TY - JOUR

T1 - Alterations in the brain's connectome during recovery from severe traumatic brain injury

T2 - Protocol for a longitudinal prospective study

AU - Conde, Virginia

AU - Andreasen, Sara Hesby

AU - Petersen, Tue Hvass

AU - Larsen, Karen Busted

AU - Madsen, Karine

AU - Andersen, Kasper Winther

AU - Akopian, Irina

AU - Madsen, Kristoffer Hougaard

AU - Hansen, Christian Pilebæk

AU - Poulsen, Ingrid

AU - Kammersgaard, Lars Peter

AU - Siebner, Hartwig Roman

PY - 2017/6

Y1 - 2017/6

N2 - Introduction Traumatic brain injury (TBI) is considered one of the most pervasive causes of disability in people under the age of 45. TBI often results in disorders of consciousness, and clinical assessment of the state of consciousness in these patients is challenging due to the lack of behavioural responsiveness. Functional neuroimaging offers a means to assess these patients without the need for behavioural signs, indicating that brain connectivity plays a major role in consciousness emergence and maintenance. However, little is known regarding how changes in connectivity during recovery from TBI accompany changes in the level of consciousness. Here, we aim to combine cutting-edge neuroimaging techniques to follow changes in brain connectivity in patients recovering from severe TBI. Methods and analysis A multimodal, longitudinal assessment of 30 patients in the subacute stage after severe TBI will be made comprising an MRI session combined with electroencephalography (EEG), a positron emission tomography session and a transcranial magnetic stimulation (TMS) combined with EEG (TMS/EEG) session. A group of 20 healthy participants will be included for comparison. Four sessions for patients and two sessions for healthy participants will be planned. Data analysis techniques will focus on whole-brain, both data-driven and hypothesis-driven, connectivity measures that will be specific to the imaging modality. Ethics and dissemination The project has received ethical approval by the local ethics committee of the Capital Region of Denmark and by the Danish Data Protection. Results will be published as original research articles in peer-reviewed journals and disseminated in international conferences. None of the measurements will have any direct clinical impact on the patients included in the study but may benefit future patients through a better understanding of the mechanisms underlying the recovery process after TBI. Trial registration number: NCT02424656; Pre-results.

AB - Introduction Traumatic brain injury (TBI) is considered one of the most pervasive causes of disability in people under the age of 45. TBI often results in disorders of consciousness, and clinical assessment of the state of consciousness in these patients is challenging due to the lack of behavioural responsiveness. Functional neuroimaging offers a means to assess these patients without the need for behavioural signs, indicating that brain connectivity plays a major role in consciousness emergence and maintenance. However, little is known regarding how changes in connectivity during recovery from TBI accompany changes in the level of consciousness. Here, we aim to combine cutting-edge neuroimaging techniques to follow changes in brain connectivity in patients recovering from severe TBI. Methods and analysis A multimodal, longitudinal assessment of 30 patients in the subacute stage after severe TBI will be made comprising an MRI session combined with electroencephalography (EEG), a positron emission tomography session and a transcranial magnetic stimulation (TMS) combined with EEG (TMS/EEG) session. A group of 20 healthy participants will be included for comparison. Four sessions for patients and two sessions for healthy participants will be planned. Data analysis techniques will focus on whole-brain, both data-driven and hypothesis-driven, connectivity measures that will be specific to the imaging modality. Ethics and dissemination The project has received ethical approval by the local ethics committee of the Capital Region of Denmark and by the Danish Data Protection. Results will be published as original research articles in peer-reviewed journals and disseminated in international conferences. None of the measurements will have any direct clinical impact on the patients included in the study but may benefit future patients through a better understanding of the mechanisms underlying the recovery process after TBI. Trial registration number: NCT02424656; Pre-results.

KW - Brain connectivity

KW - Disorders of Consciousness

KW - Longitudinal study

KW - Multimodal study

KW - Neuroimaging

KW - Traumatic Brain Injury

UR - http://bmjopen.bmj.com/content/7/6/e016286

U2 - 10.1136/bmjopen-2017-016286

DO - 10.1136/bmjopen-2017-016286

M3 - Journal article

C2 - 28615277

AN - SCOPUS:85020513903

VL - 7

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 6

M1 - e016286

ER -