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Disrupted Structural Connectome Is Associated with Both Psychometric and Real-World Neuropsychological Impairment in Diffuse Traumatic Brain Injury

Published online by Cambridge University Press:  07 October 2014

Junghoon Kim ,
Drew Parker ,
John Whyte ,
Tessa Hart ,
John Pluta ,
Madhura Ingalhalikar ,
H. B. Coslett  and
Ragini Verma
Junghoon Kim*
Affiliation:
Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania
Drew Parker
Affiliation:
Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
John Whyte
Affiliation:
Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania
Tessa Hart
Affiliation:
Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania
John Pluta
Affiliation:
Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
Madhura Ingalhalikar
Affiliation:
Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
H. B. Coslett
Affiliation:
Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
Ragini Verma
Affiliation:
Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
*
Correspondence and reprint requests to: Junghoon Kim, Department of Physiology, Pharmacology, and Neuroscience, Sophie Davis School of Biomedical Education, The City College of New York, 160 Convent Avenue, New York, NY 10031. E-mail: jkim@med.cuny.edu
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Abstract

Traumatic brain injury (TBI) is likely to disrupt structural network properties due to diffuse white matter pathology. The present study aimed to detect alterations in structural network topology in TBI and relate them to cognitive and real-world behavioral impairment. Twenty-two people with moderate to severe TBI with mostly diffuse pathology and 18 demographically matched healthy controls were included in the final analysis. Graph theoretical network analysis was applied to diffusion tensor imaging (DTI) data to characterize structural connectivity in both groups. Neuropsychological functions were assessed by a battery of psychometric tests and the Frontal Systems Behavior Scale (FrSBe). Local connection-wise analysis demonstrated reduced structural connectivity in TBI arising from subcortical areas including thalamus, caudate, and hippocampus. Global network metrics revealed that shortest path length in participants with TBI was longer compared to controls, and that this reduced network efficiency was associated with worse performance in executive function and verbal learning. The shortest path length measure was also correlated with family-reported FrSBe scores. These findings support the notion that the diffuse form of neuropathology caused by TBI results in alterations in structural connectivity that contribute to cognitive and real-world behavioral impairment. (JINS, 2014, 20, 1–10)

Keywords

Graph theoryDiffusion tensor imagingObservational rating scalesFrontal Systems Behavior ScaleExecutive functionVerbal learning
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 20 , Supplement 9 , October 2014 , pp. 887 - 896
Copyright
Copyright © The International Neuropsychological Society 2014 

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