Post-Acute Cortical Thickness in Children with Mild Traumatic Brain Injury versus Orthopedic Injury

Ware, Ashley L.; Goodrich-Hunsaker, Naomi J.; Lebel, Catherine; Shukla, Ayushi; Wilde, Elisabeth A.; Abildskov, Tracy J.; Bigler, Erin D.; Cohen, Daniel M.; Mihalov, Leslie; Bacevice, Ann; Bangert, Barbara; Taylor, H. Gerry; Yeates, Keith Owen

doi:10.1089/neu.2019.6850

Cited by 18 publications

(29 citation statements)

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“…9 In regards to cortical thickness, our findings extend those of Bigler and colleagues who found no significant group effects at approximately 6 months postinjury. 11 However, our results contrast with other studies that suggested thicker left parietal cortex 35 in a mild traumatic brain injury group at less than 2 weeks postinjury, 10 thinner cortex in bilateral frontal regions in concussed youth when compared to controls 4 months postinjury, 7 and thinner cortex in the left dorsolateral prefrontal region and the right anterior and posterior inferior parietal lobes 4 months postinjury. 8 Additionally, although a systematic review of white matter structural integrity using diffusion tensor imaging has found effects from pediatric concussion on diffusion properties around 6 months postinjury, 36 a recent diffusion tensor imaging study conducted in the same sample as the current study found no effects on diffusivity properties several years after injury.…”

Section: Discussioncontrasting

confidence: 99%

“…[7][8][9] Although Ware and colleagues used orthopedically injured controls and observed group differences, cortical measures were obtained very shortly after injury (*10 days) and were suggestive of thicker and not thinner cortex (potentially because of the role of edema). 10 When looking at time points long after injury, Bigler and colleagues have been the only other study to use orthopedically injured controls, and they found no group differences by 6 months postconcussion. 11 This suggests (based on only a small number of studies) that group differences longer after injury may only be present when compared to a healthy control group, not an orthopedically injured group.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 One study also suggests lower total gray matter volume at 10 years postinjury when compared to noninjured healthy children. 9 Only 2 studies have compared youth with pediatric concussion to orthopedically injured controls; 1 reported greater left parietal cortical thickness at approximately 10 days postinjury, 10 whereas the other reported no cortical group differences at 6 months postinjury. 10,11 Studies of adults with concussion have suggested that cortical alterations can be found at various time points following injury.…”

mentioning

confidence: 99%

“…9 Only 2 studies have compared youth with pediatric concussion to orthopedically injured controls; 1 reported greater left parietal cortical thickness at approximately 10 days postinjury, 10 whereas the other reported no cortical group differences at 6 months postinjury. 10,11 Studies of adults with concussion have suggested that cortical alterations can be found at various time points following injury. When comparing those with a history of concussion to healthy controls, there is reduced cortical volume at follow-ups ranging from 2 months to 1 year postinjury.…”

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Cortical Volume and Thickness in Youth Several Years After Concussion

et al. 2020

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Objective: The long-term effects of pediatric concussion on brain morphometry remain poorly delineated. This study used magnetic resonance imaging (MRI) to investigate cortical volume and thickness in youth several years after concussion. Methods: Participants aged 8-19 years old with a history of concussion (n = 37) or orthopedic injury (n = 20) underwent MRI, rated their postconcussion symptoms, and completed cognitive testing on average 2.6 years (SD = 1.6) after injury. FreeSurfer was used to obtain cortical volume and thickness measurements as well as determine any significant correlations between brain morphometry, postconcussion symptoms (parent and self-report), and cognitive functioning. Results: No significant group differences were found for either cortical volume or thickness. Youth with a history of concussion had higher postconcussion symptom scores (both parent and self-report Postconcussion Symptom Inventory) than the orthopedic injury group, but symptom ratings did not significantly correlate with cortical volume or thickness. Across both groups, faster reaction time on a computerized neurocognitive test battery (CNS Vital Signs) was associated with a thinner cortex in the left pars triangularis of the inferior frontal gyrus and the left caudal anterior cingulate. Better verbal memory was associated with a thinner cortex in the left rostral middle frontal gyrus. Conclusion: Findings do not support differences in cortical volume or thickness approximately 2.5 years postconcussion in youth, suggesting either long-term cortical recovery or no cortical differences as a result of injury. Further research using a longitudinal study design and larger samples is needed.

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Cortical Volume and Thickness in Youth Several Years After Concussion

et al. 2020

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“… 136 A recent study that examined post-TBI (mild TBI) cortical thickness, which varied by brain sub-region, compared to controls with orthopedic injury highlights the complexity of using neuroimaging techniques to predict TBI outcomes. 137 Brain imaging has been explored in the prediction of post-TBI behavioral deficits. 138 In addition, several metabolites detected during brain imaging have been examined for their applicability as biomarkers of TBI, including N -acetyl aspartate, creatine, choline, lactate, and myoinositol.…”

Section: Neuroimaging and Assessment Of Clinical Biomarkers Following...mentioning

confidence: 99%

Pediatric Traumatic Brain Injury: An Update on Preclinical Models, Clinical Biomarkers, and the Implications of Cerebrovascular Dysfunction

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Brichacek

Foster

et al. 2022

J Cent Nerv Syst Dis

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Traumatic brain injury (TBI) is a leading cause of pediatric morbidity and mortality. Recent studies suggest that children and adolescents have worse post-TBI outcomes and take longer to recover than adults. However, the pathophysiology and progression of TBI in the pediatric population are studied to a far lesser extent compared to the adult population. Common causes of TBI in children are falls, sports/recreation-related injuries, non-accidental trauma, and motor vehicle-related injuries. A fundamental understanding of TBI pathophysiology is crucial in preventing long-term brain injury sequelae. Animal models of TBI have played an essential role in addressing the knowledge gaps relating to pTBI pathophysiology. Moreover, a better understanding of clinical biomarkers is crucial to diagnose pTBI and accurately predict long-term outcomes. This review examines the current preclinical models of pTBI, the implications of pTBI on the brain’s vasculature, and clinical pTBI biomarkers. Finally, we conclude the review by speculating on the emerging role of the gut-brain axis in pTBI pathophysiology.

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Participant factors that contribute to magnetic resonance imaging motion artifacts in children with mild traumatic brain injury or orthopedic injury

Ware

Shukla

Guo

et al. 2021

Brain Imaging and Behavior

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Background: Motion can compromise image quality and confound results, especially in pediatric research. This study evaluated qualitative and quantitative approaches to motion artifacts detection and correction, and whether motion artifacts relate to injury history, age, or sex in children with mild traumatic brain injury or orthopedic injury relative to typically developing children. The concordance between qualitative and quantitative motion ratings was also examined.Method: Children aged 8-16 years with mild traumatic brain injury (n=141) or orthopedic injury (n=73) were recruited from the emergency department and completed an MRI scan roughly 2 weeks post-injury.Typically developing children (n=41) completed a single MRI scan. T1-and diffusion-weighted images were visually inspected and rated for motion artifacts by trained examiners. Quantitative estimates of motion artifacts were derived from FreeSurfer and FSL.Results: Age (younger > older) and sex (boys > girls) were signi cantly associated with motion artifacts on both T1-and diffusion-weighted images. Children with mild traumatic brain or orthopedic injury had signi cantly more motion-corrupted diffusion-weighted volumes than typically developing children, but mild traumatic brain injury and orthopedic injury groups did not differ from each other. The exclusion of motion-corrupted volumes did not signi cantly change diffusion tensor imaging metrics.Discussion: Results indicate that automated quantitative estimates of motion artifacts, which are less labour-intensive than manual methods, are appropriate. Results have implications for the reliability of structural magnetic resonance imaging research and highlight the importance of considering motion artifacts in studies of pediatric mild traumatic brain injury.

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Post-Acute Cortical Thickness in Children with Mild Traumatic Brain Injury versus Orthopedic Injury

Cited by 18 publications

References 60 publications

Cortical Volume and Thickness in Youth Several Years After Concussion

Cortical Volume and Thickness in Youth Several Years After Concussion

Pediatric Traumatic Brain Injury: An Update on Preclinical Models, Clinical Biomarkers, and the Implications of Cerebrovascular Dysfunction

Participant factors that contribute to magnetic resonance imaging motion artifacts in children with mild traumatic brain injury or orthopedic injury

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