Understanding individual variability in symptoms and recovery following mTBI: a role for TMS-EEG
Abstract
The pathophysiology associated with mild traumatic brain injury (mTBI) includes neurometabolic and cytoskeletal changes that have been shown to impair structural and functional connectivity. Evidence that persistent neuropsychological impairments post injury are linked to structural and functional connectivity changes is increasing. However, to date the relationship between connectivity changes, heterogeneity of persistent symptoms and recovery post mTBI has been poorly characterised. Recent innovations in neuroimaging provide new ways of exploring connectivity changes post mTBI. Namely, combined transcranial magnetic stimulation and electroencephalography (TMS-EEG) offers several advantages over traditional approaches for studying connectivity changes post TBI. Its ability to perturb neural function in a controlled manner allows for measurement of causal interactions or effective connectivity between brain regions. We review the current literature assessing structural and functional connectivity following mTBI and outline the rationale for the use of TMS-EEG as an ideal tool for investigating the neural substrates of connectivity dysfunction and reorganisation post mTBI. The diagnostic, prognostic and potential therapeutic implications will also be explored.
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Dysregulated connectivity is associated with higher self-reported symptoms and poorer cognitive performance, leading mTBI to be conceptualized as a disorder of brain connectivity and a disconnection syndrome.
“Associations have been reported between dysregulated connectivity, higher levels of self-reported symptoms and poorer cognitive performance, leading mTBI to be conceptualized as a “disorder of brain connectivity” (Hayes, Bigler, & Verfaellie, 2016) and a “disconnection syndrome” (Coyle, Ponsford, & Hoy, 2018).”
From Investigation of neurobiological responses to theta burst stimulation during recovery from mild traumatic brain injury (mTBI) (2023) · cites this paper as Coyle, Ponsford, & Hoy, 2018
mTBI-induced pathophysiology may further increase inter- and intra-individual variability in response to NIBS compared to healthy subjects.
“Consequently, mTBI induced pathophysiology may further increase inter and intra individual variability in response to NIBS compared to healthy subjects.”
From Investigation of neurobiological responses to theta burst stimulation during recovery from mild traumatic brain injury (mTBI) (2023) · cites this paper as Coyle et al., 2018
One of the key challenges in mTBI diagnosis and prognosis is heterogeneity, and the diffuse and dynamic nature of mTBI may make each injury potentially unique.
“One of the key challenges in mTBI diagnosis and prognosis is heterogeneity, and it has been proposed that the diffuse and dynamic nature of mTBI may make each injury potentially unique (Bigler & Maxwell, 2012;Coyle et al., 2018).”
From Investigation of neurobiological responses to theta burst stimulation during recovery from mild traumatic brain injury (mTBI) (2023) · cites this paper as Coyle et al., 2018
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References 175 · Cited by 21
- Authors
- Coyle, H. L., Ponsford, J., & Hoy, K. E.
- Affiliations
- The Alfred Hospital (AU)
- Monash University (AU)
- Corresponding author
- Coyle, Hannah L.
- Venue
- Neuroscience & Biobehavioral Reviews
- Publisher
- Elsevier BV
- Published
- 2018-09
- Volume
- 92
- Pages
- 140-149
- ISSN
- 0149-7634 (ISSN-L)
- OpenAlex
- W2805717408
- Cited by
- 21
- References
- 175
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 5 · 2022: 2 · 2021: 2 · 2020: 4 · 2019: 1
- FWCI
- 0.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neuroscience & Biobehavioral Reviews (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Health and Medical Research Council (1082894)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Keywords
- mild traumatic brain injury, TMS-EEG, structural connectivity, functional connectivity, effective connectivity, brain injury recovery, cytoskeletal changes, prognostic factors, therapeutic target
- MeSH terms
- Brain Injuries, Traumatic, Animals, Brain, Electroencephalography, Humans, Recovery of Function, Transcranial Magnetic Stimulation, Neuroimaging
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