Proactive inhibition deficits with normal perfusion after pediatric mild traumatic brain injury

Mayer, Andrew R.; Stephenson, David D.; Wertz, Christopher J.; Dodd, Andrew B.; Shaff, Nicholas A.; Ling, Josef M.; Park, Grace; Oglesbee, Scott; Wasserott, Ben C.; Meier, Timothy B.; Witkiewitz, Katie; Campbell, Richard A.; Yeo, Ronald A.; Phillips, J. P.; Quinn, Davin K.; Pottenger, Amy

doi:10.1002/hbm.24778

Cited by 16 publications

(31 citation statements)

References 54 publications

(80 reference statements)

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“…In the regional analysis of cerebral perfusion, an effect of tDCS was observed, with reductions of CBF occurring in the right IFG in the sham group, and increases of CBF in the right IFG of the active group. Although FDR correction resulted in nonsignificance, this finding is still of some interest, as there is theoretical and empirical basis for altered right prefrontal and right fronto-parietal perfusion after mTBI (32,(73)(74)(75). The right frontoparietal network is implicated in lateralization of cognitive and emotional functions, including inhibition (76), visual attention, and emotional sham.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Perfusion Effects of Cognitive Training and Transcranial Direct Current Stimulation in Mild-Moderate TBI

et al. 2020

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Background: Persistent post-traumatic symptoms (PPS) after traumatic brain injury (TBI) can lead to significant chronic functional impairment. Pseudocontinuous arterial spin labeling (pCASL) has been used in multiple studies to explore changes in cerebral blood flow (CBF) that may result in acute and chronic TBI, and is a promising neuroimaging modality for assessing response to therapies. Methods: Twenty-four subjects with chronic mild-moderate TBI (mmTBI) were enrolled in a pilot study of 10 days of computerized executive function training combined with active or sham anodal transcranial direct current stimulation (tDCS) for treatment of cognitive PPS. Behavioral surveys, neuropsychological testing, and magnetic resonance imaging (MRI) with pCASL sequences to assess global and regional CBF were obtained before and after the training protocol. Results: Robust improvements in depression, anxiety, complex attention, and executive function were seen in both active and sham groups between the baseline and post-treatment visits. Global CBF decreased over time, with differences in regional CBF noted in the right inferior frontal gyrus (IFG). Active stimulation was associated with static or increased CBF in the right IFG, whereas sham was associated with reduced CBF. Neuropsychological performance and behavioral symptoms were not associated with changes in CBF. Discussion: The current study suggests a complex picture between mmTBI, cerebral perfusion, and recovery. Changes in CBF may result from physiologic effect of the intervention, compensatory neural mechanisms, or confounding factors. Limitations include a small sample size and heterogenous injury sample, but these findings suggest promising directions for future studies of cognitive training paradigms in mmTBI.

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Section: Discussionmentioning

confidence: 99%

Cerebral Perfusion Effects of Cognitive Training and Transcranial Direct Current Stimulation in Mild-Moderate TBI

et al. 2020

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“…This concept was further supported in this study which also found that active tDCS was associated with increased CBF in the right inferior frontal gyrus, a brain area likely under the anode, whereas regional CBF of this same area was reduced in sham; although this finding again did not survive statistical correction. Nevertheless, this was interesting because of theoretical and empirical findings that have indicated different right prefrontal and right frontoparietal perfusions after mTBI [ 76 , 79 , 80 , 81 ]. The latter region is likely part of a network that has been associated with inhibition [ 82 ], visual attention, and emotion.…”

Section: Resultsmentioning

confidence: 99%

Transcranial Direct Current Stimulation as a Treatment Tool for Mild Traumatic Brain Injury

Rudroff

Workman

2021

Brain Sciences

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Mild traumatic brain injury (mTBI) has been defined as a transient (<24 h) condition of confusion and/or loss of consciousness for less than 30 min after brain injury and can result in short- and long-term motor and cognitive impairments. Recent studies have documented the therapeutic potential of non-invasive neuromodulation techniques for the enhancement of cognitive and motor function in mTBI. Alongside repetitive transcranial magnetic stimulation (rTMS), the main technique used for this purpose is transcranial direct current stimulation (tDCS). The focus of this review was to provide a detailed, comprehensive (i.e., both cognitive and motor impairment) overview of the literature regarding therapeutic tDCS paradigms after mTBI. A publication search of the PubMed, Scopus, CINAHL, and PsycINFO databases was performed to identify records that applied tDCS in mTBI. The publication search yielded 14,422 records from all of the databases, however, only three met the inclusion criteria and were included in the final review. Based on the review, there is limited evidence of tDCS improving cognitive and motor performance. Surprisingly, there were only three studies that used tDCS in mTBI, which highlights an urgent need for more research to provide additional insights into ideal therapeutic brain targets and optimized stimulation parameters.

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“…Participants were from an ongoing study examining biomarkers in pmTBI [ 36 ]. Inclusion criteria for mTBI participants were based on the American Congress of Rehabilitation Medicine and the Zurich Concussion in Sport Group guidelines (see details in Supplemental Materials).…”

Section: Methodsmentioning

confidence: 99%

DNA methylation under the major depression pathway predicts pediatric quality of life four-month post-pediatric mild traumatic brain injury

et al. 2021

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Background Major depression has been recognized as the most commonly diagnosed psychiatric complication of mild traumatic brain injury (mTBI). Moreover, major depression is associated with poor outcomes following mTBI; however, the underlying biological mechanisms of this are largely unknown. Recently, genomic and epigenetic factors have been increasingly implicated in the recovery following TBI. Results This study leveraged DNA methylation within the major depression pathway, along with demographic and behavior measures (features used in the clinical model) to predict post-concussive symptom burden and quality of life four-month post-injury in a cohort of 110 pediatric mTBI patients and 87 age-matched healthy controls. The results demonstrated that including DNA methylation markers in the major depression pathway improved the prediction accuracy for quality of life but not persistent post-concussive symptom burden. Specifically, the prediction accuracy (i.e., the correlation between the predicted value and observed value) of quality of life was improved from 0.59 (p = 1.20 × 10–3) (clinical model) to 0.71 (p = 3.89 × 10–5); the identified cytosine-phosphate-guanine sites were mainly in the open sea regions and the mapped genes were related to TBI in several molecular studies. Moreover, depression symptoms were a strong predictor (with large weights) for both post-concussive symptom burden and pediatric quality of life. Conclusion This study emphasized that both molecular and behavioral manifestations of depression symptoms played a prominent role in predicting the recovery process following pediatric mTBI, suggesting the urgent need to further study TBI-caused depression symptoms for better recovery outcome.

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Proactive inhibition deficits with normal perfusion after pediatric mild traumatic brain injury

Cited by 16 publications

References 54 publications

Cerebral Perfusion Effects of Cognitive Training and Transcranial Direct Current Stimulation in Mild-Moderate TBI

Cerebral Perfusion Effects of Cognitive Training and Transcranial Direct Current Stimulation in Mild-Moderate TBI

Transcranial Direct Current Stimulation as a Treatment Tool for Mild Traumatic Brain Injury

DNA methylation under the major depression pathway predicts pediatric quality of life four-month post-pediatric mild traumatic brain injury

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