Long-Term Attention Problems in Children With Traumatic Brain Injury

Yeates, Keith Owen; Armstrong, Kira; Janusz, Jennifer; Taylor, H. Gerry; Wade, Shari L.; Stancin, Terry; Drotar, Dennis

doi:10.1097/01.chi.0000159947.50523.64

Cited by 179 publications

(137 citation statements)

References 51 publications

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“…Pediatric traumatic brain injury (TBI) results in substantial neurobehavioral morbidity for survivors, including persistent impairments in emotional, social, behavioral, and neuropsychological functioning that persist well beyond the acute phase of injury (e.g., Anderson et al, 2001Anderson et al, , 2006Taylor et al, 2002;Yeates et al, 2005). A clear relationship has been observed for physical and cognitive outcomes in TBI, with the severity of TBI contributing to greater impairment .…”

Section: Introductionmentioning

confidence: 99%

“…In general, children with severe TBI display poorer performance on a variety of measures of attention than less-severely injured or healthy control children across behavioral paradigms (e.g., Anderson et al, 1998Anderson et al, , 2005Ewing-Cobbs et al, 1998;Yeates et al, 2005). Attention deficits adversely affect neurobehavioral outcomes and functional skills (Ganesalingam et al, 2006(Ganesalingam et al, , 2007.…”

Section: Introductionmentioning

confidence: 99%

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Long-term neural processing of attention following early childhood traumatic brain injury: fMRI and neurobehavioral outcomes

Kramer

Chiu

Walz

et al. 2008

J Inter Neuropsych Soc

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Attentional deficits are common and significant sequelae of pediatric traumatic brain injury (TBI). However, little is known about how the underlying neural processes that support different components of attention are affected. The present study examined brain activation patterns using f MRI in a group of young children who sustained a TBI in early childhood (n 5 5; mean age 5 9.4), and a group of age-matched control children with orthopedic injuries (OI) (n 5 8) during a continuous performance task (CPT). Four children in the TBI group had moderate injuries, and one had a severe injury. Performance on the CPT task did not differ between groups. Both TBI and OI children activated similar networks of brain regions relevant to sustained attention processing, but the TBI group demonstrated several areas of significantly greater activation relative to controls, including frontal and parietal regions. These findings of over-activation of the relevant attention network in the TBI group contrast with those obtained in imaging studies of Attention-Deficit0Hyperactivity Disorder where under-activation of the attention network has been documented. This study provides evidence that young children's brains function differently following a traumatic brain injury, and that these differences persist for years after the injury. (JINS, 2008, 14, 424-435.)

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term neural processing of attention following early childhood traumatic brain injury: fMRI and neurobehavioral outcomes

Kramer

Chiu

Walz

et al. 2008

J Inter Neuropsych Soc

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“…Of note, high attrition rates are common in longitudinal research, 16,17 particularly in early TBI, in which families of young children are more mobile and difficult to locate with time.…”

Section: Participantsmentioning

confidence: 99%

Predictors of Cognitive Function and Recovery 10 Years After Traumatic Brain Injury in Young Children

et al. 2012

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BACKGROUND AND OBJECTIVES: Childhood traumatic brain injury (TBI) has implications for functional outcomes, but few studies have documented long-term outcomes. The purpose of this study was to plot recovery of cognitive and functional skills after early childhood TBI to 10 years postinjury and to identify the contribution of injury, environment, preinjury characteristics, and acute functional recovery. METHODS: Subjects were recruited consecutively to this prospective, longitudinal study, which used a between-factor design, with injury severity as the independent variable. Forty children with TBI aged 2 and 7 years were recruited on admission to a tertiary pediatric hospital, divided according to injury severity, and compared with 16 healthy controls acutely and 12 and 30 months and 10 years postinjury. Cognition, adaptive ability, executive function, and social/behavioral skills were examined. RESULTS: Children with severe TBI had poorest outcomes, with deficits greatest for cognition. Recovery trajectories were similar across severity groups but with significant gains in verbal skills from 12 and 30 months to 12 months and 10 years. Predictors of outcome included preinjury ability (for adaptive function) and family function (social/behavioral skills). CONCLUSIONS: Results confirm a high risk of persisting deficits after severe TBI in early childhood. Children with less severe TBI appear to recover to function normally. Contrary to speculation about “growing into deficits,” after protracted recovery to 30 months, young children make age-appropriate progress at least to 10 years postinsult. Environmental factors were found to contribute to adaptive and social/behavioral recovery.

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“…t raumatic brain injury (TBI) is the leading cause of death and disability in children and often results in persistent behavioral disturbances and neurocognitive deficits in attention, learning, and memory (1)(2)(3). Children with cognitive impairment following TBI impose a great economic and social burden on their families and communities.…”

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confidence: 99%

Association of traumatic brain injury in childhood and attention-deficit/hyperactivity disorder: a population-based study

et al. 2016

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Background:We evaluated the risk of attention-deficit hyperactivity disorder (ADHD) following childhood traumatic brain injury (TBI). Methods: Using Taiwan's National Health Insurance Research Database, we included 10,416 newly diagnosed TBI children (aged ≤12 y) between 2001 and 2002 and 41,664 children without TBI, who were frequency matched by sex, age, and year of the index medical service with each TBI child, as controls. Children who had been diagnosed with ADHD prior to their medical service index were excluded. Each individual was followed for 9 y to identify ADHD diagnosis. We also compared the ADHD risk in children who were treated for fractures but not TBI as sensitivity analysis. results: During the 9-y follow-up period, children with TBI had a higher ADHD risk (adjusted hazard ratio (AHR) = 1.32, 95% confidence interval (CI) = 1.19, 1.45) than did those without TBI. Furthermore, children with mild and severe TBI had higher AHRs for ADHD than did those without TBI (AHR = 1.30; 95% CI = 1.10, 1.53; and AHR = 1.37; 95% CI = 1.22, 1.55). However, no significant association was observed between fractures and ADHD. conclusion: TBI in childhood is associated with a greater likelihood of developing ADHD. t raumatic brain injury (TBI) is the leading cause of death and disability in children and often results in persistent behavioral disturbances and neurocognitive deficits in attention, learning, and memory (1-3). Children with cognitive impairment following TBI impose a great economic and social burden on their families and communities. In addition, these children are more likely to have slower psychosocial development and exhibit poor academic achievement. Therefore, the relationship between TBI and neuropsychiatric consequences has become a crucial research topic.Attention-deficit-hyperactivity disorder (ADHD), a neurodevelopmental disorder, is associated with impulsivity, excessive talking, difficulty in sustaining attention, being easily distracted, and injuries (4-6). Studies have reported a relationship between ADHD and childhood TBI (7-10). Unlike other diseases resulting from various pathogenic mechanisms, TBI is caused by a complex interplay among damages occurring in the neuroanatomy, neurochemistry, and neurophysiology because of primary and secondary processes (11). A meta-analytic review showed that neurocognitive outcomes after pediatric TBI have a dose-response relationship with injury severity. Babikian and colleagues found that patients with severe TBI exhibited poorer performance in intelligence quotient tests, executive functioning, processing speed, attention maintenance, verbal immediate memory, and delayed memory, whereas patients with mild TBI exhibited no change (12). In addition, several studies have suggested that children with moderate to severe TBI are significantly more likely to develop ADHD symptoms than are those with mild TBI (8,(13)(14)(15)(16)(17). A longitudinal birth cohort study reported no association between preschool mild TBI and ADHD after adjusting for potential co...

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Long-Term Attention Problems in Children With Traumatic Brain Injury

Cited by 179 publications

References 51 publications

Long-term neural processing of attention following early childhood traumatic brain injury: fMRI and neurobehavioral outcomes

Long-term neural processing of attention following early childhood traumatic brain injury: fMRI and neurobehavioral outcomes

Predictors of Cognitive Function and Recovery 10 Years After Traumatic Brain Injury in Young Children

Association of traumatic brain injury in childhood and attention-deficit/hyperactivity disorder: a population-based study

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