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Cited by 13Traumatic Brain Injury ResearchFunctional Brain Connectivity StudiesAdvanced Neuroimaging Techniques and Applications

Concussion-Related Disruptions to Hub Connectivity in the Default Mode Network Are Related to Symptoms and Cognition

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Bouchard, Heather C., Higgins, Kate L., Amadon, Grace K., Laing-Young, Julia M., Maerlender, Arthur, Al‑Momani, Seima, Neta, Maital, Savage, Cary R. +1 more·2024·Journal of Neurotrauma
DOI 10.1089/neu.2023.0089

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Abstract

Concussions present with a myriad of symptomatic and cognitive concerns; however, the relationship between these functional disruptions and the underlying changes in the brain are not yet well understood. Hubs, or brain regions that are connected to many different functional networks, may be specifically disrupted after concussion. Given the implications in concussion research, we quantified hub disruption within the default mode network (DMN) and between the DMN and other brain networks. We collected resting-state functional magnetic resonance imaging data from collegiate student-athletes ( n = 44) at three time points: baseline (before beginning their athletic season), acute post-injury (approximately 48h after a diagnosed concussion), and recovery (after starting return-to-play progression, but before returning to contact). We used self-reported symptoms and computerized cognitive assessments collected across similar time points to link these functional connectivity changes to clinical outcomes. Concussion resulted in increased connectivity between regions within the DMN compared with baseline and recovery, and this post-injury connectivity was more positively related to symptoms and more negatively related to visual memory performance compared with baseline and recovery. Further, concussion led to decreased connectivity between DMN hubs and visual network non-hubs relative to baseline and recovery, and this post-injury connectivity was more negatively related to somatic symptoms and more positively related to visual memory performance compared with baseline and recovery. Relationships between functional connectivity, symptoms, and cognition were not significantly different at baseline versus recovery. These results highlight a unique relationship between self-reported symptoms, visual memory performance, and acute functional connectivity changes involving DMN hubs after concussion in athletes. This may provide evidence for a disrupted balance of within- and between-network communication highlighting possible network inefficiencies after concussion. These results aid in our understanding of the pathophysiological disruptions after concussion and inform our understanding of the associations between disruptions in brain connectivity and specific clinical presentations acutely post-injury.

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  • Persistent post-concussive symptoms are associated with disruptions in large-scale functional brain networks.

    “The rationale for applying TMS, and specifically iTBS, to PCS stems from converging evidence suggesting that persistent post-concussive symptoms are associated with disruptions in largescale functional brain networks.”

    From Functional MRI Guided Accelerated Intermittent Theta Burst Stimulation for Chronic Post-Concussive Syndrome: A Feasibility and Efficacy Study (2025) · cites this paper as [8]

    The Discussion and Conclusion (pages not provided) link disrupted connectivity within and between large-scale networks to cognitive and somatic symptoms after concussion. However, the study found the symptom–connectivity relationship was strongest acutely, about 48 hours after injury; it does not establish that persistent post-concussive symptoms are associated with those disruptions. The Conclusion notes that some connectivity disruptions remained after clinical recovery even when symptoms returned to baseline. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Alterations in DMN connectivity are commonly observed post-mTBI and linked to cognitive complaints.

    “Default Mode Network (DMN): Implicated in self-referential thought and introspection, alterations in DMN connectivity (often increased intra-network connectivity or altered connectivity with other networks) are commonly observed post-mTBI and linked to cognitive complaints 89 10 11 .”

    From Functional MRI Guided Accelerated Intermittent Theta Burst Stimulation for Chronic Post-Concussive Syndrome: A Feasibility and Efficacy Study (2025) · cites this paper as [8]

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Cited by

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Authors
Bouchard, H. C., Higgins, K. L., Amadon, G. K., Laing-Young, J. M., Maerlender, A., Al‑Momani, S., Neta, M., Savage, C. R., & Schultz, D. H.
Affiliations
  • University of Nebraska–Lincoln (US)
  • Center for Brain, Biology and Behavior, University of Nebraska-Lincoln, Lincoln, Nebraska, USA.
Corresponding author
Bouchard, Heather C.
ORCID
Venue
Journal of Neurotrauma
Publisher
SAGE Publications
Published
2024-02-27
Volume
41
Issue
5-6
Pages
571-586
ISSN
  • 0897-7151 (ISSN-L)
  • 1557-9042
DOI
10.1089/neu.2023.0089
OpenAlex
W4388801635
Cited by
13
References
4
Citations by year
2026: 3 · 2025: 8 · 2024: 2
FWCI
3.99
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Neurotrauma (publishedVersion)
  • bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion, cc-by-nd)
  • PubMed (publishedVersion)
  • Lincoln (University of Nebraska) (submittedVersion, cc-by-nd)
Funders
University of Nebraska-Lincoln
Topics
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
Keywords
concussion, default mode network, resting-state functional connectivity, visual memory, somatic symptoms, post-concussion symptoms, cognitive impairment, collegiate athletes, return to sport
MeSH terms
Default Mode Network, Brain, Brain Concussion, Cognition, Humans, Athletes

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