Specific and Evolving Resting-State Network Alterations in Post-Concussion Syndrome Following Mild Traumatic Brain Injury

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.

创伤后综合征（Post-concussion Syndrome, PCS）与轻度创伤性脑损伤（mild traumatic brain injury, mTBI）患者的轴突损伤存在关联，但目前学界对该类损伤对脑网络造成的影响仍知之甚少。本研究旨在利用静息态功能磁共振成像（resting-state functional magnetic resonance imaging, rs-fMRI）数据，对创伤后综合征患者在轻度创伤性脑损伤后的脑功能网络变化进行特征分析。本研究纳入17例损伤后6个月仍符合《精神障碍诊断与统计手册第四版》（DSM-IV）标准的持续性创伤后综合征患者，并以38例无创伤后综合征的轻度创伤性脑损伤患者及34例健康受试者作为对照。所有受试者均在损伤后的亚急性期（伤后1~3周）与晚期（伤后6个月）接受磁共振成像扫描。本研究采用图论（graph theory）分析方法，对各组间脑功能网络的差异进行了比较。所有轻度创伤性脑损伤患者均表现出远距离功能网络的异常模式；合并创伤后综合征的轻度创伤性脑损伤患者，其脑网络异常程度较无创伤后综合征的患者更为显著。在创伤后综合征患者中，脑网络异常以亚急性期累及颞叶与丘脑区域、晚期累及额叶区域为特征。本研究结果表明，创伤后综合征与脑功能网络的特异性异常存在关联，该异常或可解释创伤后综合征患者常见的各项功能缺损症状。