Neural Connectivity Changes Facilitated by Familiar Auditory Sensory Training in Disordered Consciousness: A TBI Pilot Study

Theresa L. Bender Pape*, Sherri L. Livengood, Sandra L. Kletzel, Brett Blabas, Ann Guernon, Dulal K. Bhaumik, Runa Bhaumik, Trudy Mallinson, Jennifer A. Weaver, James P. Higgins, Xue Wang, Amy Anne Herrold, Joshua M. Rosenow, Todd Parrish

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

For people with disordered consciousness (DoC) after traumatic brain injury (TBI), relationships between treatment-induced changes in neural connectivity and neurobehavioral recovery have not been explored. To begin building a body of evidence regarding the unique contributions of treatments to changes in neural network connectivity relative to neurobehavioral recovery, we conducted a pilot study to identify relationships meriting additional examination in future research. To address this objective, we examined previously unpublished neural connectivity data derived from a randomized clinical trial (RCT). We leveraged these data because treatment efficacy, in the RCT, was based on a comparison of a placebo control with a specific intervention, the familiar auditory sensory training (FAST) intervention, consisting of autobiographical auditory-linguistic stimuli. We selected a subgroup of RCT participants with high-quality imaging data (FAST n = 4 and placebo n = 4) to examine treatment-related changes in brain network connectivity and how and if these changes relate to neurobehavioral recovery. To discover promising relationships among the FAST intervention, changes in neural connectivity, and neurobehavioral recovery, we examined 26 brain regions and 19 white matter tracts associated with default mode, salience, attention, and language networks, as well as three neurobehavioral measures. Of the relationships discovered, the systematic filtering process yielded evidence supporting further investigation of the relationship among the FAST intervention, connectivity of the left inferior longitudinal fasciculus, and auditory-language skills. Evidence also suggests that future mechanistic research should focus on examining the possibility that the FAST supports connectivity changes by facilitating redistribution of brain resources. For a patient population with limited treatment options, the reported findings suggest that a simple, yet targeted, passive sensory stimulation treatment may have altered functional and structural connectivity. If replicated in future research, then these findings provide the foundation for characterizing the unique contributions of the FAST intervention and could inform development of new treatment strategies. For persons with severely damaged brain networks, this report represents a first step toward advancing understanding of the unique contributions of treatments to changing brain network connectivity and how these changes relate to neurobehavioral recovery for persons with DoC after TBI. Clinical Trial Registry: NCT00557076, The Efficacy of Familiar Voice Stimulation During Coma Recovery (http://www.clinicaltrials.gov).

Original languageEnglish (US)
Article number1027
JournalFrontiers in Neurology
Volume11
DOIs
StatePublished - Oct 8 2020

Funding

This work was supported by the US Department of Veterans Affairs, Office of Research and Development, Rehabilitation Research and Development (# B4591R and #B4949N to TBP) and by the National Center for Research Resources, National Institutes of Health (#UL1RR025741 to Northwestern University’s Clinical and Translation Sciences Institute). Financial support of unanticipated research expenses was also provided by the Nick Kot Charity for TBI (www.nkc4tbi. com). In-kind contributions from the Edward Hines Jr. VA hospital and Northwestern’s Departments of Neurosurgery and PM&R also made this work possible. The funding agencies and organizations played no role in the study design, in the collection, analysis, and interpretation of data, in the writing of the report, and in the decision to submit the article for publication. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the United States Department of Veterans Affairs or the United States government.

Keywords

  • attention
  • consciousness disorders
  • language
  • traumatic brain injury
  • white matter

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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