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Altered Recruitment of the Attention Network Is Associated with Disability and Cognitive Impairment in Pediatric Patients with Acquired Brain Injury.

Strazzer S, Rocca MA, Molteni E, De Meo E, Recla M, Valsasina P, Arrigoni F, Galbiati S, Bardoni A, Filippi M - Neural Plast. (2015)

Bottom Line: With increasing task demand, compared to controls, ABI patients had an impaired ability to increase the recruitment of several posterior regions of the attention network.Such abnormal brain recruitment was significantly influenced by the type of lesion (focal versus diffuse axonal injury) and time elapsed from the event.Pediatric ABI patients experienced an inability to optimize attention network recruitment, especially when task difficulty was increased, which likely contributes to their clinical and cognitive deficits.

View Article: PubMed Central - PubMed

Affiliation: Acquired Brain Injury Unit, Scientific Institute "Eugenio Medea", Via Don Luigi Monza 20, 23842 Bosisio Parini, Italy.

ABSTRACT
We assessed abnormalities of brain functional magnetic resonance imaging (fMRI) activity during a sustained attention task (Conners' Continuous Performance Test (CCPT)) in 20 right-handed pediatric acquired brain injury (ABI) patients versus 7 right-handed age-matched healthy controls, and we estimated the correlation of such abnormalities with clinical and cognitive deficits. Patients underwent the Wechsler Intelligence Scale for Children (WISC), Wisconsin Card Sorting Test, and Functional Independence Measure (FIM) evaluations. During fMRI, patients and controls activated regions of the attention network. Compared to controls, ABI patients experienced a decreased average fMRI recruitment of the left cerebellum and a decreased deactivation of the left anterior cingulate cortex. With increasing task demand, compared to controls, ABI patients had an impaired ability to increase the recruitment of several posterior regions of the attention network. They also experienced a greater activation of frontal regions, which was correlated with worse performance on FIM, WISC, and fMRI CCPT. Such abnormal brain recruitment was significantly influenced by the type of lesion (focal versus diffuse axonal injury) and time elapsed from the event. Pediatric ABI patients experienced an inability to optimize attention network recruitment, especially when task difficulty was increased, which likely contributes to their clinical and cognitive deficits.

No MeSH data available.


Related in: MedlinePlus

Brain regions showing significant activation (colour coded with red-yellow scales) and deactivation (colour coded with blue-light blue scales) during fMRI with the modified Conners Continuous Performance Test (CCPT) (average condition and load effect) in healthy controls and patients with acquired brain injury (ABI). (a) and (c) Average activation and deactivation in healthy controls; (b) and (d) average activation and deactivation in ABI patients; (e) and (g) activation and deactivation during the load effect in healthy controls; (f) and (h) activation and deactivation during the load effect in ABI patients. Results are shown at p < 0.001, uncorrected. Images are in neurological convention. See text for further details.
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fig1: Brain regions showing significant activation (colour coded with red-yellow scales) and deactivation (colour coded with blue-light blue scales) during fMRI with the modified Conners Continuous Performance Test (CCPT) (average condition and load effect) in healthy controls and patients with acquired brain injury (ABI). (a) and (c) Average activation and deactivation in healthy controls; (b) and (d) average activation and deactivation in ABI patients; (e) and (g) activation and deactivation during the load effect in healthy controls; (f) and (h) activation and deactivation during the load effect in ABI patients. Results are shown at p < 0.001, uncorrected. Images are in neurological convention. See text for further details.

Mentions: Table 2 and Figure 1 report brain regions significantly activated/deactivated during the CCPT task in controls and ABI patients. Both groups showed task-related activation in regions of the frontal, parietal, and temporal lobes, cerebellum, insulae, and left thalamus (Figures 1(a) and 1(b)). In controls, deactivation was observed in the left fusiform gyrus, middle occipital gyrus (MOG), precuneus, and inferior frontal gyrus (IFG) (Figure 1(c)). ABI patients experienced a more distributed pattern of deactivation, which also included the right superior temporal gyrus (STG), left superior frontal gyrus (SFG), and right middle frontal gyrus (MFG) (Figure 1(d)). With increasing task demand (load effect), both groups showed a linear increase of recruitment of the bilateral occipital lobes, lingual gyri, cerebellum, and left inferior parietal lobule (IPL) (Figures 1(e) and 1(f)). ABI patients also recruited the precentral gyrus and supplementary motor area (SMA), bilaterally (Figure 1(f)). Significant deactivation was observed in both groups in the precuneus/posterior cingulate cortex (PCC), STG, SFG, MFG, and insula, bilaterally (Figures 1(g) and 1(h)). The results obtained from the analysis of TBI patients only were virtually similar to those reported for the whole group of ABI patients (data not shown). No significant gender-related differences of fMRI recruitment were found in ABI patients.


Altered Recruitment of the Attention Network Is Associated with Disability and Cognitive Impairment in Pediatric Patients with Acquired Brain Injury.

Strazzer S, Rocca MA, Molteni E, De Meo E, Recla M, Valsasina P, Arrigoni F, Galbiati S, Bardoni A, Filippi M - Neural Plast. (2015)

Brain regions showing significant activation (colour coded with red-yellow scales) and deactivation (colour coded with blue-light blue scales) during fMRI with the modified Conners Continuous Performance Test (CCPT) (average condition and load effect) in healthy controls and patients with acquired brain injury (ABI). (a) and (c) Average activation and deactivation in healthy controls; (b) and (d) average activation and deactivation in ABI patients; (e) and (g) activation and deactivation during the load effect in healthy controls; (f) and (h) activation and deactivation during the load effect in ABI patients. Results are shown at p < 0.001, uncorrected. Images are in neurological convention. See text for further details.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4581560&req=5

fig1: Brain regions showing significant activation (colour coded with red-yellow scales) and deactivation (colour coded with blue-light blue scales) during fMRI with the modified Conners Continuous Performance Test (CCPT) (average condition and load effect) in healthy controls and patients with acquired brain injury (ABI). (a) and (c) Average activation and deactivation in healthy controls; (b) and (d) average activation and deactivation in ABI patients; (e) and (g) activation and deactivation during the load effect in healthy controls; (f) and (h) activation and deactivation during the load effect in ABI patients. Results are shown at p < 0.001, uncorrected. Images are in neurological convention. See text for further details.
Mentions: Table 2 and Figure 1 report brain regions significantly activated/deactivated during the CCPT task in controls and ABI patients. Both groups showed task-related activation in regions of the frontal, parietal, and temporal lobes, cerebellum, insulae, and left thalamus (Figures 1(a) and 1(b)). In controls, deactivation was observed in the left fusiform gyrus, middle occipital gyrus (MOG), precuneus, and inferior frontal gyrus (IFG) (Figure 1(c)). ABI patients experienced a more distributed pattern of deactivation, which also included the right superior temporal gyrus (STG), left superior frontal gyrus (SFG), and right middle frontal gyrus (MFG) (Figure 1(d)). With increasing task demand (load effect), both groups showed a linear increase of recruitment of the bilateral occipital lobes, lingual gyri, cerebellum, and left inferior parietal lobule (IPL) (Figures 1(e) and 1(f)). ABI patients also recruited the precentral gyrus and supplementary motor area (SMA), bilaterally (Figure 1(f)). Significant deactivation was observed in both groups in the precuneus/posterior cingulate cortex (PCC), STG, SFG, MFG, and insula, bilaterally (Figures 1(g) and 1(h)). The results obtained from the analysis of TBI patients only were virtually similar to those reported for the whole group of ABI patients (data not shown). No significant gender-related differences of fMRI recruitment were found in ABI patients.

Bottom Line: With increasing task demand, compared to controls, ABI patients had an impaired ability to increase the recruitment of several posterior regions of the attention network.Such abnormal brain recruitment was significantly influenced by the type of lesion (focal versus diffuse axonal injury) and time elapsed from the event.Pediatric ABI patients experienced an inability to optimize attention network recruitment, especially when task difficulty was increased, which likely contributes to their clinical and cognitive deficits.

View Article: PubMed Central - PubMed

Affiliation: Acquired Brain Injury Unit, Scientific Institute "Eugenio Medea", Via Don Luigi Monza 20, 23842 Bosisio Parini, Italy.

ABSTRACT
We assessed abnormalities of brain functional magnetic resonance imaging (fMRI) activity during a sustained attention task (Conners' Continuous Performance Test (CCPT)) in 20 right-handed pediatric acquired brain injury (ABI) patients versus 7 right-handed age-matched healthy controls, and we estimated the correlation of such abnormalities with clinical and cognitive deficits. Patients underwent the Wechsler Intelligence Scale for Children (WISC), Wisconsin Card Sorting Test, and Functional Independence Measure (FIM) evaluations. During fMRI, patients and controls activated regions of the attention network. Compared to controls, ABI patients experienced a decreased average fMRI recruitment of the left cerebellum and a decreased deactivation of the left anterior cingulate cortex. With increasing task demand, compared to controls, ABI patients had an impaired ability to increase the recruitment of several posterior regions of the attention network. They also experienced a greater activation of frontal regions, which was correlated with worse performance on FIM, WISC, and fMRI CCPT. Such abnormal brain recruitment was significantly influenced by the type of lesion (focal versus diffuse axonal injury) and time elapsed from the event. Pediatric ABI patients experienced an inability to optimize attention network recruitment, especially when task difficulty was increased, which likely contributes to their clinical and cognitive deficits.

No MeSH data available.


Related in: MedlinePlus