Abstract Details

Title Resting State Functional Connectivity is Directly Related to Clinical Presentation of Mild Traumatic Brain Injury

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) S8 - Neuro Trauma and Sports Neurology (3:30 PM-3:41 PM)

Poster/Presentation
Number 001

Background

mTBI is defined by a constellation of functional rather than structural deficits. As a measure of functional connectivity, fALFF has been implicated in long term outcomes post-mTBI. It is unclear however, how longitudinal changes in fALFF may relate to the clinical presentation of mTBI.

Objective

To determine the utility of fractional amplitude of low frequency fluctuations (fALFF) during resting state fMRI (rs-fMRI) as an advanced neuroimaging biomarker for Mild Traumatic Brain Injury (mTBI).

Design/Methods 111 patients and 32 controls (15-50 years old) were enrolled acutely after mTBI and followed with up to 4 standardized serial assessments. Patients were enrolled at either Encounter 1 (E1), within 72 hours, or Encounter 2 (E2), 5-10 days post-injury, and returned for Encounter 3 (E3) at 15-29 days and Encounter 4 (E4) at 83-97 days. Each encounter included a clinical exam, neuropsychological assessment, as well as rs-fMRI imaging. fALFF was analyzed independently in 14 functional networks and, in grey and white matter as a function of symptom severity. Symptom severity scores (SSS) ranged from 0-132 as defined by the SCAT2 symptom evaluation

Results In mTBI patients, fALFF scores across 5 functional brain networks (language, sensorimotor, visuospatial, higher-order visual, and posterior salience) differed between mTBI patients with low versus high SSS (SSS <5 and >30, respectively). Overall, greater SSS were indexed by reduced connectivity (p<0.03, Bonferroni corrected). Further analysis also identified corresponding network pairs which were most predictive of increased SSS. White matter fALFF was not correlated with symptom severity, however, decreased grey matter fALFF was significantly correlated with greater SSS (r = -0.25, p=0.002).

Conclusions

Grey matter fALFF was correlated with mTBI symptom burden suggesting that patterns of neural connectivity relate directly to the clinical presentation of mTBI. Furthermore, differences in functional network connectivity as a function of SSS may reflect which networks are implicated in recovery of mTBI.

Authors/Disclosures
Teena Shetty, MD, FAAN (Hospital for Special Surgery) PRESENTER	Dr. Shetty has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for mTBI, Inc. The institution of Dr. Shetty has received research support from Marker AG. The institution of Dr. Shetty has received research support from GE-NFL.
Joseph T Nguyen	Joseph T Nguyen has nothing to disclose.
Esther Kim, NP (Columbia University/Neurological Institute)	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Kristin Halvorsen (Hospital for Special Surgery)	No disclosure on file
	No disclosure on file
Joseph C. Masdeu, MD, PhD, FAAN (Houston Methodist Neurological Institute)	Dr. Masdeu has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Masdeu has received research support from NIH. The institution of Dr. Masdeu has received research support from Moody Foundation. The institution of Dr. Masdeu has received research support from Biogen. The institution of Dr. Masdeu has received research support from Eli Lilly. The institution of Dr. Masdeu has received research support from Eisai. The institution of Dr. Masdeu has received research support from Novartis. Dr. Masdeu has received publishing royalties from a publication relating to health care. Dr. Masdeu has received personal compensation in the range of $100,000-$499,999 for serving as a Director, Nantz Nal Alzheimer Center with HOUSTON METHODIST NEUROLOGICAL INSTITUTE.
	No disclosure on file
Luca Marinelli	Luca Marinelli has received personal compensation for serving as an employee of General Electric.

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