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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 significantly different fMRI activation during the modified Conners Continuous Performance Test (CCPT) between controls and patients with acquired brain injury (ABI). (a) and (b) Between-group differences during the average condition; (c) and (d) between-group differences during the load effect. Differences of activation are coded in red-yellow scales, whereas differences of deactivation are coded in blue-light blue scales. Results are shown at p < 0.001, uncorrected. Images are in neurological convention. See text for further details.
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fig2: Brain regions showing significantly different fMRI activation during the modified Conners Continuous Performance Test (CCPT) between controls and patients with acquired brain injury (ABI). (a) and (b) Between-group differences during the average condition; (c) and (d) between-group differences during the load effect. Differences of activation are coded in red-yellow scales, whereas differences of deactivation are coded in blue-light blue scales. Results are shown at p < 0.001, uncorrected. Images are in neurological convention. See text for further details.

Mentions: Compared to controls, ABI patients showed decreased fMRI recruitment of the left cerebellum, crus I (MNI coordinates: −36, −56, −32, t value = 4.12) (Figure 2(a)) and a decreased deactivation of the left anterior cingulate cortex (ACC) (MNI coordinates: −4, −28, 16, t value = 4.27) (Figure 2(b)). During the load condition, compared to controls, ABI patients experienced reduced activation of the right MOG (MNI coordinates: 38, −72, 14, t value = 4.03), right fusiform gyrus (MNI coordinates: 40, −50, −14, t value = 4.63), left thalamus (MNI coordinates: −8, −14, 14, t value = 5.58), right cerebellum, lobule VI (MNI coordinates: 32, −76, 20, t value = 3.95), and vermis (MNI coordinates: 0, −62, −2,  t value = 3.64) (Figure 2(c)). They also experienced an increased activation of the left MFG (MNI coordinates: −34, 46, 22, t value = 3.86) and right SFG (MNI coordinates: 22, 56, 24, t value = 3.69) (Figure 2(d)). Similar results were obtained when comparing TBI patients only with controls.


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 significantly different fMRI activation during the modified Conners Continuous Performance Test (CCPT) between controls and patients with acquired brain injury (ABI). (a) and (b) Between-group differences during the average condition; (c) and (d) between-group differences during the load effect. Differences of activation are coded in red-yellow scales, whereas differences of deactivation are coded in blue-light blue scales. 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

fig2: Brain regions showing significantly different fMRI activation during the modified Conners Continuous Performance Test (CCPT) between controls and patients with acquired brain injury (ABI). (a) and (b) Between-group differences during the average condition; (c) and (d) between-group differences during the load effect. Differences of activation are coded in red-yellow scales, whereas differences of deactivation are coded in blue-light blue scales. Results are shown at p < 0.001, uncorrected. Images are in neurological convention. See text for further details.
Mentions: Compared to controls, ABI patients showed decreased fMRI recruitment of the left cerebellum, crus I (MNI coordinates: −36, −56, −32, t value = 4.12) (Figure 2(a)) and a decreased deactivation of the left anterior cingulate cortex (ACC) (MNI coordinates: −4, −28, 16, t value = 4.27) (Figure 2(b)). During the load condition, compared to controls, ABI patients experienced reduced activation of the right MOG (MNI coordinates: 38, −72, 14, t value = 4.03), right fusiform gyrus (MNI coordinates: 40, −50, −14, t value = 4.63), left thalamus (MNI coordinates: −8, −14, 14, t value = 5.58), right cerebellum, lobule VI (MNI coordinates: 32, −76, 20, t value = 3.95), and vermis (MNI coordinates: 0, −62, −2,  t value = 3.64) (Figure 2(c)). They also experienced an increased activation of the left MFG (MNI coordinates: −34, 46, 22, t value = 3.86) and right SFG (MNI coordinates: 22, 56, 24, t value = 3.69) (Figure 2(d)). Similar results were obtained when comparing TBI patients only with controls.

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