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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 group differences of fMRI activation during the modified Conners Continuous Performance Test (CCPT) (load effect) between acute/subacute and chronic patients with acquired brain injury (ABI) and healthy controls. (a) Significantly increased activation in chronic patients versus controls and acute/subacute patients; (b) significantly increased activation in acute/subacute patients versus controls and chronic patients. Results are shown at p < 0.001, uncorrected. Images are in neurological convention.
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fig3: Brain regions showing significant group differences of fMRI activation during the modified Conners Continuous Performance Test (CCPT) (load effect) between acute/subacute and chronic patients with acquired brain injury (ABI) and healthy controls. (a) Significantly increased activation in chronic patients versus controls and acute/subacute patients; (b) significantly increased activation in acute/subacute patients versus controls and chronic patients. Results are shown at p < 0.001, uncorrected. Images are in neurological convention.

Mentions: With increasing task demand, compared to acute/subacute patients and controls, chronic patients showed an increased activation (conjunction analysis: p < 0.001) of the left SMA (MNI coordinates: −8, 4, 50; k = 181), right (MNI coordinates: 48, 18, 2; k = 69) and left (MNI coordinates: −48, 18, 14; k = 211) IFG, and right inferior occipital gyrus (IOG) (MNI coordinates: 48, −78, −8; k = 139). Compared to the other two groups, acute/subacute patients showed an increased activation (conjunction analysis: p < 0.001) of the left (MNI coordinates: −18, 34, 30; k = 132) and the right (MNI coordinates: 18, 64, 24; k = 26) SFG, right (MNI coordinates: 26, −20, −18; k = 277) and left (MNI coordinates: −22, −10, −22; k = 697) hippocampal/parahippocampal gyrus, and right precuneus (MNI coordinates: 8, −40, 56; k = 119) (Figure 3).


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 group differences of fMRI activation during the modified Conners Continuous Performance Test (CCPT) (load effect) between acute/subacute and chronic patients with acquired brain injury (ABI) and healthy controls. (a) Significantly increased activation in chronic patients versus controls and acute/subacute patients; (b) significantly increased activation in acute/subacute patients versus controls and chronic patients. Results are shown at p < 0.001, uncorrected. Images are in neurological convention.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig3: Brain regions showing significant group differences of fMRI activation during the modified Conners Continuous Performance Test (CCPT) (load effect) between acute/subacute and chronic patients with acquired brain injury (ABI) and healthy controls. (a) Significantly increased activation in chronic patients versus controls and acute/subacute patients; (b) significantly increased activation in acute/subacute patients versus controls and chronic patients. Results are shown at p < 0.001, uncorrected. Images are in neurological convention.
Mentions: With increasing task demand, compared to acute/subacute patients and controls, chronic patients showed an increased activation (conjunction analysis: p < 0.001) of the left SMA (MNI coordinates: −8, 4, 50; k = 181), right (MNI coordinates: 48, 18, 2; k = 69) and left (MNI coordinates: −48, 18, 14; k = 211) IFG, and right inferior occipital gyrus (IOG) (MNI coordinates: 48, −78, −8; k = 139). Compared to the other two groups, acute/subacute patients showed an increased activation (conjunction analysis: p < 0.001) of the left (MNI coordinates: −18, 34, 30; k = 132) and the right (MNI coordinates: 18, 64, 24; k = 26) SFG, right (MNI coordinates: 26, −20, −18; k = 277) and left (MNI coordinates: −22, −10, −22; k = 697) hippocampal/parahippocampal gyrus, and right precuneus (MNI coordinates: 8, −40, 56; k = 119) (Figure 3).

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