Graph theoretical analysis of the structural connectome has been employed successfully to characterise brain network alterations in patients with traumatic brain injury (TBI). However, heterogeneity in neuropathology is a well-known issue in the TBI population, such that group comparisons of patients against controls are confounded by within-group variability. Recently, novel single-subject profiling approaches have been developed to capture inter-patient heterogeneity. We present a personalised connectomics approach that examines structural brain alterations in five chronic patients with moderate-to-severe TBI who underwent anatomical and diffusion magnetic resonance imaging (MRI). We generated individualised profiles of lesion characteristics and network measures (including personalised graph metric ‘GraphMe’ plots, and nodal and edge-based brain network alterations) and compared them against healthy reference cases (N = 12) to assess brain damage qualitatively and quantitatively at the individual level. Our findings revealed alterations of brain networks with high variability between patients. With validation and comparison to stratified, normative healthy control comparison cohorts, this approach could be used by clinicians to formulate a neuroscience-guided integrative rehabilitation program for TBI patients, and for designing personalised rehabilitation protocols based on their unique lesion load and connectome.

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Handling Editor: Olaf Sporns

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