Recovery of Intellectual Ability following Traumatic Brain Injury in Childhood: Impact of Injury Severity and Age at Injury

Anderson, Vicki; Catroppa, Cathy; Morse, Sue; Haritou, Flora; Rosenfeld, Jeffrey V.

doi:10.1159/000028956

Cited by 174 publications

(133 citation statements)

References 12 publications

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“…A review of the literature in this area suggested that important global cognitive changes occur at this age that allow children to have metacognitive skills (the ability to become aware of one's cognitions), employ strategies for learning and retaining information, and effectively problem-solve (30). Furthermore, studies investigating age at injury effects on cognitive outcome post injury have noted significant group differences in recovery trends based on this age cutoff (31,32). It has, therefore, been suggested that age at injury is a moderator of outcome and not a predictor since injury occurs in the context of ongoing cognitive and physical development (33).…”

Section: Discussionmentioning

confidence: 99%

MR spectroscopy: Predicting long‐term neuropsychological outcome following pediatric TBI

Babikian¹,

Freier²,

Ashwal³

et al. 2006

Magnetic Resonance Imaging

103

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Purpose: To identify useful acute indicators of long-term neurocognitive outcome beyond clinical variables for children and adolescents treated for a traumatic brain injury (TBI). Materials and Methods:The efficacy of magnetic resonance spectroscopy (MRS) acquired 6 Ϯ 4 days after TBI in 20 children/adolescents in predicting intellectual and neuropsychological functioning one to four years post injury was assessed. Short echo-time single voxel MRS (SVS) from normal-appearing brain was compared to intermediate echo-time multivoxel MR spectroscopic imaging (MRSI) from normal-appearing and visibly-injured brain acquired through the level of the corpus callosum (CC).Results: N-acetyl aspartate (NAA) was moderate to strongly correlated with cognitive scores. Mean NAA/creatine (Cre) from MRSI alone explained over 40% of the variance in cognitive scores and 18% of the variance above and beyond demographic and clinical variables alone. Mild to moderate associations were noted between SVS metabolites (glutamate/glutamine [Glx] and myoinositol [mI]) and cognitive scores, with no such associations apparent for choline (Cho) or Cre. Exploratory analyses revealed trends for regional neuroimaging data and specific cognitive abilities. Conclusion:Acute MR spectroscopy of the pediatric brain injury patient improves prognostic ability and may provide valuable information for early treatment and intervention planning.

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Section: Discussionmentioning

confidence: 99%

MR spectroscopy: Predicting long‐term neuropsychological outcome following pediatric TBI

Babikian¹,

Freier²,

Ashwal³

et al. 2006

Magnetic Resonance Imaging

103

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“…4,6,16,50 However, both animals and humans demonstrate some recovery of neurological function and intellectual ability after injury. 3,21,22 While the processes leading to recovery have not been fully ascertained, one possible mechanism may relate to the brain's innate ability to continuously generate new neurons in specific brain regions. There are 2 regions in which the process of neurogenesis is conserved throughout the lifespan of most mammalian species: the subventricular zone (SVZ) of the lateral ventricle and the subgranular zone (SGZ) of the hippocampus.…”

Section: ©Aans 2013mentioning

confidence: 99%

Maturation-dependent response of neurogenesis after traumatic brain injury in children

Taylor

Smith²,

Harris

et al. 2013

PED

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Object Traumatic brain injury (TBI) is the leading cause of acquired disability in children, yet innate repair mechanisms are incompletely understood. Given data from animal studies documenting neurogenesis in response to trauma and other insults, the authors investigated whether similar responses could be found in children of different ages after TBI. Methods Immunohistochemistry was used to label doublecortin (DCX), a protein expressed by immature migrating neuroblasts (newborn neurons), in specimens from patients ranging in age from 3 weeks to 10 years who had died either after TBI or from other causes. Doublecortin-positive (DCX+) cells were examined in the subventricular zone (SVZ) and periventricular white matter (PWM) and were quantified within the granule cell layer (GCL) and subgranular zone (SGZ) of the dentate gyrus to determine if age and/or injury affect the number of DCX+ cells in these regions. Results The DCX+ cells decreased in the SVZ as patient age increased and were found in abundance around a focal subacute infarct in a 1-month-old non-TBI patient, but were scarce in all other patients regardless of age or history of trauma. The DCX+ cells in the PWM and dentate gyrus demonstrated a migratory morphology and did not co-localize with markers for astrocytes, microglia, or macrophages. In addition, there were significantly more DCX+ cells in the GCL and SGZ of the dentate gyrus in children younger than 1 year old than in older children. The density of immature migrating neuroblasts in infants (under 1 year of age) was significantly greater than in young children (2–6 years of age, p = 0.006) and older children (7–10 years of age, p = 0.007). Conclusions The main variable influencing the number of migrating neuroblasts observed in the SVZ, PWM, and hippocampus was patient age. Trauma had no discernible effect on the number of migrating neuroblasts in this cohort of patients in whom death typically occurred within hours to days after TBI.

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“…Deficits in sustained attention, as measured by lower levels of performance or slower processing speed, have been reported in school-age children or adolescents with TBI compared to controls (e.g., Catroppa & Anderson, 1999;Dennis et al, 1995;Robin et al, 1999;Wassenberg et al, 2004) and also in children with severe TBI compared to children with mild to moderate TBI (e.g., Catroppa & Anderson, 2003). Finally, research also suggests that a TBI in a young child results in potentially more severe sequelae than for older children (Anderson et al, 2000). Children injured in early, compared to late, childhood perform worse on sustained attention tasks regardless of injury severity (Ewing-Cobbs et al, 1998), and preschool-aged children who sustain severe TBI are at risk for significant and long-term impairments in information processing speed and accuracy .…”

Section: Introductionmentioning

confidence: 96%

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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Recovery of Intellectual Ability following Traumatic Brain Injury in Childhood: Impact of Injury Severity and Age at Injury

Cited by 174 publications

References 12 publications

MR spectroscopy: Predicting long‐term neuropsychological outcome following pediatric TBI

MR spectroscopy: Predicting long‐term neuropsychological outcome following pediatric TBI

Maturation-dependent response of neurogenesis after traumatic brain injury in children

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

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