Pilot study examines neural mechanisms of balance disorders after traumatic brain injury

East Hanover, NJ. October 20, 2021. Using neuroimaging techniques and electroencephalography (EEG), the Kessler Foundation researchers compared the neural correlates of balance in individuals with traumatic brain injury and matched controls. This study is the first to report EEG-based functional connectivity measurements during an imbalance task and show the association with brain white matter integrity.

The article Graph-theoretical analysis of EEG Functional Connectivity during Balance Perturbation in Traumatic Brain Injury: A Pilot Study (doi:10.1002/hbm.25554) was published online on July 26, 2021 by Human Brain Mapping. It is freely available at: The authors are Vikram Shenoy Handiru, PhD, Alaleh Alivar, PhD, Armand Hoxha, MS, Soha Saleh, PhD, Easter S. Suviseshamuthu, PhD, Guang Yue, PhD, and Didier Allexandre, PhD, from the Center for Mobility and Rehabilitation Engineering Research in the Kessler Foundation.

Postural instability is an understudied complication of traumatic brain injury that hinders progress in rehabilitation, limits independence, and compromises safety. Despite the impact on the daily lives of individuals and their caregivers, little research has been conducted on the neural mechanisms that contribute to balance function.

For this pilot study, researchers from the Neuromuscular and Electrophysiology Laboratory of Dr. Allexandre 17 adults with traumatic brain injury and 15 matched controls. Using a computerized posturography platform and an EEG, the scientists provided random vestibular disturbances and measured each participant’s neural and postural responses. In addition, a subset of participants underwent magnetic resonance imaging (MRI) at the Kessler Foundation’s Rocco Ortenzio Center for Neuroimaging to measure brain structural integrity using diffusion tensor imaging (DTI).

DTI studies revealed widespread structural damage in the traumatic brain injury group, which exhibited poorer balance performance and decreased brain activity and connectivity during balance tasks. The graph-theoretic measurements of brain functional connectivity derived from EEG data reveal an abnormal brain network response during the balance task, an intriguing finding that warrants further investigation.

Using EEG-based plot measurements, we were able to examine the differences in underlying structural and functional mechanisms in individuals with and without traumatic brain injury, which could lead to the identification of a neural biomarker for vestibular disorders. Future investigations need to examine how brain networks affected by brain injury can be modulated. We hypothesize that postural training could be a way to rewire damaged networks so that their function mimics that of the healthy brain, leading to the desired outcome of improved balance function.

lead author dr Shenoy Handiru.

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Funding Sources: New Jersey Commission on Brain Injury Research CBIR15MIG004

About the Kessler Foundation

The Kessler Foundation, a major disability nonprofit, is a global leader in rehabilitation research aimed at improving cognition, mobility, and long-term outcomes, including employment, for people with neurological disabilities resulting from disease and injury of the brain and spinal cord. The Kessler Foundation is a national leader in funding innovative programs that expand employment opportunities for people with disabilities.

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