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Quantitative electroencephalography reveals regional brain dysfunction in mild traumatic brain injury (22043)

Caerwen S Beaton 1 2 , Andre Avila 1 2 , Melissa Papini 1 2 , Jacinta Thorne 1 2 , Aleksandra Gozt 1 2 , Francesca Buhagiar 3 , Elizabeth Thomas 4 5 , Alexander Ring 6 7 , Glenn Arendts 8 9 , John C Iliff 10 11 12 13 , Antonio Celenza 14 15 , Sjinene Van Schalkwyk 16 , Philip Brooks 5 10 17 , Dan Xu 4 10 18 , Stephen Honeybul 19 20 , Gill Cowen 1 4 10 , Carmela Pestell 1 3 , Daniel Fatovich 9 21 22 , Ben Smedley 23 , Ashes Mukherjee 24 , Michael Bynevelt 25 , Melinda Fitzgerald 1 2 , Sarah Hellewell 1 2
  1. Faculty of Health Sciences, Curtin Health Innovation Research Institute, Perth, WA, Australia
  2. Perron Institute of Neurological and Translational Science, Perth, WA, Australia
  3. The University of Western Australia, School of Psychological Science, Perth, WA, Australia
  4. Curtin University, School of Population Health, Perth, WA, Australia
  5. School of Medicine, The University of Western Australia, Division of Pathology and Laboratory Medicine, Perth, WA, Australia
  6. Murdoch University, Institute for Immunology and Infectious Diseases, Perth, WA, Australia
  7. Faculty of Health Sciences, Curtin University, School of Physiotherapy and Exercise Science, Perth, WA, Australia
  8. Fiona Stanley Hospital, Emergency Department, Perth, WA, Australia
  9. Harry Perkins Institute of Medical Research, Centre for Clinical Research in Emergency Medicine, Perth, WA, Australia
  10. Curtin University, Curtin Medical School, Perth, WA, Australia
  11. Saint John of God Hospital Murdoch, Emergency Department, Perth, WA, Australia
  12. Royal Perth Hospital, Emergency Department, Perth, WA, Australia
  13. Western Operations, Royal Flying Doctor Service, Perth, WA, Australia
  14. Sir Charles Gairdner Hospital, Emergency Department, Perth, WA, Australia
  15. School of Medicine, The University of Western Australia, Division of Emergency Medicine, Perth, WA, Australia
  16. Joondalup Health Campus, Emergency Department, Perth, WA, Australia
  17. Saint John of God Midland Public Hospital, Emergency Department, Perth, WA, Australia
  18. Sun Yat-Sen University, The First Affiliated Hospital, Guangzhou, China
  19. Government of Western Australia, Department of Health, Perth, WA, Australia
  20. Royal Perth Hospital and Fiona Stanley Hospital, Sir Charles Gairdner Hospital, Perth, WA, Australia
  21. Royal Perth Hospital, Emergency Medicine, Perth, WA, Australia
  22. The University of Western Australia, Perth, WA, Australia
  23. Rockingham General Hospital, Emergency Department, Perth, WA, Australia
  24. Armadale Health Service, Emergency Department, Perth, WA, Australia
  25. Sir Charles Gairdner Hospital, The Neurological Intervention & Imaging Service of Western Australia, Perth, WA, Australia

Objectives: Mild traumatic brain injury (mTBI) can cause physical, psychological, cognitive and sleep-related symptoms, though it is unclear how symptoms relate to brain dysfunction. This study used quantitative electroencephalography (qEEG) to detect regional brain dysfunction and determine correlation with symptoms post-mTBI.

Methods: 24 participants with mTBI (36.56±12.87y; 10F) and 30 matched controls (33.88±12.15y; 14F) were included in the Concussion REcovery STudy subanalysis. Participants completed the Post-Concussion Symptom Scale (PCSS) and Depression-Anxiety-Stress Scale (DASS-21) 5-days post-injury. qEEG scans were acquired in Neuroguide across 19 channels in resting-state with eyes open. NeuroNavigator generated Brodmann areas (BA) current source density (CSD). T-tests were used to determine the effects of mTBI on CSD across BAs. Pearson correlations evaluated the relationship of BA CSD findings to PCSS and DASS-21 scores.

Findings: Substantial bilateral CSD increases in mTBI participants were detected within the cingulate and retrosplenial cortices compared to controls. In the mTBI group, delta CSD within the left cingulate correlated with PCSS total score (r= -0.48, p<0.05) and severity (r= -0.53, p<0.05). Beta band bilateral CSD of cingulate (BAs 23, 31) and retrosplenial cortices (BAs 26, 29) correlated with DASS-21 anxiety and stress scores (all r>0.44; p<0.05), while unilateral CSD correlated with depression scores: right-BA 23, r=0.47, p<0.05; left-BA 26, r=0.52, p<0.05; right-BA 29, r=0.63, p<0.001.

Conclusion: These findings suggest that the cingulate and retrosplenial cortices are vulnerable to mTBI. Early CSD alterations may drive emotional symptoms post-injury, as they correlate with emotional states linked to BAs involved in anxiety, depression, and stress-related memory.