain injury (TBI) frequently produces impairments of attention in humans. These can result in a failure to maintain consistent goal-directed behavior. A predominantly right-lateralized frontoparietal network is often engaged during attentionally demanding tasks. However, lapses of attention have also been associated with increases in activation within the default mode network (DMN). Here, we study TBI patients with sustained attention impairment, defined on the basis of the consistency of their behavioral performance over time. We show that sustained attention impairments in patients are associated with an increase in DMN activation, particularly within the precuneus and posterior cingulate cortex. Furthermore, the interaction of the precuneus with the rest of the DMN at the start of the task, i.e., its functional connectivity, predicts which patients go on to show impairments of attention. Importantly, this predictive information is present before any behavioral evidence of sustained attention impairment, and the relationship is also found in a subgroup of patients without focal brain damage. TBI often results in diffuse axonal injury, which produces cognitive impairment by disconnecting nodes in distributed brain networks. Using diffusion tensor imaging, we demonstrate that structural disconnection within the DMN also correlates with the level of sustained attention. These results show that abnormalities in DMN function are a sensitive marker of impairments of attention and suggest that changes in connectivity within the DMN are central to the development of attentional impairment after TBI.