Resting-State Network Plasticity Induced by Music Therapy after Traumatic Brain Injury

Abstract

Traumatic brain injury (TBI) is characterized by a complex pattern of abnormalities in resting-state functional connectivity (rsFC) and network dysfunction, which can potentially be ameliorated by rehabilitation. In our previous randomized controlled trial, we found that a 3-month neurological music therapy intervention enhanced executive function (EF) and increased grey matter volume in the right inferior frontal gyrus (IFG) in patients with moderate-to-severe TBI ( N = 40 ). Extending this study, we performed longitudinal rsFC analyses of resting-state fMRI data using a ROI-to-ROI approach assessing within-network and between-network rsFC in the frontoparietal (FPN), dorsal attention (DAN), default mode (DMN), and salience (SAL) networks, which all have been associated with cognitive impairment after TBI. We also performed a seed-based connectivity analysis between the right IFG and whole-brain rsFC. The results showed that neurological music therapy increased the coupling between the FPN and DAN as well as between these networks and primary sensory networks. By contrast, the DMN was less connected with sensory networks after the intervention. Similarly, there was a shift towards a less connected state within the FPN and SAL networks, which are typically hyperconnected following TBI. Improvements in EF were correlated with rsFC within the FPN and between the DMN and sensorimotor networks. Finally, in the seed-based connectivity analysis, the right IFG showed increased rsFC with the right inferior parietal and left frontoparietal (Rolandic operculum) regions. Together, these results indicate that the rehabilitative effects of neurological music therapy after TBI are underpinned by a pattern of within- and between-network connectivity changes in cognitive networks as well as increased connectivity between frontal and parietal regions associated with music processing.

The Effect of Repetitive Transcranial Magnetic Stimulation (rTMS) on Cognition in Patients With Traumatic Brain Injury: A Protocol for a Randomized Controlled Trial

“…In the proposed study, resting-state functional magnetic resonance imaging (rs-fMRI) will be used to explore the pathophysiological processes mediating TBI cognitive dysfunction through DLPFC stimulation delivered through rTMS. Disruption of brain network connectivity is an important mechanism leading to cognitive dysfunction in TBI ( 40 ); cognitive dysfunction may be primarily associated with disruptions to the default mode network (DMN) ( 41 , 42 ). The DMN is a task-negative network that is preferentially activated when the individual is not concerned with the external environment and involves several internal cognitions, such as autobiographical memory extraction, looking into the future, envisioning others' perspectives, and processing emotional cognition ( 43 ).…”

Resting-State Functional Connectivity following Phonological Component Analysis: The Combined Action of Phonology and Visual Orthographic Cues

“…In this paper, the authors wish to disclose two limitations from the rs-fMRI data preprocessing. First, regarding the outlier detection, although the parameters used are commonly applied in the clinical studies [ 34 , 58 , 59 , 60 ], using liberal settings leads to higher frame-wise displacement values, which can have an impact on the results. Second, the lesion was segmented and regressed out as CSF.…”

“…Images were slice-time corrected with reference to the acquisition time of the middle slice and motion-corrected with 12 motion parameters realignment to the first volume. Outliers were detected using ART (available online: , accessed on 6 September 2016) and defined as volumes with realignment parameters >2 mm and 2 degrees, or with signal intensity changes >4 times the standard deviations, parameters suggested as liberal settings [ 57 ] and used in several recent studies [ 34 , 58 , 59 , 60 ]. The T1 structural volume was co-registered and segmented into gray matter, white matter, and cerebrospinal fluid (CSF).…”

“…An ROI-to-ROI analysis was conducted by computing the Fisher-transformed bivariate correlation coefficients between the time-series of each pair of ROIs. The bivariate correlation is preferred to facilitate comparing results throughout studies in the field in the future [ 34 , 60 ]. The whole brain was parcellated into 132 structurally homogenous ROIs, per the FSL Harvard-Oxford atlas for the gray matter and subcortical regions.…”

Neuropsychiatric Treatment for Mild Traumatic Brain Injury: Nonpharmacological Approaches

“…140 Mechanistically, MuBIs appear to engage both cortical and subcortical areas governing attention, working memory, planning, and flexibility and can modulate these areas over time. 140 143 In more recent years, a growing understanding of neuroscientific underpinnings of music processing has allowed more precise targeting of specific cognitive domains. 144 145 This has led to growing calls for the integration of MuBIs in the care pathway of TBI, particularly to target postconcussive cognitive impairment, and for more research to be done in this area.…”