Altered functional connectivity in children with mild to moderate TBI relates to motor control

Issue title: Emerging Data in Pediatric Traumatic Brain Injury

Guest editors: Stacy Suskauer

Article type: Research Article

Authors: Risen, S.R.^{a; b; c} | Barber, A.D.^{a; b} | Mostofsky, S.H.^{a; b; c} | Suskauer, S.J.^{a; c; d; *}

Affiliations: [a] Kennedy Krieger Institute, Baltimore, MD, USA | [b] Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA | [c] Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA | [d] Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD, USA

Correspondence: [*] Corresponding author: Stacy Suskauer, Department of Physical Medicine and Rehabilitation, Kennedy Krieger Institute and Johns Hopkins School of Medicine, 707 N. Broadway, Baltimore, MD 21205, USA. Tel.: +1 443 923 9440; Fax: +1 443 923 9445; E-mail:suskauer@kennedykrieger.org

Abstract: PURPOSE: Functionally relevant alterations in resting state fMRI (rs-fMRI) connectivity have been identified in adults with traumatic brain injury (TBI). We evaluated rs-fMRI connectivity in children with TBI and explored the relationship between altered connectivity and measures of neurological function. METHODS: Rs-fMRI was obtained in 14 children after TBI and 14 controls matched for age, sex, and handedness. Whole-brain connectivity was evaluated separately for the default mode network (DMN) and dorsal attention network (DAN); Between-group contrasts identified regions with altered connectivity between TBI and control cohorts. In children with TBI, the relationships between regions of altered connectivity and performance on relevant functional measures were examined. RESULTS: Compared to controls, children with TBI showed significantly greater connectivity between DMN and right dorsal premotor cortex (RdPM) and between DAN and bilateral sensorimotor cortex (SM1). In children with TBI, greater DMN-RdPM connectivity was associated with worse motor performance whereas greater DAN-LSM1 connectivity was associated with better motor performance; furthermore, DMN-RdPM and DAN-LSM1 connectivity were negatively correlated. CONCLUSION: Rs-fMRI reveals significant altered connectivity in children with TBI compared to controls. After TBI in children, patterns of altered connectivity appear divergent, with increased DMN-motor network connectivity associated with worse motor control whereas increased DAN-motor network connectivity appears compensatory.

Keywords: TBI, pediatric, resting-state networks, fMRI

DOI: 10.3233/PRM-150349

Journal: Journal of Pediatric Rehabilitation Medicine, vol. 8, no. 4, pp. 309-319, 2015