Brain mechanisms explaining postural imbalance in traumatic brain injury: a systematic review
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Accepted version
Accepted version
Author(s)
Hadi, Zaeem
Mahmud, Mohammad
Seemungal, Barry
Type
Journal Article
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.
Date Acceptance
2024-02-04
Citation
Brain Connectivity, 14
ISSN
2158-0022
Publisher
Mary Ann Liebert
Journal / Book Title
Brain Connectivity
Volume
14
Copyright Statement
Copyright © 2024 PubMed. This is the author’s accepted manuscript made available under a CC-BY licence in accordance with Imperial’s Research Publications Open Access policy (www.imperial.ac.uk/oa-policy)
License URL
Identifier
https://www.liebertpub.com/doi/10.1089/brain.2023.0064?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Publication Status
Published online
Date Publish Online
2024-02-12