Network co-activation relates to executive function following pediatric traumatic brain injury

This study investigated functional connectivity in the default mode, central executive, dorsal attention, and salience networks (SN) and its relation to executive function in youth with traumatic brain injury.

Twenty-three youth with traumatic brain injury (11 with moderate-to-severe injury (6 male, m_age = 11.78 ± 2.68 years, m_{timesinceinjury} = 3.71 ± 2.43 years) and 12 with complicated-mild injury (9 male, m_age = 12.59 ± 1.99 years, m_{timesinceinjury} = 4.55 ± 1.59 years) and 17 youth with orthopedic injury (11 male, m_age = 11.75 ± 2.12 years, m_{timesinceinjury} = 3.95 ± 1.79 years)) completed resting-state functional magnetic resonance imaging and a parent rated their child's executive function.

We found group differences in the strength of connectivity among four regions in the default mode network (DMN) and two regions of the SN, ps < .05, Eta² = .151-.229. The orthopedic injury group demonstrated significant negative between-network connectivity, while brain injury groups had negligible negative or, in some cases, positive between-network associations. Groups did not differ on parent ratings of executive function, as all groups fell above the normative mean, reflecting poorer than expected everyday executive behavior. Attenuation of typical negative between-network association between the posterior cingulate in the DMN and two regions of the salience network was associated with worse parent-rated executive behavior (rs = .291-.317, ps < .05).

Findings illustrate the implications of disrupted downregulation of the default mode network by the SN following pediatric brain injury. They also demonstrate how disruption in functional connectivity may underlie poor executive function after childhood traumatic brain injury.