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Review
. 2020:25:102129.
doi: 10.1016/j.nicl.2019.102129. Epub 2019 Dec 14.

Task-related functional magnetic resonance imaging activations in patients with acute and subacute mild traumatic brain injury: A coordinate-based meta-analysis

Michael J Cook  1 , Andrew J Gardner  2 , Magdalena Wojtowicz  3 , W Huw Williams  4 , Grant L Iverson  5 , Peter Stanwell  6
Affiliations
Review

Task-related functional magnetic resonance imaging activations in patients with acute and subacute mild traumatic brain injury: A coordinate-based meta-analysis

Michael J Cook et al. Neuroimage Clin. 2020.

Abstract

Task-based functional magnetic resonance imaging (fMRI) has been used to examine neuroanatomical and functional changes following mild traumatic brain injury (mTBI). Prior studies have lacked consistency in identifying common regions of altered neural activity during cognitive tasks. This may be partly due to differences in task paradigm, patient heterogeneity, and methods of fMRI analysis. We conducted a meta-analysis using an activation likelihood estimation (ALE) method to identify regions of differential brain activation in patients with mTBI compared to healthy controls. We included experiments that performed scans from acute to subacute time points post-injury. The seven included studies recruited a total sample of 174 patients with mTBIs and 139 control participants. The results of our coordinate based meta-analysis revealed a single cluster of reduced activation within the right middle frontal gyrus (MFG) that differentiated mTBI from healthy controls. We conclude that the cognitive impairments in memory and attention typically reported in mTBI patients may be associated with a deficit in the right MFG, which impacts the recruitment of neural networks important for attentional control.

Keywords: Activation likelihood estimation; Cognition; Concussion; Functional MRI; Mild traumatic brain injury; Neuroimaging.

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Conflict of interest statement

Declaration of Competing Interest Michael J. Cook has received support through an Australian Government Research Training Program Scholarship. W. Huw Williams, and Magdalena Wojtowicz have no disclosures. Andrew J. Gardner and Peter Stanwell have been funded to conduct research into concussion in rugby league through a New South Wales Sporting Injuries Committee–Sports Research & Injury Prevention Scheme Grant, and a Brain Foundation, Australia–Brain Injury Award. Andrew J. Gardner acknowledges sport concussion research fellowship funding from Jennie Thomas, Life Governor of the Hunter Medical Research Institute, the Hunter Medical Research Institute supported by Anne Greaves, the School of Medicine and Public Health, University of Newcastle, and the National Health and Medical Council (NHMRC) Early Career Fellowship. Grant Iverson has a clinical and consulting practice in forensic neuropsychology involving individuals who have sustained mild TBIs (including athletes). He has received research funding from several test publishing companies, including ImPACT Applications, Inc., CNS Vital Signs, and Psychological Assessment Resources (PAR, Inc.). He acknowledges unrestricted philanthropic support from the Mooney-Reed Charitable Foundation, Heinz Family Foundation, and ImPACT Applications, Inc. Grant Iverson has received salary support from research grants from the Harvard Integrated Program to Protect and Improve the Health of National Football League Players Association Members and the National Football League.

Figures

Fig. 1
Fig. 1
Preferred reporting items of systematic reviews and meta-analyses flow diagram. BOLD, blood oxygenation level dependent; mTBI, mild traumatic brain injury; ROI, region of interest; fMRI, functional magnetic resonance imaging.
Fig. 2
Fig. 2
Meta-analytical map of pooled activation in mTBI group. Activation was localized within the right middle frontal gyrus. Values indicate MNI-coordinates.
Fig. 3
Fig. 3
Meta-analytical map of reduced activation in mTBI group. Activation was localized within the right middle frontal gyrus. Values indicate MNI-coordinates.
See this image and copyright information in PMC

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