Resting state functional connectivity in pediatric concussion

Abstract

Children and adolescents with concussion display aberrant functional connectivity in some of the major neurocognitive networks. This includes the Default Mode Network, Central Executive Network and Salience Network. Using resting state fMRI, the purpose of this thesis was to explore the functional connectivity of cognition-related networks in youth experiencing concussion. With a prospective cohort study, the functional connectivity (defined as the temporal coherence between spatially separated brain regions) of children and adolescents ages 10-18 years old was evaluated in relation to a number of demographic and injury-specific factors including recovery length, age at the time of injury, symptom severity, and neurocognitive performance. The results showed two general trends: (1) a reduction in connectivity (i.e., hypoconnectivity) between the regions of the Default Mode Network, and (2) an increase in connectivity (i.e., hyperconnectivity) between additional sensory-related regions like the cerebellum and hippocampus. The Default Mode Network, which processes self-referential information, has a long-protracted development across childhood through adulthood. Given that the participants in this cohort exhibited reduced functional connectivity within the Default Mode Network and between the Default Mode Network and other neurocognitive networks suggests that this is an area of vulnerability in youth in the event of concussion. Increased connectivity between the Central Executive Network and Salience Network, and between cognitive- and sensory-related regions such as the hippocampus and cerebellum might be interpreted as a compensatory mechanism to supplement deficits of the Default Mode Network. This thesis sheds light on important concussion-related regions for future research to investigate further and delves into the possible neural mechanisms contributing to the cognitive, sensory, mood, and sleep disturbances in children and adolescents with concussion.