Exploring the Connection Between Brain Network Connectivity and Cognitive Attention Following Acquired Brain Injury: A Systematic Review of Structural and Functional Measures
Athena Stein1, Jacob Thorstensen1, Jonathan Ho1, Daniel Ashley2, Kartik Iyer1, Karen Barlow1
1Acquired Brain Injury in Children Research Group, Child Health Research Centre, The University of Queensland, 2Faculty of Medicine, The University of Queensland; Ochsner Health
Objective:
This systematic review examined the relationship between brain connectivity, measured across multimodal forms of neuroimaging (diffusion tensor imaging, functional magnetic resonance imaging, electroencephalography, functional near-infrared spectroscopy), and attention following acquired brain injury (ABI).
Background:
Worldwide, traumatic brain injury (TBI) affects 69 million each year. Cognitive complaints are common following ABI and have been linked to alterations in brain network connectivity following injury. However, the relationship between brain network disruption and common cognitive issues such as attention dysfunction is heterogeneous.
Design/Methods:
Following the initial search (4693 results) and full text screening, we systematically reviewed 43 studies which reported a correlation between attention and brain connectivity. The quality of the included studies was assessed using the AXIS tool.
Results:
Following ABI, greater attention was associated with greater structural global and local efficiency within and between the executive network (ECN), salience network (SN), and default mode network (DMN); greater fc within and between the ECN and DMN; greater fc between the DMN and other task-positive networks; or greater cerebellar/motor fc. Attention-related structural connectivity differed across pediatric (n=7 studies) and adult (n=36 studies) populations, whereas fc trends were similar across the lifespan. Following stroke, poorer attention was associated with lower structural connectivity within the ECN; or greater fc between ECN, dorsal attention, motor, visual, and subcortical networks, particularly in DAN.
Conclusions:
These results indicate that structural and functional connectivity changes in the ECN, DMN, DAN and VAN, and other networks are significantly associated with attention following acquired brain injury across the lifespan and during recovery. The use of portable techniques such as EEG and fNIRS demonstrates the potential for use at the point-of-care. Limitations include the predominant utilization of ROI-based analyses, therefore biasing brain regions examined. Future research is needed using standardized analysis pipelines to limit heterogeneity, as well as long-term follow-up to better understand recovery trajectories.