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to monitor improvements in motor function related to Local and large-scale beta oscillatory dysfunction in
neuroplasticity following rehabilitation for severe trau- males with mild traumatic brain injury (2020)
matic brain injury (TBI). The findings demonstrated that
motor function improvements can occur years beyond Zhang, Jing; Safar, Kristina; Emami, Zahra; Ibrahim,
current established limits. The current study extends George M; Scratch, Shannon E; da Costa, Leodante;
the functional imaging investigation to characterize Dunkley, Benjamin T
neuromodulation effects on neuroplasticity to further
push the limits. Neurosciences & Mental Health, SickKids Research Institute,
Toronto Ontario, Canada; Department of Neurosurgery, Hos-
METHODS Canadian Soldier Captain (retired) Trevor pital for Sick Children, Toronto, Ontario, Canada; Rehabilita-
Greene (TG) survived a severe open-TBI when attacked tion Sciences Institute, University of Toronto, Toronto, Ontario,
with an axe during a 2006 combat tour in Afghanistan. Canada; Sunnybrook Health Sciences Centre, Toronto,
TG has since continued intensive daily rehabilitation to Ontario, Canada; Department of Medical Imaging, University
recover motor function, experiencing an extended pla- of Toronto, Toronto, Ontario, Canada
teau using conventional physical therapy. To overcome
this plateau, we paired translingual neurostimulation ABSTRACT Mild traumatic brain injury (mTBI) is impos-
(TLNS) with the continuing rehabilitation program. sible to detect with standard neuroradiological assess-
ment such as structural magnetic resonance imaging
RESULTS Combining TLNS with rehabilitation resulted (MRI). Injury does, however, disrupt the dynamic rep-
in demonstrable clinical improvements along with ertoire of neural activity indexed by neural oscillations.
corresponding changes in movement evoked electro- In particular, beta oscillations are reliable predictors of
encephalography (EEG) activity. High-density magneto- cognitive, perceptual, and motor system functioning,
encephalography (MEG) characterized cortical activa- as well as correlating highly with underlying myelin ar-
tion changes in corresponding beta frequency range chitecture and brain connectivity-all factors particularly
(27 Hz). MEG activation changes corresponded with susceptible to dysregulation after mTBI. We measured
reduced interhemispheric inhibition in the post-central local and large-scale neural circuit function by magne-
gyri regions together with increased right superior/ toencephalography (MEG) with a data-driven model
middle frontal activation suggesting large scale net- fit approach using the fitting oscillations and one-over
work level changes. f algorithm in a group of young adult men with mTBI
and a matched healthy control group. We quantified
CONCLUSIONS The findings provide valuable insight band-limited regional power and functional connectiv-
into the potential importance of non-invasive neuro- ity between brain regions. We found reduced regional
modulation to enhance neuroplasticity mechanisms for power and deficits in functional connectivity across
recovery beyond the perceived limits of rehabilitation. brain areas, which pointed to the well-characterized
thalamocortical dysconnectivity associated with mTBI.
Keywords: Brain vital signs, Electroencephalography Furthermore, our results suggested that beta functional
(EEG), Functional connectivity, Magnetoencephalography connectivity data reached the best mTBI classifica-
(MEG), Motor function, Neuroplasticity, Portable neuro- tion performance compared with regional power and
modulation stimulator (PoNS), Rehabilitation, Translingual symptom severity [measured with Sport Concussion
neurostimulation (TLNS), Traumatic brain injury (TBI) Assessment Tool 2 (SCAT2)]. The present study reveals
the relevance of beta oscillations as a window into neu-
Journal of neuroengineering and rehabilitation (2020), Vol. rophysiological dysfunction in mTBI and also highlights
17, No. 1 (33261623) (6 citations) the reliability of neural synchrony biomarkers in disor-
der classification.NEW & NOTEWORTHY Mild traumatic
brain injury (mTBI) disrupts the dynamic repertoire of
neural oscillations, but so far beta activity has not been

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