Department of Physical Therapy, High Point University, High Point, North Carolina, USA.
Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, Kentucky, USA.
Brain Inj. 2021 Sep 19;35(11):1326-1337. doi: 10.1080/02699052.2021.1972339. Epub 2021 Sep 6.
Mild traumatic brain injuries (mTBI) are associated with functional network connectivity alterations throughout recovery. Yet, little is known about the adaptive or maladaptive nature of post-mTBI connectivity and which networks are predisposed to altered function and adaptation. The objective of this review was to determine functional connectivity changes post-mTBI and to determine the adaptive or maladaptive nature of connectivity through direct comparisons of connectivity and behavioral data. Literature was systematically searched and appraised for methodological quality. A total of 16 articles were included for review. There was conflicting evidence of post-mTBI connectivity responses as decreased connectivity was noted in 4 articles, 6 articles reported increased connectivity, 5 reported a mixture of increased and decreased connectivity, while 1 found no differences in connectivity. Supporting evidence for adaptive post-mTBI increases in connectivity were found, particularly in the frontoparietal, cerebellar, and default mode networks. Although initial results are promising, continued longitudinal research that systematically controls for confounding variables and that standardizes methodologies is warranted to adequately understand the neurophysiological recovery trajectory of mTBI.
轻度创伤性脑损伤(mTBI)与恢复过程中功能网络连接的改变有关。然而,人们对 post-mTBI 连接的适应性或不良性本质以及哪些网络容易发生功能改变和适应性改变知之甚少。本综述的目的是确定 mTBI 后功能连接的变化,并通过直接比较连接和行为数据来确定连接的适应性或不良性本质。系统地搜索和评估文献以确定其方法学质量。共有 16 篇文章被纳入综述。mTBI 后连接反应的证据相互矛盾,有 4 篇文章报道连接减少,6 篇文章报道连接增加,5 篇文章报道连接增加和减少混合,1 篇文章报道连接无差异。有证据表明,mTBI 后连接适应性增加,特别是在前顶叶、小脑和默认模式网络中。尽管初步结果很有希望,但需要进行持续的纵向研究,系统地控制混杂变量并标准化方法,以充分了解 mTBI 的神经生理恢复轨迹。