Alterations in Topological Structure and Modular Interactions in Pediatric Patients with Complete Spinal Cord Injury:...

Area of Science:

• Neuroscience
• Medical Imaging
• Pediatric Neurology

Background:

• Traumatic complete spinal cord injury (CSCI) causes significant sensory-motor deficits and neuropsychological issues like anxiety and depression in pediatric patients.
• The specific alterations in brain functional network organization and modular interactions in children with CSCI are not well understood.

Purpose of the Study:

• To investigate the changes in whole-brain functional network topology and modular organization in pediatric patients with CSCI compared to healthy controls.
• To identify potential neuroimaging biomarkers for assessing motor function recovery in pediatric CSCI.

Main Methods:

• Resting-state functional MRI was performed on 34 pediatric CSCI patients and 36 healthy controls (ages 6-12).
• Graph theory analysis using the Automated Anatomical Labeling (AAL 90) atlas was applied to resting-state functional MRI data to assess network topology at nodal, global, and modular levels.
• Between-group comparisons and partial correlation analyses were conducted to identify significant differences and relationships.

Main Results:

• Pediatric CSCI patients showed decreased nodal metrics, especially in subcortical networks (SN), and altered core node distribution, with new core nodes in the default mode network (DMN).
• Patients exhibited altered modular interactions: increased within-DMN and DMN-attention network (AN) connectivity, but reduced DMN-SN, DMN-vision network (VN), and AN-SN connectivity.
• Lower modularity was observed in CSCI patients, and the participation coefficient of the left temporal pole was positively correlated with motor scores.

Conclusions:

• Pediatric CSCI leads to significant alterations in brain functional network organization and modularity, particularly affecting emotional cognition and visual processing regions.
• These network changes highlight the need to address psychocognitive well-being in pediatric CSCI patients.
• The identified network alterations and correlations with motor function suggest potential targets for neurorehabilitation strategies, including visual-feedback interventions.