Citation

Hadi Z, Mahmud M, Seemungal B. Brain Connect. 2024; ePub(ePub): ePub.

Copyright

(Copyright © 2024, Mary Ann Liebert Publishers)

DOI

10.1089/brain.2023.0064

PMID

38343363

Abstract

Persisting imbalance and falls in community-dwelling traumatic brain injury (TBI) survivors are linked to reduced long-term survival. However, a detailed understanding of the impact of TBI upon the brain mechanisms mediating imbalance is lacking. To understand the state of the art concerning the brain mechanisms mediating imbalance in TBI, we performed a systematic review of the literature. PubMed, Web of Science, and Scopus were searched and peer-reviewed research articles in humans, with any severity of TBI (mild, moderate, severe, or concussion), that linked a postural balance assessment (objective or subjective) with brain imaging (via CT, T1-weighted imaging, fMRI, resting-state fMRI, DTI, MRS, SPECT, EEG, MEG, NIRS, and evoked potentials) were included. Out of 1940 articles, 60 were retrieved and screened, and 25 articles fulfilling inclusion criteria were included. The most consistent finding was the link between imbalance and the cerebellum, however, the regions within the cerebellum were inconsistent. The lack of consistent findings could reflect that imbalance in TBI is due to a widespread brain network dysfunction, as opposed to focal cortical damage. The inconsistency in the reported findings may also be attributed to heterogeneity of methodology including data analytical techniques, small sample sizes, and choice of control groups. Future studies should include a detailed clinical phenotyping of vestibular function in TBI patients to account for the confounding effect of peripheral vestibular disorders on imbalance and brain imaging.

Language: en

Keywords

Functional connectivity; Structural connectivity; Traumatic brain injury