The network-based underpinnings of persisting symptoms after concussion: a multimodal neuroimaging meta-analysis
Bibliographic record
Abstract
Persisting symptoms after concussion (PSaC) represent a complex and poorly understood neuropsychiatric phenomenon with limited treatment options. Neural network dysfunction has been associated with PSaC, and neuromodulation, particularly repetitive transcranial magnetic stimulation, may be a promising intervention. However, neuroimaging findings have been inconsistent, limiting understanding of underlying network dysfunction. We aimed to identify a core neural network associated with PSaC and explore whether this network could yield candidate cortical targets for neuromodulation at the individual level. We hypothesized that differences in network disruption would be evident between individuals with high versus low symptom burden in PSaC. Here we show that a convergent multi-analytic approach combining symptom-activation maps generated from existing fMRI datasets, systematic review of resting-state fMRI studies of PSaC, and network-based meta-analysis of coordinates derived from these studies co-localize to the salience network in high symptom burden PSaC. Using Human Connectome Project data, we mapped this network to cortical regions that could serve as individualized targets for neuromodulation. This aligns with current clinical models of PSaC and may present a new direction for network-based therapy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.019 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.017 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".