Resting-state functional connectivity after concussion is associated with clinical recovery
Resting-state functional connectivity after concussion is associated with clinical recovery
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DOI：
10.1002/hbm.24440
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发表时间：
2019-03-01
影响因子：
4.8
通讯作者：
Meier, Timothy B.
中科院分区：
文献类型：
--
作者：
Kaushal, Mayank;Espana, Lezlie Y.;Meier, Timothy B.
最近有人呼吁进行纵向成像研究，以更好地描述运动相关脑震荡(SRC)后生理恢复的时间进程及其与临床恢复的关系。为了解决这一问题，我们评估了SRC后全脑网络静息状态功能连接(Rs-FC)的变化，并探索了RS-FC与临床结果测量之间的关联。高中和大学足球运动员在季前赛期间被招募。对遭受SRC(N=62)的运动员进行急性期(48小时内)和亚急性期(第8、15和45天)的评估。没有脑震荡的匹配的足球运动员作为对照(N=60)，并参加类似的访问。使用基于网络的统计数据和使用普通全脑切片定义的感兴趣区域的平均结节强度，在每次访问时使用多频段静息状态功能磁共振成像来评估全脑RS-FC。与对照组相比，脑震荡运动员在脑震荡后48小时有更高的症状、心理困扰、动眼运动、平衡和记忆缺陷，在第8天症状和心理困扰有所减少但显著升高。RS-FC分析都显示，脑震荡运动员在脑震荡后8天的连通性比对照组有所增加，在48小时、15天或45天的访问中没有差异。进一步的分析表明，在为期8天的访问中，群体效应是由大多数脑震荡运动员在访问时仍有症状推动的；无症状脑震荡运动员与对照组没有区别。这项大规模前瞻性研究的结果表明，SRC后的全脑RS-FC改变起病延迟，但与自我报告的症状存在相关。
There has been a recent call for longitudinal imaging studies to better characterize the time course of physiological recovery following sport-related concussion (SRC) and its relationship with clinical recovery. To address this, we evaluated changes to resting-state functional connectivity (rs-FC) of the whole-brain network following SRC and explored associations between rs-FC and measures of clinical outcome. High school and collegiate football athletes were enrolled during preseason. Athletes that suffered SRC (N = 62) were assessed across the acute (within 48 hr) and sub-acute (days 8, 15, and 45) phases. Matched football athletes without concussion served as controls (N = 60) and participated in similar visits. Multi-band resting-state fMRI was used to assess whole-brain rs-FC at each visit using network-based statistic and average nodal strength from regions of interest defined using a common whole-brain parcellation. Concussed athletes had elevated symptoms, psychological distress, and oculomotor, balance, and memory deficits at 48 hr postconcussion relative to controls, with diminished yet significant elevations in symptoms and psychological distress at 8 days. Both rs-FC analyses showed that concussed athletes had a global increase in connectivity at 8 days postconcussion relative to controls, with no differences at the 48-hr, 15-day, or 45-day visits. Further analysis revealed the group effect at the 8-day visit was driven by the large minority of concussed athletes still symptomatic at their visit; asymptomatic concussed athletes did not differ from controls. Findings from this large-scale, prospective study suggest whole-brain rs-FC alterations following SRC are delayed in onset but associated with the presence of self-reported symptoms.