The effects of plasticity-based cognitive rehabilitation on resting-state functional connectivity in chronic traumatic brain injury: A pilot study

Article type: Research Article

Authors: Lindsey, Hannah M.^{a; b; c} | Lazar, Mariana^d | Mercuri, Giulia^{e; f} | Rath, Joseph F.^g | Bushnik, Tamara^g | Flanagan, Steven^g | Voelbel, Gerald T.^{g; h; *}

Affiliations: [a] Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA | [b] Department of Psychology, Brigham Young University, Provo, UT, USA | [c] Department of Psychology, New York University, New York, NY, USA | [d] Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA | [e] Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA | [f] Department of Psychology, New York University, New York, NY, USA | [g] Department of Rehabilitation Medicine, Rusk Rehabilitation at NYU Langone Health, New York, NY, USA | [h] Department of Occupational Therapy and Center of Health and Rehabilitation Research, New York University, New York, NY, USA

Correspondence: [*] Address for correspondence: Gerald T. Voelbel, PhD, Department of Occupational Therapy, New York University, Pless Hall, 82 Washington Square East, 6^th Floor, New York, NY 10003, USA. Tel.: +1 212 998 5827; Fax: +1 212 995 4044; E-mail: gv23@nyu.edu.

Abstract: BACKGROUND:Traumatic brain injury (TBI) often results in chronic impairments to cognitive function, and these may be related to disrupted functional connectivity (FC) of the brain at rest. OBJECTIVE:To investigate changes in default mode network (DMN) FC in adults with chronic TBI following 40 hours of auditory processing speed training. METHODS:Eleven adults with chronic TBI underwent 40-hours of auditory processing speed training over 13-weeks and seven adults with chronic TBI were assigned to a non-intervention control group. For all participants, resting-state FC and cognitive and self-reported function were measured at baseline and at a follow-up visit 13-weeks later. RESULTS:No significant group differences in cognitive function or resting-state FC were observed at baseline. Following training, the intervention group demonstrated objective and subjective improvements on cognitive measures with moderate-to-large effect sizes. Repeated measures ANCOVAs revealed significant (p < 0.001) group×time interactions, suggesting training-related changes in DMN FC, and semipartial correlations demonstrated that these were associated with changes in cognitive functioning. CONCLUSIONS:Changes in the FC between the DMN and other resting-state networks involved in the maintenance and manipulation of internal information, attention, and sensorimotor functioning may be facilitated through consistent participation in plasticity-based auditory processing speed training in adults with chronic TBI.

Keywords: Chronic traumatic brain injury, functional magnetic resonance imaging, functional connectivity, cognitive rehabilitation, neuronal plasticity

DOI: 10.3233/NRE-210264

Journal: NeuroRehabilitation, vol. 51, no. 1, pp. 133-150, 2022