Search

For people with disordered consciousness (DoC) after traumatic brain injury (TBI), relationships between treatment-induced changes in neural connectivity and neurobehavioral recovery have not been explored. To begin building a body of evidence regarding the unique contributions of treatments to changes in neural network connectivity relative to neurobehavioral recovery, we conducted a pilot study to identify relationships meriting additional examination in future research. To address this objective, we examined previously unpublished neural connectivity data derived from a randomized clinical trial (RCT). We leveraged these data because treatment efficacy, in the RCT, was based on a comparison of a placebo control with a specific intervention, the familiar auditory sensory training (FAST) intervention, consisting of autobiographical auditory-linguistic stimuli. We selected a subgroup of RCT participants with high-quality imaging data (FAST n = 4 and placebo n = 4) to examine treatment-related changes in brain network connectivity and how and if these changes relate to neurobehavioral recovery. To discover promising relationships among the FAST intervention, changes in neural connectivity, and neurobehavioral recovery, we examined 26 brain regions and 19 white matter tracts associated with default mode, salience, attention, and language networks, as well as three neurobehavioral measures. Of the relationships discovered, the systematic filtering process yielded evidence supporting further investigation of the relationship among the FAST intervention, connectivity of the left inferior longitudinal fasciculus, and auditory-language skills. Evidence also suggests that future mechanistic research should focus on examining the possibility that the FAST supports connectivity changes by facilitating redistribution of brain resources. For a patient population with limited treatment options, the reported findings suggest that a simple, yet targeted, passive sensory stimulation treatment may have altered functional and structural connectivity. If replicated in future research, then these findings provide the foundation for characterizing the unique contributions of the FAST intervention and could inform development of new treatment strategies. For persons with severely damaged brain networks, this report represents a first step toward advancing understanding of the unique contributions of treatments to changing brain network connectivity and how these changes relate to neurobehavioral recovery for persons with DoC after TBI.Clinical Trial Registry: NCT00557076, The Efficacy of Familiar Voice Stimulation During Coma Recovery (http://www.clinicaltrials.gov).

Musical preference is highly individualized and is an area of active study to develop methods for its quantification. Recently, preference-based behavior, associated with activity in brain reward circuitry, has been shown to follow lawful, quantifiable patterns, despite broad variation across individuals. These patterns, observed using a keypress paradigm with visual stimuli, form the basis for relative preference theory (RPT). Here, we sought to determine if such patterns extend to non-visual domains (i.e., audition) and dynamic stimuli, potentially providing a method to supplement psychometric, physiological, and neuroimaging approaches to preference quantification. For this study, we adapted our keypress paradigm to two sets of stimuli consisting of seventeenth to twenty-first century western art music (Classical) and twentieth to twenty-first century jazz and popular music (Popular). We studied a pilot sample and then a separate primary experimental sample with this paradigm, and used iterative mathematical modeling to determine if RPT relationships were observed with high R2 fits. We further assessed the extent of heterogeneity in the rank ordering of keypress-based responses across subjects. As expected, individual rank orderings of preferences were quite heterogeneous, yet we observed mathematical patterns fitting these data similar to those observed previously with visual stimuli. These patterns in music preference were recurrent across two cohorts and two stimulus sets, and scaled between individual and group data, adhering to the requirements for lawfulness. Our findings suggest a general neuroscience framework that predicts human approach/avoidance behavior, while also allowing for individual differences and the broad diversity of human choices; the resulting framework may offer novel approaches to advancing music neuroscience, or its applications to medicine and recommendation systems.