Early Changes in Cortical Emotion Processing Circuits after Mild Traumatic Brain Injury from Motor Vehicle Collision

Abstract

Mild traumatic brain injury (mTBI) patients frequently experience emotion dysregulation symptoms, including post-traumatic stress. Although mTBI likely affects cortical activation and structure, resulting in cognitive symptoms after mTBI, early effects of mTBI on cortical emotion processing circuits have rarely been examined. To assess early mTBI effects on cortical functional and structural components of emotion processing, we assessed cortical activation to fearful faces within the first 2 weeks after motor vehicle collision (MVC) in survivors who did and did not experience mTBI. We also examined the thicknesses of cortical regions with altered activation. MVC survivors with mTBI (n = 21) had significantly less activation in left superior parietal gyrus (SPG) (-5.9, -81.8, 33.8; p = 10), left medial orbitofrontal gyrus (mOFG) (-4.7, 36.1, -19.3; p = 10), and left and right lateral orbitofrontal gyri (lOFG) (left: -16.0, 41.4, -16.6; p = 10; right: 18.7, 22.7, -17.7; p = 10) than MVC survivors without mTBI (n = 23). SPG activation in mTBI survivors within 2 weeks after MVC was negatively correlated with subsequent post-traumatic stress symptom severity at 3 months (r = -0.68, p = 0.03). Finally, the SPG region was thinner in the mTBI survivors than in the non-mTBI survivors (F = 11.07, p = 0.002). These results suggest that early differences in activation and structure in cortical emotion processing circuits in trauma survivors who sustain mTBI may contribute to the development of emotion-related symptoms.

Concussion and the autonomic nervous system: An introduction to the field and the results of a systematic review

“…Some authors have found correlates between level of emotional distress after concussion and autonomic anomalies. It is unclear at this point to what extent the emotional impact of concussion reflects the physiologic impact of situational/physical/emotional stressors associated with the injury or direct physiologic impact of the injury to the emotional circuitry in the brain ( X. Wang et al, 2017 ). It is also unclear to what extent circuitry associated with resilience, such as pain resilience might also be compromised ( Leung et al, 2016 ).…”

An integrated perspective linking physiological and psychological consequences of mild traumatic brain injury

“…One of the most important top-down emotion regulation strategies is cognitive reappraisal, which refers to the process of rethinking negative thoughts and changing them into more neutral or perhaps even positive thoughts [58]. Top-down emotion regulation is mainly conducted using the executive network, a network that is also important for cognitive performance [17,57,59]. Neural networks that play a pivotal role in emotion regulation are depicted in Fig.…”

“…To our best knowledge, only two studies have been published that used emotion regulation fMRI paradigms in mTBI. One study demonstrated lower activity in the orbitofrontal cortex and superior parietal lobe during bottom-up emotion induction (i.e., condition in which subjects had to judge whether an angry, fearful or neutral face belonged to a male or female), possibly indicating impaired emotion regulation [59]. These findings were related to higher post-traumatic stress scores.…”

Noninvasive magnetic resonance imaging techniques in mild traumatic brain injury research and diagnosis

“…SEAT : Left superior parietal gyrus and left medial orbitofrontal gyrus, and lateral orbitofrontal gyri bilaterally (Wang et al, 2017)…”

“…Most of the recent studies have used working memory tasks (N‐back) for their ease of presentation in the scanner as well as for their sensitivity to alterations in brain activity. Other tasks proven to be useful in studies on the role of fMRI in the diagnosis of mTBI are, among others, the spatial navigation task (Holmes et al, 2019; Saluja et al, 2015), the Flanker task (Sullivan, Hayes, Lafleche, Salat, & Verfaellie, 2018), the Shifted‐attention Emotion Appraisal Task (SEAT; Wang et al, 2017) and the visual tracking eye movement tests (Astafiev et al, 2015).…”