Abstract Details

Title Functional Reorganization of the Language Network During Recovery from Severe Traumatic Brain Injury: A Longitudinal fMRI Study

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) S2 - Neurocritical Care (1:44 PM-1:55 PM)

Poster/Presentation
Number 005

Background The mechanisms underlying recovery of language function after severe TBI are poorly understood, and the functional neuroanatomic correlates of language recovery have not been characterized.

Objective To identify neurophysiological changes in the language network during recovery from acute severe traumatic brain injury (TBI).

Design/Methods We performed a longitudinal, prospective, observational study of 9 patients with acute severe TBI who recovered language function by six months post-injury. Patients underwent functional MRI (fMRI) with a spoken language stimulus as soon as they were stable to travel to the scanner. We assessed level of consciousness and language function using the Coma Recovery Scale-Revised immediately prior to fMRI. We repeated fMRI and behavioral assessments at 6 months post-injury. FMRI responses in the bilateral superior temporal gyri (STG) and bilateral inferior frontal gyri (IFG) were compared between early and follow-up scans. We also performed an exploratory whole-brain analysis to evaluate for stimulus-induced activation outside of these frontotemporal language regions.

Results We observed a longitudinal increase in fMRI responses to language in the right STG (p=0.01). No longitudinal changes in fMRI responses were detected in the left STG, left IFG, or right IFG. Whole-brain analysis did not reveal any longitudinal changes in fMRI responses outside of the right STG.

Conclusions These longitudinal fMRI results provide initial evidence that reorganization of the language network may be a mechanism by which patients with severe TBI recover language function.

Authors/Disclosures
Brian J. Coffey, MD PRESENTER	Dr. Coffey has nothing to disclose.
Zachary D. Threlkeld, MD, FAAN (Center for Academic Medicine)	Dr. Threlkeld has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Baim Institute for Clinical Research, Inc.. Dr. Threlkeld has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Medical Legal Consulting. Dr. Threlkeld has received publishing royalties from a publication relating to health care.
Yelena Bodien, PhD (Spaulding Rehabilitation Hospital)	Dr. Bodien has nothing to disclose.
Brian Edlow, MD	Dr. Edlow has received research support from NIH.

��ɫ��

��ɫ��