Abstract Details

Title Neurovascular Coupling as Novel Biomarker of TBI-related Cognitive Decline

Topic Neuro Trauma and Critical Care

Presentation(s) S34 - Neuro Trauma and Sports Neurology (11:51 AM-12:03 PM)

Poster/Presentation
Number 004

Objective

Traumatic brain injury (TBI) patients report chronic cognitive difficulties after the injury. By using simultaneous EEG-fNIRS assessment under cognitive strain in TBI patients, we aimed to examine distinct neural and hemodynamic signatures that could potentially explain the experienced decline.

Background

TBI affects approximately 2.8 million Americans annually, with veterans of the US armed forces experiencing disproportionately high rates. Despite long-term cognitive complaints, conventional imaging is often normal, leaving neurophysiological mechanisms driving persistent cognitive decline elusive. While EEG and fNIRS independently demonstrate sensitivity to TBI-related dysfunction, simultaneous recording enables direct examination of the coordination between neural activity and cerebral blood flow, an effect described as neurovascular coupling.

Design/Methods

Thirteen individuals (aged 45.7±10.5) with history of combat-related mild TBI and without dementia underwent simultaneous 16-16 channel EEG-fNIRS recording during an n-back working memory task. All TBI participants passed standard cognitive screening (MOCA: 26±1.6); however, a comprehensive cognition battery using NIH Toolbox revealed two distinct subgroups: cognitively under-performing (score=31.57±5.71; n=6) and maintained (score=56.17±9.36; n=7). We paired our dataset with age-matched healthy controls (n=5). Hemodynamic responses, spectral power, event-related potentials, and functional connectivity between modalities were analyzed.

Results

Cognitively underperforming TBI patients demonstrated significantly reduced prefrontal hemodynamic responses during working memory compared to unimpaired TBI patients and controls, despite preserved spatial activation patterns. EEG analyses revealed characteristic TBI signatures: reduced alpha power, elevated slow-wave activity, and altered event-related potential amplitudes consistent with established literature. EEG-fNIRS correlation patterns revealed a significant decrease in functional connectivity in the cognitively underperforming group, implying a dissociation in neurovascular coupling.

Conclusions

Simultaneous EEG-fNIRS detected neurovascular coupling abnormalities in TBI patients who passed conventional screening, with reduced hemodynamic efficiency and altered neural oscillations correlating with cognitive underperformance. This multimodal approach offers potential biomarkers for detecting subtle TBI-related dysfunction and identifying candidates for targeted cognitive rehabilitation.

Authors/Disclosures
Zalan B. Kaposzta, MD, PhD Candidate PRESENTER	Dr. Kaposzta has nothing to disclose.
Mihaly Muranyi (The University of Oklahoma)	No disclosure on file
Ana Clara da Costa Pinaffi Langley, PhD	Mrs. da Costa Pinaffi Langley has nothing to disclose.
Leslie Guthery	Leslie Guthery has nothing to disclose.
Qingzhong Kong, PhD	The institution of Dr. Kong has received research support from CJD Foundation. Dr. Kong has received personal compensation in the range of $500-$4,999 for serving as a Grant reviewer with NIH and Alberta Innovates.
Andrea Vincent	Andrea Vincent has received personal compensation for serving as an employee of Vista LifeSciences. The institution of Andrea Vincent has received research support from Medical Technology Enterprise Consortium (MTEC).
Calin I. Prodan, MD (Univ of Oklahoma - Neurology Dept)	The institution of Dr. Prodan has received research support from US Department of Veterans Affairs (Merit award CX000340).
Andriy Yabluchanskiy	Andriy Yabluchanskiy has nothing to disclose.

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