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Longitudinal structural connectomic and rich-club analysis in adolescent mTBI reveals persistent, distributed brain alterations acutely through to one year post-injury
Abstract
The diffuse nature of mild traumatic brain injury (mTBI) impacts brain white-matter pathways with potentially long-term consequences, even after initial symptoms have resolved. To understand post-mTBI recovery in adolescents, longitudinal studies are needed to determine the interplay between highly individualised recovery trajectories and ongoing development. To capture the distributed nature of mTBI and recovery, we employ connectomes to probe the brain’s structural organisation. We present a diffusion MRI study on adolescent mTBI subjects scanned one day, two weeks and one year after injury with controls. Longitudinal global network changes over time suggests an altered and more ‘diffuse’ network topology post-injury (specifically lower transitivity and global efficiency). Stratifying the connectome by its back-bone, known as the ‘rich-club’, these network changes were driven by the ‘peripheral’ local subnetwork by way of increased network density, fractional anisotropy and decreased diffusivities. This increased structural integrity of the local subnetwork may be to compensate for an injured network, or it may be robust to mTBI and is exhibiting a normal developmental trend. The rich-club also revealed lower diffusivities over time with controls, potentially indicative of longer-term structural ramifications. Our results show evolving, diffuse alterations in adolescent mTBI connectomes beginning acutely and continuing to one year.
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“alongside reduced global network efficiency”
From A systematic review of brain structural and functional alterations in pediatric mild traumatic brain injury (2026) · cites this paper as Chung et al., 2019
In the citing paper
“while three additional studies observed similar alterations in commissural fibers (corpus callosum genu and splenium) and projection pathways (internal capsule, corona radiata, and superior longitudinal fasciculus) (Mayer et al., 2012; Van Beek et al., 2015a; Chung et al., 2019).”
From A systematic review of brain structural and functional alterations in pediatric mild traumatic brain injury (2026) · cites this paper as Chung et al., 2019
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“disrupted hub connectivity in executive and salience networks”
From A systematic review of brain structural and functional alterations in pediatric mild traumatic brain injury (2026) · cites this paper as Chung et al., 2019
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“In addition, 4 studies applied graph theoretical approaches, with 3 studies reporting altered network topology characterized by reduced global efficiency and disrupted hub connectivity in regions associated with executive control and salience networks, including the superior frontal gyrus, middle frontal gyrus, insula, and fusiform gyrus (Chung et al., 2019; Yuan et al., 2014; Ware et al., 2022;”
From A systematic review of brain structural and functional alterations in pediatric mild traumatic brain injury (2026) · cites this paper as Chung et al., 2019
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Citations
Cites
Network hubs in the human brain
van den Heuvel, M. P., & Sporns, O. (2013) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2013.09.012 · Cited by 2,123
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Tractography-based connectomes are dominated by false-positive connections
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The hubs of the human connectome are generally implicated in the anatomy of brain disorders
Crossley, N. A., Mechelli, A., Scott, J., Carletti, F., Fox, P. T., McGuire, P., & Bullmore, E. T. (2014) · Brain · doi:10.1093/brain/awu132 · Cited by 1,166
Detecting rich-club ordering in complex networks
Colizza, V., Flammini, A., Serrano, M. A., & Vespignani, A. (2006) · Nature Physics · doi:10.1038/nphys209 · Cited by 1,001
Zemek, R., Barrowman, N., Freedman, S. B., Gravel, J., Gagnon, I., McGahern, C., Aglipay, M., Sangha, G., Boutis, K., Beer, D., et al. (2016) · JAMA · doi:10.1001/jama.2016.1203 · Cited by 900
High-cost, high-capacity backbone for global brain communication
van den Heuvel, M. P., Kahn, R. S., Goñi, J., & Sporns, O. (2012) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1203593109 · Cited by 781
Neuroimaging after mild traumatic brain injury: review and meta-analysis
Eierud, C., Craddock, R. C., Fletcher, S., Aulakh, M., King-Casas, B., Kuehl, D., & LaConte, S. M. (2014) · NeuroImage: Clinical · doi:10.1016/j.nicl.2013.12.009 · Cited by 524
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Cited by
Xu, H., Wu, S., Zhan, H., Xu, G., Zhao, J., & Yin, B. (2026) · Frontiers in Neuroscience · doi:10.3389/fnins.2026.1879109
Metadata
- Authors
- Chung, A. W., Mannix, R., Feldman, H. A., Grant, P. E., & Im, K.
- ORCID
- Chung, Ai Wern
- Venue
- Scientific Reports
- Published
- 2019-12-11
- Volume
- 9
- Issue
- 1
- ISSN
- 2045-2322
- Cited by
- 16
- References
- 13
- Language
- en
- Licence
- creativecommons.org/licenses/by/4.0 (tdm)
- creativecommons.org/licenses/by/4.0 (vor)
- Funders
- American Heart Association (19POST34880005)
- Children's Heart Foundation (19POST34880005)
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