Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA.
Georgia Statue University/Georgia Tech Center for Advanced Brain Imaging, Atlanta, GA.
J Neuroimaging. 2021 Mar;31(2):277-286. doi: 10.1111/jon.12834. Epub 2021 Jan 21.
Vestibular symptoms after concussion are common and associated with protracted recovery. The purpose of this study is to define resting-state functional MRI (rs-fMRI) brain connectivity alterations in patients with postconcussion vestibular dysfunction (PCVD) and correlations between rs-fMRI connectivity and symptoms provoked during Vestibular/Ocular-Motor Screening (VOMS) assessment.
Prospective IRB approved study.
12 subjects with subacute PCVD (2-10 weeks); control group: 10 age-matched subjects without history of concussion or vestibular impairment. Both groups underwent clinical vestibular assessment. rs-fMRI was acquired on 3.0T Siemens Trio with a 12-channel head coil. rs-fMRI data analysis included independent component analysis-based functional connectivity group differences, graph theory analysis, and ROI-to-ROI connectivity correlation analysis with VOMS clinical derivatives. Group difference maps between resting-state networks were calculated using dual regression method and corrected for multiple comparisons. Correlation analysis between ROI-to-ROI rs-fMRI brain activation and VOMS assessment ratings was performed using Pearson correlation coefficient, with a significance threshold of P ≤ .05.
Compared to controls, PCVD group demonstrated significantly increased rs-fMRI connectivity between the default-mode network and right middle frontal gyrus and right postcentral gyrus; and between a vestibular-sensorimotor network and right prefrontal cortex. Significant positive correlations were found between clinical derivative VOMS scores and components of the vestibular, visual networks, and multisensory processing cortical representations.
Altered rs-fMRI brain connectivity with increased connectivity of visual input, multisensory processing, and spatial memory in PCVD is correlative with clinical derivative VOMS scores, suggesting maladaptive brain plasticity underlying vestibular symptomatology.
脑震荡后前庭症状很常见，且与恢复时间延长有关。本研究旨在确定脑震荡后前庭功能障碍（PCVD）患者静息态功能磁共振成像（rs-fMRI）脑连接改变，并探讨 rs-fMRI 连接与前庭/眼动筛查（VOMS）评估中诱发症状之间的相关性。
前瞻性 IRB 批准的研究。
12 例亚急性 PCVD 患者（2-10 周）；对照组：10 例无脑震荡或前庭功能障碍史的年龄匹配患者。两组均进行了临床前庭评估。rs-fMRI 在 3.0T 西门子 Trio 扫描仪上进行，使用 12 通道头部线圈。rs-fMRI 数据分析包括基于独立成分分析的功能连接组差异、图论分析以及与 VOMS 临床衍生指标的 ROI-ROI 连接相关性分析。使用双回归方法计算静息态网络之间的组差异图，并进行多重比较校正。使用 Pearson 相关系数对 ROI-ROI rs-fMRI 脑激活与 VOMS 评估评分之间的相关性进行分析，显著性阈值为 P≤0.05。
与对照组相比，PCVD 组静息态功能磁共振成像显示默认模式网络与右侧额中回和右侧中央后回之间以及前庭感觉运动网络与右侧前额叶之间的连接明显增加。VOMS 临床衍生指标与前庭、视觉网络和多感觉处理皮质代表的成分之间存在显著正相关。
PCVD 患者 rs-fMRI 脑连接改变，包括视觉输入、多感觉处理和空间记忆连接增加，与 VOMS 临床衍生评分相关，提示前庭症状背后存在适应性脑可塑性。
