Changes in Cortical Excitability After Mild Traumatic Brain Injury: A Scoping Review
Locke, Sara J Hotchkiss-Yager, Eliza Burke, Rosalie N Norberto, Thomas Abbate, Crystal
Locke, Sara J
Hotchkiss-Yager, Eliza
Burke, Rosalie N
Norberto, Thomas
Abbate, Crystal
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Abstract
Title: Changes in Cortical Excitability After Mild Traumatic Brain Injury: A Scoping Review Introduction: Mild Traumatic Brain Injury (mTBI) is a major cause of disability in the United States; however, researchers struggle to identify a true prevalence, incidence and severity. The objective of this scoping review is to identify changes in cortical excitability after mTBI in adults via non-invasive diagnostic tools such as transcranial magnetic stimulation (TMS), functional magnetic resonance imaging (fMRI), electroencephalography (EEG), diffusion tensor imaging (DTI) and neuropsychological assessments. Methods: A scoping review was performed using PubMed, CINAHL, Web of Science, Google Scholar, and Ovid MEDLINE databases. All relevant articles to our search question were reviewed according to our predefined inclusion and exclusion criteria. Articles that met inclusion criteria were reviewed by 5 independent reviewers and then discussed. Results: 64 relevant articles were initially identified and 42 met the inclusion criteria. Eleven TMS studies noted prolonged increased cortical silent period (CSP) in subjects post-mTBI. Structural imaging revealed damage to the corticospinal tract in patients with mTBI and widespread fractional anisotropy, mean diffusivity and axial diffusivity differences between patients with mTBI and healthy controls. Functional imaging showed decreased BOLD signals during motor tasks and deactivation during task performance. EEG showed reduced ERP amplitude in P300, N350, and N170 components. Neuropsychological assessments revealed reduced processing speed, accuracy and attention in patients with mTBI. Discussion: Non-invasive techniques primarily identified physiologic changes due to decreased cortical excitability after mTBI. Better understanding of cortical and neuropsychological changes will provide critical information to researchers as well as clinicians on optimal recovery trajectory after an mTBI.
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Date
2020-01-01