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An Investigation of the Default Mode Interference Hypothesis in Mild Traumatic Brain Injury.

机译：轻度颅脑损伤中默认模式干扰假说的调查。

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摘要

Traumatic brain injury (TBI) is a leading cause of death and lifelong disability throughout developed nations, resulting in an emotional burden on the patients and a vast financial burden on the nation. While the majority of these cases are mild in nature, current clinical imaging often fails to perceive the extent of this subtle injury, making it difficult to predict which of these individuals will go on to suffer from persistent post concussive symptoms. Through the use of resting state functional MRI (fMRI), resting state cerebral perfusion, and task based fMRI, we test the hypothesis that the diffuse neuronal damage associated with mild TBI (mTBI) interrupts large-scale network function resulting in cognitive and neuropsychological symptoms. The Default Mode Interference Hypothesis suggests that the interactions within and between the Default Mode Network (DMN), Task Positive Network (TPN), and Salience Network (SN) are associated with cognitive performance. Therefore, we focused our investigation upon these three networks.;Using resting state fMRI on prospectively collected data, our results demonstrate reduced resting state functional connectivity (rs-FC) within the DMN and TPN, but increased rs-FC between the three networks across the acute, sub-acute, and chronic stages of injury. Furthermore, the alterations noted in rs-FC are exacerbated in mTBI patients with persistent symptoms and are associated with reduced cognitive performance. Through the use of resting state cerebral perfusion, our findings demonstrate an altered balance in network perfusion of the DMN and TPN that is more prominent in mTBI patients with greater symptom severity. Finally, through the use of task based fMRI during the N-back working memory paradigm, we note that mTBI patients reveal reduced deactivation of regions of the DMN, over recruitment of regions of the TPN, as well as regions of novel recruitment. Further, mTBI patients demonstrate reduced segregation between the DMN and TPN during the most cognitively demanding task.;These findings provide strong evidence for the Default Mode Interference Hypothesis in mTBI. Through lending support that altered communication within these large-scale neural networks contributes to the persistence of post concussive symptoms, we provide a potential avenue for therapeutic intervention to mitigate post concussive symptoms.
机译：脑外伤（TBI）是导致整个发达国家死亡和终生残疾的主要原因，给患者造成了情绪负担，给国家造成了巨大的经济负担。尽管这些病例中的大多数是轻度的，但当前的临床影像学往往无法察觉这种细微损伤的程度，从而难以预测这些个体中的哪些将继续遭受持续性脑震荡症状的折磨。通过使用静息状态功能MRI（fMRI），静息状态脑灌注和基于任务的fMRI，我们检验了以下假设：与轻度TBI（mTBI）相关的弥漫性神经元损害会破坏大规模网络功能，从而导致认知和神经心理症状。默认模式干扰假说表明，默认模式网络（DMN），任务肯定网络（TPN）和显着网络（SN）内和之间的交互作用与认知能力有关。因此，我们将研究重点放在这三个网络上。通过在预期收集的数据上使用静止状态功能磁共振成像，我们的结果表明DMN和TPN内的静止状态功能连接性（rs-FC）降低，但整个三个网络之间的rs-FC却增加了急性，亚急性和慢性损伤阶段。此外，具有持续症状的mTBI患者会加剧rs-FC中提到的改变，并与认知能力下降相关。通过使用静止状态的脑灌注，我们的发现表明DMN和TPN的网络灌注平衡发生了改变，这在症状严重程度更高的mTBI患者中更为明显。最后，通过在N背工作记忆范例期间使用基于任务的功能磁共振成像，我们注意到mTBI患者显示出DMN区域的失活减少，超过了TPN区域的征募以及新颖募集的区域。此外，在最需要认知的任务中，mTBI患者表现出DMN和TPN之间的隔离减少。;这些发现为mTBI中的默认模式干扰假说提供了有力的证据。通过提供支持，这些大型神经网络中的交流发生改变，有助于持续性脑震荡后症状的发展，我们为缓解脑震荡后症状的治疗干预提供了潜在途径。

著录项

  • 作者

    Sours, Chandler Rebecca.;

  • 作者单位

    University of Maryland, Baltimore.;

  • 授予单位 University of Maryland, Baltimore.;
  • 学科 Biology Neuroscience.;Health Sciences Radiology.;Psychology Physiological.
  • 学位 Ph.D.
  • 年度 2014
  • 页码 182 p.
  • 总页数 182
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 地球物理学;
  • 关键词

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