Research Reports - Brain network dysregulation, emotion, and complaints after mild traumatic brain injury

Hum Brain Mapp. 2016 Apr;37(4):1645-54. doi: 10.1002/hbm.23126. Epub 2016 Feb 5.

van der Horn HJ(1), Liemburg EJ(2), Scheenen ME(3), de Koning ME(1), Marsman
JB(2), Spikman JM(3), van der Naalt J(1).

OBJECTIVES: To assess the role of brain networks in emotion regulation and
post-traumatic complaints in the sub-acute phase after non-complicated mild
traumatic brain injury (mTBI).
EXPERIMENTAL DESIGN: Fifty-four patients with mTBI (34 with and 20 without
complaints) and 20 healthy controls (group-matched for age, sex, education, and
handedness) were included. Resting-state fMRI was performed at four weeks
post-injury. Static and dynamic functional connectivity were studied within and
between the default mode, executive (frontoparietal and bilateral frontal
network), and salience network. The hospital anxiety and depression scale (HADS)
was used to measure anxiety (HADS-A) and depression (HADS-D).
PRINCIPAL OBSERVATIONS: Regarding within-network functional connectivity, none of
the selected brain networks were different between groups. Regarding
between-network interactions, patients with complaints exhibited lower functional
connectivity between the bilateral frontal and salience network compared to
patients without complaints. In the total patient group, higher HADS-D scores
were related to lower functional connectivity between the bilateral frontal
network and both the right frontoparietal and salience network, and to higher
connectivity between the right frontoparietal and salience network. Furthermore,
whereas higher HADS-D scores were associated with lower connectivity within the
parietal midline areas of the bilateral frontal network, higher HADS-A scores
were related to lower connectivity within medial prefrontal areas of the
bilateral frontal network.
CONCLUSIONS: Functional interactions of the executive and salience networks were
related to emotion regulation and complaints after mTBI, with a key role for the
bilateral frontal network. These findings may have implications for future
studies on the effect of psychological interventions.  

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