Structural Connectivity Related to Persistent Symptoms After Mild TBI in Adolescents and Response to Aerobic
Weihong Yuan1, Shari L Wade, Catherine Quatman-Yates
1Pediatric Neuroimaging Research Center (Dr Yuan), Division of Physical Medicine and Rehabilitation (Drs Wade and Kurowski), and Division of Sports Medicine (Drs Quatman-Yates and Gubanich and Mr Hugentobler), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and University of Cincinnati, College of Medicine, Cincinnati, Ohio (Drs Yuan, Wade, and Kurowski).
Objective:
To quantify structural connectivity abnormalities in adolescents with mild traumatic brain injury (mTBI) and to investigate connectivity changes following aerobic training using graph theory and diffusion tensor imaging tractography.
Setting:
Outpatient research setting.
Participants:
Twenty-two children (age: 15.83 ± 1.77 years, 10 females) with 4 to 16 weeks of persistent symptoms after mTBI and a matched healthy comparison group.
Design:
Randomized clinical trial of aerobic training and stretching comparison combined with case-control comparison.
Main Measures:
(1) Five global network measures: global efficiency (Eglob), mean local efficiency, modularity, normalized clustering coefficient (γ), normalized characteristic path length (λ), and small-worldness (σ). (2) The self-reported Post-Concussion Symptom Inventory score.
Results:
At initial enrollment, adolescents with mTBI had significantly lower Eglob and higher γ, λ, and σ (all P < .05) than healthy peers. After the intervention, significantly increased Eglob and decreased λ (both P < .05) were found in the aerobic training group. Improvement in Post-Concussion Symptom Inventory scores was significantly correlated with the Eglob increase and λ decrease in the aerobic training and λ decrease in the stretching comparison group (all P < .05).
Conclusion:
This pilot study showed initial evidence that structural connectivity analysis was sensitive to brain network abnormalities and may serve as an imaging biomarker in children with persistent symptoms after mTBI.
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