White matter microstructure of the neural emotion regulation circuitry in mild traumatic brain injury

Horn, Harm Jan van der; Mangina, Namrata R.; Rakers, Sandra E.; Kok, J G M; Timmerman, Marieke E.; Leemans, Alexander; Spikman, Jacoba M.; Naalt, Joukje van der

doi:10.1111/ejn.15199

Cited by 6 publications

(4 citation statements)

References 54 publications

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“…We predicted that a personality profile associated with emotional instability would be related to poor long-term outcome, and that patients with a more emotionally unstable profile would spend more time in states that are associated with internal mentation (e.g., with a dominance of the default mode network) and would show fewer state transitions (i.e., more rigid/less flexible dFNC). We anticipated that this would be accompanied by little or no changes in dMRI measures, in accordance with our previous work [25].…”

Section: Introductionsupporting

confidence: 75%

“…It is not unlikely that perturbations in the neural circuitry that is involved in emotion regulation, which is closely related to personality traits, may result in poor recovery [23,24]. This might also be related to microstructural injury to underlying white matter tracts, although our previous work has not shown strong evidence for this [25]. Alternatively, pre-existent neural configurations of this circuitry might determine recovery after a mTBI.…”

Section: Introductionmentioning

confidence: 99%

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Dynamic phase-locking states and personality in sub-acute mild traumatic brain injury: An exploratory study

van der Horn,

de Koning,

Visser

et al. 2023

PLoS ONE

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Research has shown that maladaptive personality characteristics, such as Neuroticism, are associated with poor outcome after mild traumatic brain injury (mTBI). The current exploratory study investigated the neural underpinnings of this process using dynamic functional network connectivity (dFNC) analyses of resting-state (rs) fMRI, and diffusion MRI (dMRI). Twenty-seven mTBI patients and 21 healthy controls (HC) were included. After measuring the Big Five personality dimensions, principal component analysis (PCA) was used to obtain a superordinate factor representing emotional instability, consisting of high Neuroticism, moderate Openness, and low Extraversion, Agreeableness, and Conscientiousness. Persistent symptoms were measured using the head injury symptom checklist at six months post-injury; symptom severity (i.e., sum of all items) was used for further analyses. For patients, brain MRI was performed in the sub-acute phase (~1 month) post-injury. Following parcellation of rs-fMRI using independent component analysis, leading eigenvector dynamic analysis (LEiDA) was performed to compute dynamic phase-locking brain states. Main patterns of brain diffusion were computed using tract-based spatial statistics followed by PCA. No differences in phase-locking state measures were found between patients and HC. Regarding dMRI, a trend significant decrease in fractional anisotropy was found in patients relative to HC, particularly in the fornix, genu of the corpus callosum, anterior and posterior corona radiata. Visiting one specific phase-locking state was associated with lower symptom severity after mTBI. This state was characterized by two clearly delineated communities (each community consisting of areas with synchronized phases): one representing an executive/saliency system, with a strong contribution of the insulae and basal ganglia; the other representing the canonical default mode network. In patients who scored high on emotional instability, this relationship was even more pronounced. Dynamic phase-locking states were not related to findings on dMRI. Altogether, our results provide preliminary evidence for the coupling between personality and dFNC in the development of long-term symptoms after mTBI.

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Section: Introductionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Dynamic phase-locking states and personality in sub-acute mild traumatic brain injury: An exploratory study

van der Horn,

de Koning,

Visser

et al. 2023

PLoS ONE

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“…Although findings are mixed in the MTBI literature, most studies report greater diffusion deviations in complicated MTBI. 16 , 53-55 It should, however, be noted that patients with microbleeds, commonly used as a surrogate for axonal injury (which 11 of the patients with complicated MTBI in the present cohort had), do not necessarily have diffusion alterations. 51 PTA, a commonly used marker of injury severity, could also be expected to be associated with greater diffusion alterations, but it was not in the present study.…”

Section: Discussionmentioning

confidence: 77%

“…Surprisingly, in clusters where the group*time interaction was significant, this could be ascribed to change in the control group. In many previous longitudinal studies, 13 , 16 , 22-24 , 28 the control group was scanned once, and the results from this single time-point were compared with the repeated diffusion data from the MTBI group.…”

Section: Discussionmentioning

confidence: 99%

Diffusion Tensor and Kurtosis Imaging Findings the First Year following Mild Traumatic Brain Injury

Stenberg

Skandsen

Moen

et al. 2023

Journal of Neurotrauma

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Despite enormous research interest in diffusion tensor imaging and diffusion kurtosis imaging (DTI; DKI) following mild traumatic brain injury (MTBI), it remains unknown how diffusion in white matter evolves post-injury and relates to acute MTBI characteristics. This prospective cohort study aimed to characterize diffusion changes in white matter the first year after MTBI. Patients with MTBI ( n = 193) and matched controls ( n = 83) underwent 3T magnetic resonance imaging (MRI) within 72 h and 3- and 12-months post-injury. Diffusion data were analyzed in three steps: 1) voxel-wise comparisons between the MTBI and control group were performed with tract-based spatial statistics at each time-point; 2) clusters of significant voxels identified in step 1 above were evaluated longitudinally with mixed-effect models; 3) the MTBI group was divided into: (A) complicated (with macrostructural findings on MRI) and uncomplicated MTBI; (B) long (1-24 h) and short (< 1 h) post-traumatic amnesia (PTA); and (C) other and no other concurrent injuries to investigate if findings in step 1 were driven mainly by aberrant diffusion in patients with a more severe injury. At 72 h, voxel-wise comparisons revealed significantly lower fractional anisotropy (FA) in one tract and significantly lower mean kurtosis (Kmean) in 11 tracts in the MTBI compared with control group. At 3 months, the MTBI group had significantly higher mean diffusivity in eight tracts compared with controls. At 12 months, FA was significantly lower in four tracts and Kmean in 10 tracts in patients with MTBI compared with controls. There was considerable overlap in affected tracts across time, including the corpus callosum, corona radiata, internal and external capsule, and cerebellar peduncles. Longitudinal analyses revealed that the diffusion metrics remained relatively stable throughout the first year after MTBI. The significant group*time interactions identified were driven by changes in the control rather than the MTBI group. Further, differences identified in step 1 did not result from greater diffusion abnormalities in patients with complicated MTBI, long PTA, or other concurrent injuries, as standardized mean differences in diffusion metrics between the groups were small (0.07 ± 0.11) and non-significant. However, follow-up voxel-wise analyses revealed that other concurrent injuries had effects on diffusion metrics, but predominantly in other metrics and at other time-points than the effects observed in the MTBI versus control group analysis. In conclusion, patients with MTBI differed from controls in white matter integrity already 72 h after injury. Diffusion metrics remained relatively stable throughout the first year after MTBI and were not driven by deviating diffusion in patients with a more severe MTBI.

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An exploratory study on the association between blood-based biomarkers and subacute neurometabolic changes following mild traumatic brain injury

Visser,

de Koning,

Ciubotariu

et al. 2023

J Neurol

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White matter microstructure of the neural emotion regulation circuitry in mild traumatic brain injury

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 6 publications

References 54 publications

Dynamic phase-locking states and personality in sub-acute mild traumatic brain injury: An exploratory study

Dynamic phase-locking states and personality in sub-acute mild traumatic brain injury: An exploratory study

Diffusion Tensor and Kurtosis Imaging Findings the First Year following Mild Traumatic Brain Injury

An exploratory study on the association between blood-based biomarkers and subacute neurometabolic changes following mild traumatic brain injury

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