Investigating the Associations Between Brain Network Functional Connectivity and Health-Related Quality of Life Following a Pediatric Concussion

Abstract

Concussions negatively affect the health-related quality of life (HRQoL) of children and youth for months post-injury. In addition, connectivity within and between the default mode network (DMN), central executive network (CEN) and salience network (SN) has been shown to be altered post-concussion. Few studies have investigated connectivity within and between these 3 networks following a pediatric concussion and none have assessed its associations with HRQoL.The present study explored whether within and between-network functional connectivity (FC) differs between a pediatric concussion and orthopedic injury (OI) group aged 10-18. In the concussion group, associations between FC of these networks and HRQoL 4 weeks post-injury were also assessed. Participants underwent a resting-state functional magnetic resonance imaging (rs-fMRI) scan and HRQoL was measured with the Pediatric Quality of Life Inventory (PedsQL) at 4 weeks post-injury. One-way ANCOVA analyses were conducted between groups with the seed-based FC of the 3 networks. Multivariate linear regressions were conducted to assess the association between connectivity of the 3 networks and HRQoL. A total of 55/72 concussion and 27/30 OI participants were included in the analyses. Increased within-network FC of the CEN and SN, increased between-network FC of the DMN-SN and CEN-SN, and decreased betweennetwork FC of the DMN-CEN was found in the concussion group when compared to the OI group. No significant associations were found between HRQoL and FC within and between the DMN, CEN and SN 4 weeks after concussion. When compared to OI, differential connectivity patterns are present following a pediatric concussion at 4-weeks post-injury, however, these network differences are not associated with HRQoL.