Poster No:
1667
Submission Type:
Abstract Submission
Authors:
Caerwen Beaton1,2,3, Andre Avila1,2,3, Melissa Papini1,2,3, Jacinta Thorne1,2, Aleksandra Gozt1,2, Francesca Buhagiar4, Elizabeth Thomas5,6, Alexander Ring7,8, Glenn Arendts9,10, John Iliff3,11,12,13, Antonio Celenza14,15, Sjinene Van Schalkwyk16, Philip Brooks3,17,18, Dan Xu3,5,19, Stephen Honeybul20,21, Gill Cowen1,3, Carmela Pestell1,4, Daniel Fatovich10,22,23, Ben Smedley24, Ashes Mukherjee25,23, Michael Bynevelt26, Melinda Fitzgerald1,2, Sarah Hellewell1,2
Institutions:
1Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia, 2Perron Institute of Neurological and Translational Science, Perth, WA, Australia, 3Curtin Medical School, Curtin University, Perth, WA, Australia, 4School of Psychological Science, The University of Western Australia, Perth, WA, Australia, 5School of Population Health, Curtin University, Perth, WA, Australia, 6School of Medicine, The University of Western Australia, Perth, WA, Australia, 7Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia, 8School of Physiotherapy and Exercise Science, Faculty of Health Sciences8 School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Perth, WA, Australia, 9Emergency Department, Fiona Stanley Hospital, Perth, WA, Australia, 10Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, WA, Australia, 11Emergency Department, Saint John of God Hospital Murdoch, Perth, WA, Australia, 12Emergency Department, Royal Perth Hospital, Perth, WA, Australia, 13Royal Flying Doctor Service- Western Operations, Perth, WA, Australia, 14Emergency Department, Sir Charles Gairdner Hospital, Perth, WA, Australia, 15Division of Emergency Medicine, School of Medicine, The University of Western Australia, Perth, WA, Australia, 16Emergency Department, Joondalup Health Campus, Perth, WA, Australia, 17Emergency Department, Saint John of God Midland Public Hospital, Perth, WA, Australia, 18School of Medicine, The University of Notre Dame, Perth, WA, Australia, 19The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China, 20Department of Health, Government of Western Australia, Perth, WA, Australia, 21Sir Charles Gairdner Hospital, Royal Perth Hospital and Fiona Stanley Hospital, Perth, WA, Australia, 22Emergency Medicine, Royal Perth Hospital, Perth, WA, Australia, 23The University of Western Australia, Perth, WA, Australia, 24Emergency Department, Rockingham General Hospital, Perth, WA, Australia, 25Emergency Department, Armadale Health Service, Perth, WA, Australia, 26The Neurological Intervention & Imaging Service of Western Australia at Sir Charles Gairdner Hospita, Perth, WA, Australia
First Author:
Caerwen Beaton
Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University|Perron Institute of Neurological and Translational Science|Curtin Medical School, Curtin University
Perth, WA, Australia|Perth, WA, Australia|Perth, WA, Australia
Co-Author(s):
Andre Avila
Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University|Perron Institute of Neurological and Translational Science|Curtin Medical School, Curtin University
Perth, WA, Australia|Perth, WA, Australia|Perth, WA, Australia
Melissa Papini
Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University|Perron Institute of Neurological and Translational Science|Curtin Medical School, Curtin University
Perth, WA, Australia|Perth, WA, Australia|Perth, WA, Australia
Jacinta Thorne
Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University|Perron Institute of Neurological and Translational Science
Perth, WA, Australia|Perth, WA, Australia
Aleksandra Gozt
Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University|Perron Institute of Neurological and Translational Science
Perth, WA, Australia|Perth, WA, Australia
Francesca Buhagiar
School of Psychological Science, The University of Western Australia
Perth, WA, Australia
Elizabeth Thomas
School of Population Health, Curtin University|School of Medicine, The University of Western Australia
Perth, WA, Australia|Perth, WA, Australia
Alexander Ring
Institute for Immunology and Infectious Diseases, Murdoch University|School of Physiotherapy and Exercise Science, Faculty of Health Sciences8 School of Physiotherapy and Exercise Science, Faculty of Health Sciences
Perth, WA, Australia|Perth, WA, Australia
Glenn Arendts
Emergency Department, Fiona Stanley Hospital|Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research
Perth, WA, Australia|Perth, WA, Australia
John Iliff
Curtin Medical School, Curtin University|Emergency Department, Saint John of God Hospital Murdoch|Emergency Department, Royal Perth Hospital|Royal Flying Doctor Service- Western Operations
Perth, WA, Australia|Perth, WA, Australia|Perth, WA, Australia|Perth, WA, Australia
Antonio Celenza
Emergency Department, Sir Charles Gairdner Hospital|Division of Emergency Medicine, School of Medicine, The University of Western Australia
Perth, WA, Australia|Perth, WA, Australia
Philip Brooks
Curtin Medical School, Curtin University|Emergency Department, Saint John of God Midland Public Hospital|School of Medicine, The University of Notre Dame
Perth, WA, Australia|Perth, WA, Australia|Perth, WA, Australia
Dan Xu
Curtin Medical School, Curtin University|School of Population Health, Curtin University|The First Affiliated Hospital, Sun Yat-Sen University
Perth, WA, Australia|Perth, WA, Australia|Guangzhou, China
Stephen Honeybul
Department of Health, Government of Western Australia|Sir Charles Gairdner Hospital, Royal Perth Hospital and Fiona Stanley Hospital
Perth, WA, Australia|Perth, WA, Australia
Gill Cowen
Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University|Curtin Medical School, Curtin University
Perth, WA, Australia|Perth, WA, Australia
Carmela Pestell
Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University|School of Psychological Science, The University of Western Australia
Perth, WA, Australia|Perth, WA, Australia
Daniel Fatovich
Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research|Emergency Medicine, Royal Perth Hospital|The University of Western Australia
Perth, WA, Australia|Perth, WA, Australia|Perth, WA, Australia
Ben Smedley
Emergency Department, Rockingham General Hospital
Perth, WA, Australia
Ashes Mukherjee
Emergency Department, Armadale Health Service|The University of Western Australia
Perth, WA, Australia|Perth, WA, Australia
Michael Bynevelt
The Neurological Intervention & Imaging Service of Western Australia at Sir Charles Gairdner Hospita
Perth, WA, Australia
Melinda Fitzgerald
Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University|Perron Institute of Neurological and Translational Science
Perth, WA, Australia|Perth, WA, Australia
Sarah Hellewell
Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University|Perron Institute of Neurological and Translational Science
Perth, WA, Australia|Perth, WA, Australia
Introduction:
Mild Traumatic Brain Injury (mTBI) results from a direct impact or rapid acceleration and deceleration of the head, which can alter brain function. Following mTBI, patients may experience varied signs and symptoms which may be broadly classed as physical, cognitive or emotional. However, the relationship between brain alterations and presence of symptoms is complex and poorly understood. Quantitative electroencephalography (qEEG) utilises digital EEG signals that are processed, transformed and analysed using mathematical algorithms. qEEG is rapid to acquire and could provide insight into brain dysfunction after injury. This study used qEEG to detect regional brain dysfunction following mTBI and investigated whether qEEG findings were associated with reporting of mTBI signs and symptoms, including those related to emotion.
Methods:
24 adult participants aged 36.56±12.87 years (10 female) with medically diagnosed mTBI were recruited from major metropolitan emergency departments in Perth, Western Australia as part of the Concussion REcovery STudy (CREST) (Gozt, et al., 2021). 30 age and sex-matched healthy controls were also recruited (33.88±12.15 years; 14 female). Within 7 days of injury, participants completed the Post-Concussion Symptom Scale (PCSS) and Depression Anxiety Stress Scale (DASS-21) questionnaires. qEEG scans (resting-state, eyes-open condition) were acquired using a 19-channel Electro-cap (Electro-cap International Inc., Eaton, USA) with a standardised 10-20 electrode placement, and a MITSAR-EEG-BT amplifier (Mitsar, Ltd., St. Petersburg, Russia). Analysis was performed using NeuroGuide and NeuroNavigator software (Applied Neuroscience, Inc., St. Petersburg, USA). Five minutes of activity were recorded with linked-ears montage, using a sampling rate of 500 Hz, with impedance <10 kΩ and a low pass filter of 50 Hz. At least one minute of artifact-free data from the recording was selected in NeuroGuide and imported into NeuroNavigator to generate current source density (CSD) for Brodmann areas (BA). Data from mTBI and control participants were expressed as Z-scores and compared using t-tests for each BA to determine the effects of mTBI on CSD. Pearson correlations were performed separately for mTBI and control groups to assess the relationship to PCSS and DASS-21 scores.
Results:
Substantial bilateral increases in CSD (Z-score >1.65) were detected within the cingulate (BAs 23, 31) and retrosplenial cortices (BAs 26, 29) (p <0.05) across multiple bands: delta (1-3 Hz), theta (4-7 Hz), beta (12-24 Hz) and high beta (25-30 Hz). mTBI participants had higher mean PCSS symptom (10.63±4.49 vs. 4.57±4.04; p<0.0001) and severity scores (30.25±18.99 vs.7.93±9.2; p<0.0001); as well as DASS-21 depression subscale scores (3.5±3.69 vs. 1.77±2.25; p<0.05) compared to controls. In the mTBI group, increased CSD in the delta band within the left cingulate (BA 29) was moderately associated with PCSS total score (r = -0.48, p<0.05) and symptom severity (r = -0.53, p<0.05). In the beta band, bilateral increases in CSD in the cingulate (BAs 23, 31) and retrosplenial cortex (BAs 26, 29) were moderately to highly correlated with DASS-21 anxiety and stress subscale scores in each hemisphere (all r>0.44; p<0.05), while unilateral CSD increases correlated with depression subscale scores: right BA 23, r=0.47, p<0.05; left BA 26, r=0.52, p<0.05; right BA 29, r=0.63, p<0.001.
Conclusions:
These findings suggest that the cingulate and retrosplenial cortices are vulnerable to the effects of mTBI. These regions have known associations with anxiety, depression and stress (Straube, et al., 2009; Duval, et al., 2013; Hellewell, et al., 2019; Lin, et al., 2021). Given the relationships observed between CSD alteration in these brain regions and symptom scores, altered functioning following mTBI may contribute to the development of emotional symptoms of PPCS (Corcoran, et al., 2018).
Emotion, Motivation and Social Neuroscience:
Emotion and Motivation Other
Modeling and Analysis Methods:
EEG/MEG Modeling and Analysis 1
Novel Imaging Acquisition Methods:
EEG 2
Keywords:
Acquisition
ADULTS
Cortex
Electroencephaolography (EEG)
Emotions
Headache
Neurological
Somatosensory
Trauma
Other - Traumatic Brain Injury
1|2Indicates the priority used for review
Provide references using author date format
Corcoran, K. A., Yamawaki, N., Leaderbrand, K., & Radulovic, J. (2018), ‘Role of Retrosplenial Cortex in Processing Stress-Related Context Memories’, Behavioral Neuroscience, vol. 132, no. 5, pp. 388–395.
Duval, E. R., Hale, L. R., Liberzon, I., Lepping, R., N. Powell, J., Filion, D. L., & Savage, C. R. (2013), ‘Anterior cingulate cortex involvement in subclinical social anxiety’, Psychiatry Research: Neuroimaging, vol. 214, no. 3, pp. 459–461.
Gozt, A. K., Hellewell, S. C., Thorne, J., et al. (2021), ‘Predicting outcome following mild traumatic brain injury: Protocol for the longitudinal, prospective, observational Concussion Recovery (CREST) cohort study’, BMJ Open, vol. 11, no. 5.
Hellewell, S. C., Welton, T., Maller, J. J., Lyon, M., Korgaonkar, M. S., Koslow, S. H., Williams, L. M., Rush, A. J., Gordon, E., & Grieve, S. M. (2019). ‘Profound and reproducible patterns of reduced regional gray matter characterize major depressive disorder’, Translational Psychiatry, vol. 9, no. 1, pp. 176.
Lin, I.M., Yu, H.E., Yeh, Y.C., Huang, M.F., Wu, K.T., Ke, C.L. K., Lin, P.Y., & Yen, C.F. (2021), ‘Prefrontal Lobe and Posterior Cingulate Cortex Activations in Patients with Major Depressive Disorder by Using Standardized Weighted Low-Resolution Electromagnetic Tomography’, Journal of Personalized Medicine, vol. 11, no. 11, pp. 1054.
Straube, T., Schmidt, S., Weiss, T., Mentzel, H.-J., & Miltner, W. H. R. (2009), ‘Dynamic activation of the anterior cingulate cortex during anticipatory anxiety’. NeuroImage, vol. 44, no. 3, pp. 975–981.