Citation

Sours C, Raghavan P, Medina de Jesus A, Roys SR, Jiang L, Zhuo J, Gullapalli RP. J. Neurotrauma 2016; 34(7): 1473-1481.

Affiliation

University of Maryland School of Medicine, Department of Diagnostic Radiology & Nuclear Medicine , 22 S. Greene St , Baltimore, Maryland, United States , 21201 ; rgullapalli@umm.edu.

Copyright

(Copyright © 2016, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2016.4570

PMID

27931179

Abstract

Severe and Moderate TBI (sTBI) often results in long-term cognitive deficits such as reduced processing speed and attention. The intraparietal sulcus (IPS) is a neocortical structure that plays a crucial role in the deeply interrelated processes of multisensory processing and top down attention. Therefore, we hypothesized that disruptions in the functional and structural connections of the IPS may play a role in the development of such deficits. To examine these connections we used resting state fMRI (rsfMRI) and diffusion kurtosis imaging (DKI) in a cohort of 27 sTBI patients (29.3±8.9yrs) and 27 control participants (29.8±10.3yrs). Participants were prospectively recruited and received rsfMRI and neuropsychological assessments including the Automated Neuropsychological Assessment Metrics (ANAM) at greater than 6 months post injury. A subset of participants received a DKI scan.

RESULTS suggest that sTBI patients performed worse than controls on multiple subtests of the ANAM suggesting reduced cognitive performance. Reduced resting state functional between the IPS and cortical regions associated with multisensory processing and the dorsal attention network was observed in the sTBI patients. The patients also showed reduced structural integrity of the Superior Longitudinal Fasciculus (SLF), a key white matter tract connecting the IPS to anterior frontal areas, as measured by reduced mean kurtosis (MK) and fractional anisotropy (FA) and increased mean diffusivity (MD). Furthermore, this reduced structural integrity of the SLF was associated with a reduction in overall cognitive performance. These findings suggest that disruptions in the structural and functional connectivity of the IPS may contribute to chronic cognitive deficits experienced by these patients.

Language: en