Resting-State Connectivity Changes Vary with Psychiatric Symptoms in Psychogenic Nonepileptic Seizures Following TBI
Abstract number :
2.175
Submission category :
5. Neuro Imaging / 5B. Functional Imaging
Year :
2021
Submission ID :
1825761
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:50 AM
Authors :
Pranav Kakulamarri, Undergraduate - University of Alabama at Birmingham; Adam Goodman, PhD - Department of Neurology - University of Alabama at Birmingham; Rodolphe Nenert, PhD - Department of Neurology - University of Alabama at Birmingham; Jane Allendorfer, PhD - University of Alabama at Birmingham; Noah Philip, MD - Brown University; W. Curt LaFrance, MD,MPH - Brown University; Jerzy Szaflarski, MD,PhD - Department of Neurology - University of Alabama at Birmingham
Rationale: Onset of psychogenic nonepileptic (functional) seizures (FS) frequently follows traumatic brain injury (TBI). Better understanding of comorbid psychiatric symptoms and aberrant emotion processing comprise important gaps in elucidating the biological basis of FS and development specific treatments. Prior resting-state functional MRI (rs-fMRI) studies have examined aberrant brain networks in FS related to dissociative symptoms to characterize the etiology of FS. In the current study, a large sample of patients with FS and pre-existing TBI to were assessed using a data-driven rs-fMRI approach. We hypothesized that aberrant networks in FS are related to mood, anxiety, and somatization symptom severity.
Methods: Volunteers with a history of TBI without FS (TBI-only; n=51) and with FS (TBI+FS; n=52) were recruited from the Rhode Island Hospital and the University of Alabama at Birmingham. History of TBI was verified prior to enrollment via medical history and FS diagnosis was confirmed via video-EEG. Patients completed psychiatric symptom questionnaires including: the BDI-II (depression), BAI (anxiety), PCL-S (PTSD), and SCL-90-R SOM (somatization) prior to rs-fMRI data acquisition. Independent Component Analysis (ICA) using the GIFT-ICA toolbox identified five networks of interest and linear mixed effects (LME) analysis compared group spatial maps for salience, default-mode, executive, visual, and sensorimotor rs-fMRI networks between groups.
Results: Volunteers with a history of TBI without FS (TBI-only; n=51) and with FS (TBI+FS; n=52) were recruited from the Rhode Island Hospital and the University of Alabama at Birmingham. History of TBI was verified prior to enrollment via medical history and FS diagnosis was confirmed via video-EEG. Patients completed psychiatric symptom questionnaires including: the BDI-II (depression), BAI (anxiety), PCL-S (PTSD), and SCL-90-R SOM (somatization) prior to rs-fMRI data acquisition. Independent Component Analysis (ICA) using the GIFT-ICA toolbox identified five networks of interest and linear mixed effects (LME) analysis compared group spatial maps for salience, default-mode, executive, visual, and sensorimotor rs-fMRI networks between groups.
Conclusions: Using TBI as a model, patients with TBI + FS demonstrated aberrant connectivity within default mode and executive control networks. Connectivity strength within the default mode and executive control networks that differed between groups were negatively correlated with mood, anxiety, PTSD, and somatization severity. These findings implicate specific network disruptions linked to emotion-relevant symptom expression in FS and possibly other functional neurological symptoms.
Funding: Please list any funding that was received in support of this abstract.: This work was supported by the US Department of Defense (W81XH-17-0619) to WCL and JPS.
Neuro Imaging