Chronic post-concussive symptoms are common after mild traumatic brain injury (mTBI) and are difficult to predict or treat. Thalamic functional integrity is particularly vulnerable in mTBI and may be related to long-term outcomes but requires further investigation. We compared structural MRI and resting state functional MRI in 108 patients with a Glasgow Coma Scale (GCS) of 13-15 and normal CT, and 76 controls. We examined whether acute changes in thalamic functional connectivity were early markers for persistent symptoms and explored neurochemical associations of our findings using PET data. Of the mTBI cohort, 47% showed incomplete recovery 6 months post-injury. Despite the absence of structural changes, we found acute thalamic hyperconnectivity in mTBI, with specific vulnerabilities of individual thalamic nuclei. Acute fMRI markers differentiated those with chronic post-concussive symptoms, with time- and outcome-dependent relationships in a sub-cohort followed longitudinally. Moreover, emotional and cognitive symptoms were associated with changes in thalamic functional connectivity to known serotonergic and noradrenergic targets, respectively. Our findings suggest that chronic symptoms can have a basis in early thalamic pathophysiology. This may aid identification of patients at risk of chronic post-concussive symptoms following mTBI, provide a basis for development of new therapies and facilitate precision medicine application of these therapies.

Woodrow, R., Winzeck, S., Luppi, A., Kelleher-Unger, I., Spindler, L., Wilson, J., et al. (2023). Acute thalamic connectivity precedes chronic post-concussive symptoms in mild traumatic brain injury. BRAIN, 146(8), 3484-3499 [10.1093/brain/awad056].

Acute thalamic connectivity precedes chronic post-concussive symptoms in mild traumatic brain injury

Citerio, Giuseppe
Membro del Collaboration Group
2023

Abstract

Chronic post-concussive symptoms are common after mild traumatic brain injury (mTBI) and are difficult to predict or treat. Thalamic functional integrity is particularly vulnerable in mTBI and may be related to long-term outcomes but requires further investigation. We compared structural MRI and resting state functional MRI in 108 patients with a Glasgow Coma Scale (GCS) of 13-15 and normal CT, and 76 controls. We examined whether acute changes in thalamic functional connectivity were early markers for persistent symptoms and explored neurochemical associations of our findings using PET data. Of the mTBI cohort, 47% showed incomplete recovery 6 months post-injury. Despite the absence of structural changes, we found acute thalamic hyperconnectivity in mTBI, with specific vulnerabilities of individual thalamic nuclei. Acute fMRI markers differentiated those with chronic post-concussive symptoms, with time- and outcome-dependent relationships in a sub-cohort followed longitudinally. Moreover, emotional and cognitive symptoms were associated with changes in thalamic functional connectivity to known serotonergic and noradrenergic targets, respectively. Our findings suggest that chronic symptoms can have a basis in early thalamic pathophysiology. This may aid identification of patients at risk of chronic post-concussive symptoms following mTBI, provide a basis for development of new therapies and facilitate precision medicine application of these therapies.
Articolo in rivista - Articolo scientifico
functional connectivity; mild traumatic brain injury; postconcussive symptoms; resting-state fMRI; thalamus;
English
22-feb-2023
2023
146
8
3484
3499
open
Woodrow, R., Winzeck, S., Luppi, A., Kelleher-Unger, I., Spindler, L., Wilson, J., et al. (2023). Acute thalamic connectivity precedes chronic post-concussive symptoms in mild traumatic brain injury. BRAIN, 146(8), 3484-3499 [10.1093/brain/awad056].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/404435
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