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. 2022 Aug;16(4):1863-1872.
doi: 10.1007/s11682-022-00662-5. Epub 2022 Apr 8.

Effects of Mild Traumatic Brain Injury on Resting State Brain Network Connectivity in Older Adults

Mayra Bittencourt  1 , Harm-Jan van der Horn  2 , Sebastián A Balart-Sánchez  2 , Jan-Bernard C Marsman  3 , Joukje van der Naalt  2 , Natasha M Maurits  2
Affiliations

Effects of Mild Traumatic Brain Injury on Resting State Brain Network Connectivity in Older Adults

Mayra Bittencourt et al. Brain Imaging Behav. 2022 Aug.

Abstract

Older age is associated with worsened outcome after mild traumatic brain injury (mTBI) and a higher risk of developing persistent post-traumatic complaints. However, the effects of mTBI sequelae on brain connectivity at older age and their association with post-traumatic complaints remain understudied.We analyzed multi-echo resting-state functional magnetic resonance imaging data from 25 older adults with mTBI (mean age: 68 years, SD: 5 years) in the subacute phase (mean injury to scan interval: 38 days, SD: 9 days) and 20 age-matched controls. Severity of complaints (e.g. fatigue, dizziness) was assessed using self-reported questionnaires. Group independent component analysis was used to identify intrinsic connectivity networks (ICNs). The effects of group and severity of complaints on ICNs were assessed using spatial maps intensity (SMI) as a measure of within-network connectivity, and (static) functional network connectivity (FNC) as a measure of between-network connectivity.Patients indicated a higher total severity of complaints than controls. Regarding SMI measures, we observed hyperconnectivity in left-mid temporal gyrus (cognitive-language network) and hypoconnectivity in the right-fusiform gyrus (visual-cerebellar network) that were associated with group. Additionally, we found interaction effects for SMI between severity of complaints and group in the visual(-cerebellar) domain. Regarding FNC measures, no significant effects were found.In older adults, changes in cognitive-language and visual(-cerebellar) networks are related to mTBI. Additionally, group-dependent associations between connectivity within visual(-cerebellar) networks and severity of complaints might indicate post-injury (mal)adaptive mechanisms, which could partly explain post-traumatic complaints (such as dizziness and balance disorders) that are common in older adults during the subacute phase.

Keywords: Aging; Brain connectivity; Fusiform gyrus; Mild traumatic brain injury; Post-concussive symptoms.

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Conflict of interest statement

None of the authors have a conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Overview of the prevalence of complaints (%) per group and per domain (OA-mTBI: older adults with mTBI; OA-HC: older adults-healthy controls; DOM: complaint domain). Complaints ordered by prevalence in the older adults with mTBI group from highest to lowest within each of the five identified complaint domains. Asterisks indicated significant differences between groups (Chi-square tests; *p < 0.05, FDR-corrected; †p < 0.05, uncorrected)
Fig. 2
Fig. 2
Effects of group on spatial map intensity (SMI). (A, C): Significant effect of group (older adults with mild traumatic brain injury; OA-mTBI vs. older adults-Healthy controls; OA-HCs) for SMI of intrinsic connectivity network (ICN) showing increased SMI for OA-mTBI in the left middle temporal gyrus on ICN13, and decreased SMI for OA-mTBI in the right posterior fusiform gyrus on ICN5 (p < 0.05, FDR-corrected) in representative slices. (B, D): Boxplots of the SMI averaged over all significant voxels across participants, per group. Cog-C/Lan: Cognitive-language domain; Vis-CB: Visual(-cerebellar) domain
Fig. 3
Fig. 3
Group × sqrt(HISC) interaction effect on spatial map intensity (SMI) of older adults with mild traumatic brain injury (OA-mTBI) and older adults HCs (OA-HCs). (A, C, E): Voxels with significant Group × sqrt(HISC) interaction effect for SMI of intrinsic connectivity network (ICN) in the anterior fusiform and middle occipital gyri on ICN7 (A), in the cerebellum VI and Crus I bilaterally on ICN7 (C) and in the cuneus on ICN4 (E) (p < 0.05, FDR-corrected). (B, D, F): Scatterplot of sqrt(HISC) against SMI (z-score) averaged over all significant voxels across participants. Blue: OA-HCs; red: OA-mTBI; sqrt(HISC): square root transformed severity of complaints score. Vis-CB: Visual(-cerebellar) domain
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