Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States of America.
Department of Physical Medicine and Rehabilitation, Rutgers University-New Jersey Medical School, Newark, NJ, United States of America.
J Neural Eng. 2024 Sep 12;21(5). doi: 10.1088/1741-2552/ad7320.
Balance impairment is one of the most debilitating consequences of traumatic brain injury (TBI). To study the neurophysiological underpinnings of balance impairment, the brain functional connectivity during perturbation tasks can provide new insights. To better characterize the association between the task-relevant functional connectivity and the degree of balance deficits in TBI, the analysis needs to be performed on the data stratified based on the balance impairment. However, such stratification is not straightforward, and it warrants a data-driven approach.We conducted a study to assess the balance control using a computerized posturography platform in 17 individuals with TBI and 15 age-matched healthy controls. We stratified the TBI participants into balance-impaired and non-impaired TBI using-means clustering of either center of pressure (COP) displacement during a balance perturbation task or Berg Balance Scale score as a functional outcome measure. We analyzed brain functional connectivity using the imaginary part of coherence across different cortical regions in various frequency bands. These connectivity features are then studied using the mean-centered partial least squares correlation analysis, which is a multivariate statistical framework with the advantage of handling more features than the number of samples, thus making it suitable for a small-sample study.Based on the nonparametric significance testing using permutation and bootstrap procedure, we noticed that the weakened theta-band connectivity strength in the following regions of interest significantly contributed to distinguishing balance impaired from non-impaired population, regardless of the type of stratification:, andIdentifying neural regions linked to balance impairment enhances our understanding of TBI-related balance dysfunction and could inform new treatment strategies. Future work will explore the impact of balance platform training on sensorimotor and visuomotor connectivity.
平衡障碍是创伤性脑损伤 (TBI) 最致残的后果之一。为了研究平衡障碍的神经生理基础，可以提供大脑在扰动任务期间的功能连接提供新的见解。为了更好地描述 TBI 中与任务相关的功能连接与平衡缺陷程度之间的关联，需要根据平衡障碍对数据进行分层分析。然而，这种分层并不简单，需要采用数据驱动的方法。我们进行了一项研究，使用计算机平衡测试平台评估 17 名 TBI 患者和 15 名年龄匹配的健康对照者的平衡控制能力。我们使用压力中心（COP）位移或伯格平衡量表评分作为功能结果测量指标，通过均值聚类对 TBI 患者进行分层，分为平衡受损和非平衡受损 TBI 患者。我们分析了不同皮质区域在不同频带中的相干性的虚部，以获得脑功能连接。然后，我们使用均中心化偏最小二乘相关分析来研究这些连接特征，这是一种具有处理比样本数量更多特征的优势的多变量统计框架，因此非常适合小样本研究。通过使用置换和自举程序的非参数显著性检验，我们注意到，以下感兴趣区域中θ波段连接强度的减弱与区分平衡受损和非受损人群有显著关系，无论分层类型如何：和。确定与平衡障碍相关的神经区域可以增强我们对 TBI 相关平衡功能障碍的理解，并为新的治疗策略提供信息。未来的工作将探索平衡平台训练对感觉运动和视觉运动连接的影响。
