Acute pediatric traumatic brain injury severity predicts long-term verbal memory performance through suppression by white matter integrity on diffusion tensor imaging

Lindsey, Hannah M.; Lalani, Sanam J.; Mietchen, Jonathan; Gale, Shawn D.; Wilde, Elisabeth A.; Faber, Jessica; MacLeod, Marianne; Hunter, Jill V.; Chu, Zili; Aitken, Mary E.; Ewing‐Cobbs, Linda; Levin, Harvey S.

doi:10.1007/s11682-019-00093-9

Cited by 17 publications

(11 citation statements)

References 67 publications

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“…Specifically, our findings revealed that the TBI group had significantly lower FD, FC and FDC in several WM tracts, including the commissural tracts (corpus callosum, fornix), association fibres (e.g., superior longitudinal fasciculus), and projection fibres (e.g., internal capsule, medial lemniscus, superior corona radiata, external capsule). These results are in line with previous diffusion MRI studies of pediatric TBI (including work from our group), utilising metrics derived from DTI (for recent reviews, see Lindsey et al, 2019 , Wallace et al, 2018b , Wallace et al, 2018a , Zamani et al, 2020 ). However, previous studies have demonstrated that FBA can offer more specific, directly interpretable, and within-voxel white matter metrics, which contrasts with other widespread diffusion imaging frameworks, like DTI, that are less specific and cannot exploit sub-voxel level information (for example, DTI cannot resolve crossing fibres and hence not all white matter voxels can be accurately modelled within the voxel-based analysis framework; see Jeurissen et al, 2013 ; Mito et al, 2018 , Raffelt et al, 2015 ).…”

Section: Discussionsupporting

confidence: 89%

Longitudinal fixel-based analysis reveals restoration of white matter alterations following balance training in young brain-injured patients

Liang

Yeh

Domínguez

et al. 2021

NeuroImage: Clinical

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Section: Discussionsupporting

confidence: 89%

Longitudinal fixel-based analysis reveals restoration of white matter alterations following balance training in young brain-injured patients

Liang

Yeh

Domínguez

et al. 2021

NeuroImage: Clinical

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“…For this reason, early brain insult likely affects the maturation of the frontal and temporal cortices, as well as the white matter pathways connecting them to other areas of the brain. Such disruption is known to have detrimental and long-term consequences on the development of critical neurobehavioral functions localized within these regions, such as executive function (10,11), learning and memory (12), emotional control (13), behavioral self-regulation (14), and social adaptive behavior (15).…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Neuroimaging in Pediatric Traumatic Brain Injury: Current State and Consideration of Factors That Influence Recovery

et al. 2019

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Traumatic brain injury (TBI) is a leading cause of death and disability for children and adolescents in the U.S. and other developed and developing countries. Injury to the immature brain varies greatly from that of the mature, adult brain due to numerous developmental, pre-injury, and injury-related factors that work together to influence the trajectory of recovery during the course of typical brain development. Substantial damage to brain structure often underlies subsequent functional limitations that persist for years following pediatric TBI. Advances in neuroimaging have established an important role in the acute management of pediatric TBI, and magnetic resonance imaging (MRI) techniques have a particular relevance for the sequential assessment of long-term consequences from injuries sustained to the developing brain. The present paper will discuss the various factors that influence recovery and review the findings from the present neuroimaging literature to assess altered development and long-term outcome following pediatric TBI. Four MR-based neuroimaging modalities have been used to examine recovery from pediatric TBI longitudinally: (1) T 1 -weighted structural MRI is sensitive to morphological changes in gray matter volume and cortical thickness, (2) diffusion-weighted MRI is sensitive to changes in the microstructural integrity of white matter, (3) MR spectroscopy provides a sensitive assessment of metabolic and neurochemical alterations in the brain, and (4) functional MRI provides insight into the functional changes that occur as a result of structural damage and typical developmental processes. As reviewed in this paper, 13 cohorts have contributed to only 20 studies published to date using neuroimaging to examine longitudinal changes after TBI in pediatric patients. The results of these studies demonstrate considerable heterogeneity in post-injury outcome; however, the existing literature consistently shows that alterations in brain structure, function, and metabolism can persist for an extended period of time post-injury. With larger sample sizes and multi-site cooperation, future studies will be able to further examine potential moderators of outcome, such as the developmental, pre-injury, and injury-related factors discussed in the present review.

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“…Following DAI, as the loss of white matter integrity causes neural network connectivity disruptions, acute and long-term neurobehavioral outcomes can be negatively affected (35,36). However, functional outcome after DAI is difficult to predict as some children have profound disability while others make a better recovery (37)(38)(39)(40)(41)(42). A multitude of sophisticated neuroimaging studies have been performed to correlate pediatric DAI and outcome (41,(43)(44)(45)(46)(47).…”

Section: Introductionmentioning

confidence: 99%

Trajectory of Long-Term Outcome in Severe Pediatric Diffuse Axonal Injury: An Exploratory Study

et al. 2021

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Introduction: Pediatric severe traumatic brain injury (TBI) is one of the leading causes of disability and death. One of the classic pathoanatomic brain injury lesions following severe pediatric TBI is diffuse (multifocal) axonal injury (DAI). In this single institution study, our overarching goal was to describe the clinical characteristics and long-term outcome trajectory of severe pediatric TBI patients with DAI.Methods: Pediatric patients (<18 years of age) with severe TBI who had DAI were retrospectively reviewed. We evaluated the effect of age, sex, Glasgow Coma Scale (GCS) score, early fever ≥ 38.5°C during the first day post-injury, the extent of ICP-directed therapy needed with the Pediatric Intensity Level of Therapy (PILOT) score, and MRI within the first week following trauma and analyzed their association with outcome using the Glasgow Outcome Score—Extended (GOS-E) scale at discharge, 6 months, 1, 5, and 10 years following injury.Results: Fifty-six pediatric patients with severe traumatic DAI were analyzed. The majority of the patients were >5 years of age and male. There were 2 mortalities. At discharge, 56% (30/54) of the surviving patients had unfavorable outcome. Sixty five percent (35/54) of surviving children were followed up to 10 years post-injury, and 71% (25/35) of them made a favorable recovery. Early fever and extensive DAI on MRI were associated with worse long-term outcomes.Conclusion: We describe the long-term trajectory outcome of severe pediatric TBI patients with pure DAI. While this was a single institution study with a small sample size, the majority of the children survived. Over one-third of our surviving children were lost to follow-up. Of the surviving children who had follow-up for 10 years after injury, the majority of these children made a favorable recovery.

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Acute pediatric traumatic brain injury severity predicts long-term verbal memory performance through suppression by white matter integrity on diffusion tensor imaging

Cited by 17 publications

References 67 publications

Longitudinal fixel-based analysis reveals restoration of white matter alterations following balance training in young brain-injured patients

Longitudinal fixel-based analysis reveals restoration of white matter alterations following balance training in young brain-injured patients

Longitudinal Neuroimaging in Pediatric Traumatic Brain Injury: Current State and Consideration of Factors That Influence Recovery

Trajectory of Long-Term Outcome in Severe Pediatric Diffuse Axonal Injury: An Exploratory Study

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