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Hyper-connectivity of the thalamus during early stages following mild traumatic brain injury

  • Military/Veteran TBI
  • Published:
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Abstract

The thalamo-cortical resting state functional connectivity of seven sub-thalamic regions were examined in a prospectively recruited population of 77 acute mild TBI (mTBI) patients within the first 10 days (mean 6 ± 3 days) of injury and 35 neurologically intact control subjects using the Oxford thalamic connectivity atlas. Neuropsychological assessments were conducted using the Automated Neuropsychological Assessment Metrics (ANAM). A subset of participants received a magentic resonance spectroscopy (MRS) exam to determine metabolite concentrations in the thalamus and the posterior cingulate cortex. Results show that patients performed worse than the control group on various subtests of ANAM and the weighted throughput score, suggesting reduced cognitive performance at this early stage of injury. Both voxel and region of interest based analysis of the resting state fMRI data demonstrated that acute mTBI patients have increased functional connectivity between the various sub-thalamic regions and cortical regions associated with sensory processing and the default mode network (DMN). In addition, a significant reduction in NAA/Cr was observed in the thalamus in the mTBI patients. Furthermore, an increase in Cho/Cr ratio specific to mTBI patients with self-reported sensory symptoms was observed compared to those without self-reported sensory symptoms. These results provide novel insights into the neural mechanisms of the brain state related to internal rumination and arousal, which have implications for new interventions for mTBI patients with persistent symptoms. Furthermore, an understanding of heightened sensitivity to sensory related inputs during early stages of injury may facilitate enhanced prediction of safe return to work.

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Acknowledgments

The authors would like to thank Joshua Betz, Jacqueline Janowich, Teodora Stoica and Joseph Rosenberg for their help with patient recruitment, Dr. Robert Kane for providing access to ANAM, and and George Makris for his help with acquiring and processing the data. Support for this work was in part provided by the Department of Defense (W81XWH-08-1-0725 & W81XWH-12-1-0098 to RPG).

Competing interests

The authors declare that they have no competing interests.

Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, and the applicable revisions at the time of the investigation. Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Magnetic Resonance Research Center, University of Maryland School of Medicine, Baltimore, MD, 21201, USA

    Chandler Sours, Elijah O. George, Jiachen Zhuo, Steven Roys & Rao P. Gullapalli

  2. Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD, 21201, USA

    Chandler Sours, Elijah O. George, Jiachen Zhuo, Steven Roys & Rao P. Gullapalli

  3. Department of Bioengineering, University of Maryland, College Park, MD, 20740, USA

    Elijah O. George & Rao P. Gullapalli

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  1. Chandler Sours
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  2. Elijah O. George
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  3. Jiachen Zhuo
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  4. Steven Roys
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  5. Rao P. Gullapalli
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Corresponding author

Correspondence to Rao P. Gullapalli.

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Sours, C., George, E.O., Zhuo, J. et al. Hyper-connectivity of the thalamus during early stages following mild traumatic brain injury. Brain Imaging and Behavior 9, 550–563 (2015). https://doi.org/10.1007/s11682-015-9424-2

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