Article

OBJECTIVES: (1) To examine differences in patient-reported outcomes,
neuropsychological tests, and thalamic functional connectivity (FC) between
patients with mild traumatic brain injury (mTBI) and individuals without mTBI and
(2) to determine longitudinal associations between changes in these measures.
DESIGN: Prospective observational case-control study. SETTING: Academic medical
center. PARTICIPANTS: A sample (N=24) of 13 patients with mTBI (mean age,
39.3+/-14.0y; 4 women [31%]) and 11 age- and sex-matched controls without mTBI
(mean age, 37.6+/-13.3y; 4 women [36%]). INTERVENTIONS: Not applicable. MAIN
OUTCOME MEASURES: Resting state FC (3T magnetic resonance imaging scanner) was
examined between the thalamus and the default mode network, dorsal attention
network, and frontoparietal control network. Patient-reported outcomes included
pain (Brief Pain Inventory), depressive symptoms (Patient Health
Questionnaire-9), posttraumatic stress disorder ([PTSD] Checklist - Civilian
Version), and postconcussive symptoms (Rivermead Post-Concussion Symptoms
Questionnaire). Neuropsychological tests included the Delis-Kaplan Executive
Function System Tower test, Trails B, and Hotel Task. Assessments occurred at 6
weeks and 4 months after hospitalization in patients with mTBI and at a single
visit for controls. RESULTS: Student t tests found increased pain, depressive
symptoms, PTSD symptoms, and postconcussive symptoms; decreased performance on
Trails B; increased FC between the thalamus and the default mode network; and
decreased FC between the thalamus and the dorsal attention network and between
the thalamus and the frontoparietal control network in patients with mTBI as
compared with controls. The Spearman correlation coefficient indicated that
increased FC between the thalamus and the dorsal attention network from baseline
to 4 months was associated with decreased pain and postconcussive symptoms
(corrected P<.05). CONCLUSIONS: Findings suggest that alterations in thalamic FC
occur after mTBI, and improvements in pain and postconcussive symptoms are
correlated with normalization of thalamic FC over time.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS