Translingual Neural Stimulation Changes Cortical Surface Morphometry in Mild-Moderate TBI Patients
Poster No:
29
Submission Type:
Abstract Submission
Authors:
Jiancheng Hou1, Veena Nair2, Nagesh Adluru2, Thomas Hosseini2, Yuri Danilov2, Kurt Kaczmarek2, Mary Meyerand2, Mitchell Tyler2, Vivek Prabhakaran2
Institutions:
1Fujian Normal University, Fuzhou, Fujian, 2University of Wisconsin-Madison, Madison, WI
First Author:
Co-Author(s):
Introduction:
Mild-to-moderate traumatic brain injury (mmTBI) may result in movement, balance and gait impairments in patients. Recently, Translingual Neural Stimulation (TLNS), a novel therapeutic intervention that combines superficial electrical stimulation of the facial and trigeminal nerves with physical therapy, has emerged as a potential treatment option for balance and gait deficits (Danilov et al., 2015). A prior brain morphometry study demonstrated that TLNS can alter gray matter volume in specific brain regions and enhance neural plasticity in mmTBI patients (Hou et al., 2020). Despite these advancements, volumetric measurements have certain limitations, particularly in assessing brain surface folding (Jin et al., 2018). This study sought to investigate changes in brain surface-based morphometry before and after TLNS intervention in mmTBI patients.
Methods:
T1-weighted structural MRI data were collected from nine mmTBI patients using a 3T GE750 MRI scanner. TLNS was delivered using an experimental PoNS device (V2.5). Participants underwent pre- and post-intervention behavioral testing, which included the Sensory Organization Test (SOT) and the Dynamic Gait Index (DGI). MRI data preprocessing was performed using the Computational Anatomy Toolbox (CAT12; http://www.neuro.uni-jena.de/cat/), which consists of B1 bias-field correction, skull-stripping, alignment to the MNI template, and spatial normalization. Surface-based morphometric measures, including cortical thickness (CT), fractal dimensionality (FD), gyrification index (GI), and sulcal depth (SD), were then calculated and spatially smoothed using a FWHM Gaussian kernel (15mm for CT; 20mm for FD, GI, and SD). Paired t-tests compared morphometry changes from pre- to post-intervention, reporting statistically significant results with threshold free cluster enhancement (TFCE) based family-wise error corrected p < .05 and cluster size > 100 vertices. Surface regions were labeled using the Desikan–Killiany (DK40) atlas. Correlations between morphometric changes (post- minus pre-) and behavioral testing scores (post- minus pre-) were assessed using Pearson correlation analysis, with corrected p < 0.05 in SPSS.
Results:
Comparisons from pre-intervention to post-intervention revealed significant changes: (1) increased CT in the left frontal lobe, as well as the right frontal, temporal, parietal, occipital lobes, and cingulate cortex; (2) increased FD in the bilateral frontal lobes, and decreased FD in the left temporal and occipital lobes; (3) decreased GI in the left lingual gyrus; (4) increased SD in the left temporal and occipital lobes, right frontal lobe, bilateral supramarginal gyri, with decreased SD in the left entorhinal and parahippocampal gyri. Notably, the CT of the right inferior temporal gyrus and right superior parietal lobule negatively correlated with DGI scores, while the FD of the left precuneus negatively correlated with SOT scores (see Table 1 and Figure 1).
·Figure 1. Cortical surface morphometry changes between post- vs. pre-interventions.
·Table 1. Surface-based morphometry changes between post- vs. pre-interventions.
Conclusions:
The observed changes in cortical surface morphometry underscore the ancillary benefits of TLNS, in regions involved in gait, balance, motor control, and vision. These results highlight the brain plasticity induced by TLNS and the positive effects of TLNS on various functions. Decreases in FD, GI, and SD in regions associated with visuospatial processing, learning, and memory may reflect improved cognitive efficiency and automaticity induced by TLNS intervention. Moreover, the negative correlations between cortical morphometry in regions involved in visuospatial processes and behavioral testing suggest automatized visuospatial ability resulting from TLNS intervention. Additionally, improved behavioral performance may reflect compensatory effects from other brain regions facilitated by TLNS intervention (Hou et al., 2020). In summary, TLNS induces changes in brain cortical surface morphometry associated with gait and balance improvements in mmTBI patients.
Brain Stimulation:
Non-invasive Magnetic/TMS 1
Neuroanatomy, Physiology, Metabolism and Neurotransmission:
Cortical Anatomy and Brain Mapping 2
Keywords:
Cortex
Motor
Plasticity
STRUCTURAL MRI
1|2Indicates the priority used for review
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Provide references using APA citation style.
Hou, J., Kulkarni, A., Tellapragada, N., Nair, A., Danilov, Y., & Kaczmarek, K., & Prabhakaran, V. (2020). Translingual neural stimulation with the Portable Neuromodulation Stimulator (PoNS®) induces structural changes leading to functional recovery in patients with mild to moderate traumatic brain injury. Emergency Medicine Journal, 1, 64-71.
Jin, K., Zhang, T., Shaw, M., Sachdev, P., & Cherbuin, N. (2018), Relationship between sulcal characteristics and brain aging. Frontiers in Aging Neuroscience, 10, 339.