Regional brain volume prior to treatment is linked to outcome after cognitive rehabilitation in traumatic brain injury

Alexander Olsen; Emily L Dennis; Jan Stubberud; Elizabeth S Hovenden; Anne-Kristin Solbakk; Tor Endestad; Per Kristian Hol; Anne-Kristine Schanke; Marianne Løvstad; Sveinung Tornås

doi:10.1016/j.nicl.2022.103126

Regional brain volume prior to treatment is linked to outcome after cognitive rehabilitation in traumatic brain injury

Neuroimage Clin. 2022:35:103126. doi: 10.1016/j.nicl.2022.103126. Epub 2022 Jul 28.

Affiliations

¹ Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway; Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Electronic address: alexander.olsen@ntnu.no.
² Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA; George E. Wahlen Veteran Affairs Medical Center, Salt Lake City UT, USA.
³ Department of Psychology, University of Oslo, Oslo, Norway; Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway; Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway.
⁴ RITMO, Department of Psychology, University of Oslo, Norway; Department of Neurosurgery, Oslo University Hospital - Rikshospitalet, Norway; Department of Neuropsychology, Helgeland Hospital, 8657 Mosjøen, Norway.
⁵ RITMO, Department of Psychology, University of Oslo, Norway; Department of Neuropsychology, Helgeland Hospital, 8657 Mosjøen, Norway.
⁶ The Intervention Centre, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
⁷ Department of Psychology, University of Oslo, Oslo, Norway; Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway.
⁸ Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway.

Abstract

Cognitive rehabilitation is useful for many after traumatic brain injury (TBI), but we lack critical knowledge about which patients benefit the most from different approaches. Advanced neuroimaging techniques have provided important insight into brain pathology and systems plasticity after TBI, and have potential to inform new practices in cognitive rehabilitation. In this study, we aimed to identify candidate structural brain measures with relevance for rehabilitation of cognitive control (executive) function after TBI. Twenty-eight patients (9 female, mean age 40.5 (SD = 13.04) years) with TBI (>21 months since injury) that participated in a randomized controlled cognitive rehabilitation trial (NCT02692352) were included in the analyses. Regional brain volume was extracted from T1-weighted MRI scans before treatment using tensor-based morphometry. Both positive and negative associations between treatment outcome (everyday cognitive control function) and regional brain volume were observed. The most robust associations between regional brain volume and improvement in function were observed in midline fronto-parietal regions, including the anterior and posterior cingulate cortices. The study provides proof of concept and valuable insight for planning future studies focusing on neuroimaging in cognitive rehabilitation after TBI.

Keywords: Brain injury; Executive function; Magnetic resonance imaging; Personalized treatment; Rehabilitation medicine.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Brain
Brain Injuries, Traumatic*
Cognition
Executive Function
Female
Humans
Magnetic Resonance Imaging
Neuroimaging

Associated data

ClinicalTrials.gov/NCT02692352