Purpose

This study aimed to investigate the early functional connectivity alterations between insula subdivisions and other cortical regions in patients with acute mild traumatic brain injury (mTBI) and subsequently to explore the relationship between functional connectivity changes of insula subdivisions with other cortical regions and cognitive function.

Methods

Fifty-three mTBI patients and 37 age-, gender- and education level- matched healthy controls were included in this study. All participants obtained resting state functional magnetic resonance imaging (rs-fMRI) and clinical and neuropsychological evaluations (Montreal cognitive assessment, MoCA) at the acute stage. Functional connectivity alterations of insula subdivisions and correlations with MoCA were further explored by seed-voxel functional connectivity.

Results

Compared with healthy controls, patients with acute mTBI showed significantly decreased functional connectivity between the L-vAI and the left middle temporal gyrus and right superior frontal gyrus and significantly decreased functional connectivity between the R-vAI and the right middle frontal gyrus and right hippocampus. While significantly decreased functional connectivity were observed between the L-dAI and the right superior frontal gyrus. In addition, significantly increased functional connectivity was observed between the R-PI and the left inferior frontal gyrus. Furthermore, the mTBI group demonstrated positive correlations between performances in orientation and insula and middle temporal gyrus and superior frontal gyrus and middle frontal gyrus functional connectivities. Abstraction scores for mTBI patients positively correlated with functional connectivity between insula and middle frontal gyrus.

Conclusions

The present study demonstrated functional connectivity dysfunction of insula subdivisions and correlations between these alterations and cognitive performance, which provide a novel insight into the neurophysiological mechanism of cognitive impairment in patients with mTBI at the acute stage.

中文翻译：

---

急性轻度外伤性脑损伤后认知功能障碍中的岛状细分功能连接功能障碍。

目的

这项研究旨在调查急性轻度颅脑损伤（mTBI）患者的岛隔和其他皮质区域之间的早期功能连通性改变，并随后探讨岛隔与其他皮质区域的功能连通性变化与认知功能之间的关系。

方法

这项研究包括53例mTBI患者和37例年龄，性别和教育水平相匹配的健康对照。所有参与者在急性期均获得了静息状态功能磁共振成像（rs-fMRI）以及临床和神经心理学评估（蒙特利尔认知评估，MoCA）。种子体素功能连接性进一步探讨了岛状细分功能连接的改变以及与MoCA的相关性。

结果

与健康对照组相比，急性mTBI患者显示L-vAI与左颞中回和右上额额回之间的功能连通性显着降低，R-vAI与右中额回和右海马区之间的功能连通性显着降低。虽然观察到L-dAI和右上额额回之间的功能连通性显着降低。另外，观察到R-PI和左下额回之间的功能连接性显着增加。此外，mTBI组显示了定向和绝缘与中颞回，上额额回和中额额回的功能性连接之间的正相关。

结论

本研究证明了岛状细分的功能连通性功能障碍以及这些改变与认知表现之间的相关性，这为mTBI急性期认知障碍的神经生理机制提供了新的见解。