Resting-State Network Plasticity Induced by Music Therapy after Traumatic Brain Injury

Traumatic brain injury (TBI) is characterized by a complex pattern of abnormalities in resting-state functional connectivity (rsFC) and network dysfunction, which can potentially be ameliorated by rehabilitation. In our previous randomized controlled trial, we found that a 3-month neurological music therapy intervention enhanced executive function (EF) and increased grey matter volume in the right inferior frontal gyrus (IFG) in patients with moderate-to-severe TBI ( N = 40 ). Extending this study, we performed longitudinal rsFC analyses of resting-state fMRI data using a ROI-to-ROI approach assessing within-network and between-network rsFC in the frontoparietal (FPN), dorsal attention (DAN), default mode (DMN), and salience (SAL) networks, which all have been associated with cognitive impairment after TBI. We also performed a seed-based connectivity analysis between the right IFG and whole-brain rsFC. The results showed that neurological music therapy increased the coupling between the FPN and DAN as well as between these networks and primary sensory networks. By contrast, the DMN was less connected with sensory networks after the intervention. Similarly, there was a shift towards a less connected state within the FPN and SAL networks, which are typically hyperconnected following TBI. Improvements in EF were correlated with rsFC within the FPN and between the DMN and sensorimotor networks. Finally, in the seed-based connectivity analysis, the right IFG showed increased rsFC with the right inferior parietal and left frontoparietal (Rolandic operculum) regions. Together, these results indicate that the rehabilitative effects of neurological music therapy after TBI are underpinned by a pattern of within- and between-network connectivity changes in cognitive networks as well as increased connectivity between frontal and parietal regions associated with music processing.

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Resting-state network plasticity induced by music therapy after traumatic brain injury

10.1101/2020.05.29.20116509 ◽

2020 ◽

Author(s):

Noelia Martinez-Molina ◽

Sini-Tuuli Siponkoski ◽

Linda Kuusela ◽

Sari Laitinen ◽

Milla Holma ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Music Therapy ◽

Resting State ◽

Musical Training ◽

Controlled Trial ◽

Brain Network ◽

Grey Matter Volume ◽

Resting State Functional Connectivity ◽

Brain Morphometry

Traumatic brain injury (TBI) is characterized by a complex pattern of abnormalities in resting-state functional connectivity (rsFC), and neuropathology focused on network dysfunction. Here we report a fMRI study of brain network changes induced during a randomised controlled trial of neurological music therapy in 23 moderate/severe TBI patients. Our ROI-to- ROI approach used four networks as sources: the frontoparietal (FPN), dorsal attention (DAN), default mode (DMN), and salience (SAL) networks. These networks include high-degree nodes or network hubs, and have all been associated with cognitive impairment after TBI. Furthermore, we investigated the correlation between brain network changes and executive function (EF). Lastly, we implemented a seed-to-voxel analysis to cross-link whole-brain rsFC with brain morphometry results obtained in our previous study of this data. The neurological music therapy increased the coupling between the FPN and DAN as well as between these networks and primary sensory networks that were engaged during musical training. By contrast, the DMN was less connected with sensory networks after the intervention. Similarly, there was a shift towards a less connected state within the FPN and SAL networks, which are typically hyperconnected following TBI. Improvements in EF were correlated with rsFC within the FPN and between the DMN and sensorimotor networks. Finally, the increase in grey matter volume in frontal regions was associated with greater rsFC in areas implicated in music processing. This study is the largest of its kind, and suggests that rsFC in response to music-based rehabilitation may provide sensitive biomarkers of cognitive recovery after TBI.

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Severities in persistent mild traumatic brain injury related headache is associated with changes in supraspinal pain modulatory functions

Molecular Pain ◽

10.1177/17448069211037881 ◽

2021 ◽

Vol 17 ◽

pp. 174480692110378

Author(s):

Matthew Flowers ◽

Albert Leung ◽

Dawn M Schiehser ◽

Valerie Metzger-Smith ◽

Lisa Delano-Wood ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Parietal Cortex ◽

Resting State ◽

Premotor Cortex ◽

Sensory Response ◽

Control Group ◽

The Right ◽

Mild Headache

Emerging evidence suggests mild traumatic brain injury related headache (MTBI-HA) is a form of neuropathic pain state. Previous supraspinal mechanistic studies indicate patients with MTBI-HA demonstrate a dissociative state with diminished levels of supraspinal prefrontal pain modulatory functions and enhanced supraspinal sensory response to pain in comparison to healthy controls. However, the relationship between supraspinal pain modulatory functional deficit and severity of MTBI-HA is largely unknown. Understanding this relationship may provide enhanced levels of insight about MTBI-HA and facilitate the development of treatments. This study assessed pain related supraspinal resting states among MTBI-HA patients with various headache intensity phenotypes with comparisons to controls via functional magnetic resonance imaging (fMRI). Resting state fMRI data was analyzed with self-organizing-group-independent-component-analysis in three MTBI-HA intensity groups (mild, moderate, and severe) and one control group (n = 16 per group) within a pre-defined supraspinal pain network based on prior studies. In the mild-headache group, significant increases in supraspinal function were observed in the right premotor cortex (T = 3.53, p < 0.001) and the left premotor cortex (T = 3.99, p < 0.0001) when compared to the control group. In the moderate-headache group, a significant (T = −3.05, p < 0.01) decrease in resting state activity was observed in the left superior parietal cortex when compared to the mild-headache group. In the severe-headache group, significant decreases in resting state supraspinal activities in the right insula (T = −3.46, p < 0.001), right premotor cortex (T = −3.30, p < 0.01), left premotor cortex (T = −3.84, p < 0.001), and left parietal cortex (T = −3.94, p < 0.0001), and an increase in activity in the right secondary somatosensory cortex (T = 4.05, p < 0.0001) were observed when compared to the moderate-headache group. The results of the study suggest that the increase in MTBI-HA severity may be associated with an imbalance in the supraspinal pain network with decline in supraspinal pain modulatory function and enhancement of sensory/pain decoding.

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