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Investigations on Alterations of Hippocampal Circuit Function Following Mild Traumatic Brain Injury
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Volume Change in Frontal Cholinergic Structures After Traumatic Brain Injury and Cognitive Outcome.

Anna Östberg1,2,3, Christian Ledig4, Ari Katila5

  • 1Division of Clinical Neurosciences, Turku Brain Injury Centre, Turku University Hospital, Turku, Finland.

Frontiers in Neurology
|September 9, 2020
PubMed
Summary

Traumatic brain injury (TBI) can cause volume loss in frontal brain regions that regulate attention. This atrophy correlates with poorer performance on cognitive tests measuring attention and motor skills.

Keywords:
atlas based volumetric MRI analysischolinergic systemcognitive testingstructural MRItraumatic brain injury

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Area of Science:

  • Neuroscience
  • Neuroimaging
  • Cognitive Psychology

Background:

  • Cholinergic nuclei in the basal forebrain are crucial for attention by innervating frontal cortical structures.
  • Traumatic brain injury (TBI) can disrupt these pathways, potentially impacting cognitive functions like attention.

Purpose of the Study:

  • To investigate the relationship between cognitive test results measuring attention and longitudinal brain volume changes in TBI patients.
  • To identify specific frontal cortical structures, innervated by cholinergic neurons, that show volume changes related to attention deficits post-TBI.

Main Methods:

  • Prospective, observational study (TBIcare project) including 114 TBI patients and 17 orthopedic injury controls.
  • Acquisition of head MRI at acute (2 weeks) and late (8 months) time points post-injury.
  • Analysis of T1-weighted 3D MR images for longitudinal brain volume changes and assessment of cognitive function using the Cambridge Neuropsychological Test Automated Battery (CANTAB).

Main Results:

  • Significant correlations were found between post-traumatic volume changes in four frontal cortical structures and CANTAB test results.
  • Greater atrophy in the supplementary motor cortex was strongly correlated with poorer motor screening task performance (R-sq 0.16, p < 0.0001).
  • Increased cortical gray matter atrophy rate correlated with poorer overall CANTAB test results.

Conclusions:

  • Volume loss in TBI-affected frontal cortical structures, particularly those with heavy cholinergic innervation, is associated with impaired attention as measured by neuropsychological tests.
  • These findings highlight the impact of TBI on attention-related neural networks and suggest potential imaging biomarkers for cognitive deficits.