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Published on: January 20, 2019
Changes in Resting-State Functional Connectivity and Cognitive-Affective Symptoms in Patients With Post-Concussion
Daniel A Monti1, Vedaei Faezeh, George Zabrecky
1Author Affiliations: Department of Integrative Medicine and Nutritional Sciences, Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, PA (Drs Monti and Zabrecky, Ms Wintering, and Drs Bazzan and Newberg); and Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA (Ms Vedaei and Drs Alizadeh, Mohamed, and Newberg).
N-acetylcysteine (NAC) improved chronic post-concussion syndrome (PCS) symptoms and brain functional connectivity. This antioxidant treatment offers a potential new therapeutic avenue for patients with persistent PCS symptoms.
Area of Science:
- Neuroscience
- Clinical Medicine
- Pharmacology
Background:
- Concussion is a leading cause of traumatic brain injury, often resulting in persistent cognitive and functional deficits.
- Chronic post-concussion syndrome (PCS) affects 10-50% of individuals, with limited treatment options and poorly understood pathophysiology.
- Oxidative stress is implicated in PCS, suggesting potential therapeutic targets.
Purpose of the Study:
- To evaluate the efficacy of N-acetylcysteine (NAC), an antioxidant, in treating chronic post-concussion syndrome (PCS).
- To assess the impact of NAC on cognitive, emotional, and sensory symptoms in PCS patients.
- To investigate changes in brain functional connectivity associated with NAC treatment in PCS.
Main Methods:
- A randomized, unblinded clinical trial involving 50 patients with chronic PCS (symptoms for ≥3 months).
- Participants received either NAC (oral and intravenous) or were assigned to a waitlist control group receiving standard care.
- Resting-state functional connectivity (rsFC-MRI) and symptom assessments were conducted pre- and post-intervention.
Main Results:
- NAC treatment led to significant symptom improvements compared to the control group, as measured by validated questionnaires.
- Significant changes in resting-state functional connectivity (FC) were observed in the NAC group, particularly in the default mode, salience, and executive control networks.
- Improvements in PCS symptoms correlated with observed changes in brain FC.
Conclusions:
- N-acetylcysteine (NAC) treatment demonstrated significant efficacy in improving symptoms of chronic post-concussion syndrome (PCS).
- NAC administration was associated with notable alterations in resting-state brain functional connectivity.
- The findings suggest NAC is a promising therapeutic agent for managing cognitive and affective symptoms in PCS.
