Sensorimotor recovery in children after traumatic brain injury: analyses of gait, gross motor, and fine motor skills

Kuhtz-Buschbeck, Johann P.; Hoppe, Birgit; Gölge, Mukaddes; Dreesmann, Mona; Damm-Stünitz, Ute; Ritz, Annegret

doi:10.1017/s001216220300152x

Cited by 59 publications

(52 citation statements)

References 36 publications

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“…8 Most studies covered in that review used traditional paper-and-pencil tests of attention, often not correcting for confounding effects of deficits in processing speed or visuomotor functions that may co-occur after TBI. 11,12 The ANT, which controls for these confounders, revealed no evidence for impaired alerting, orienting, or executive attention, possibly reflecting the importance of correcting for processing speed and visuomotor functions in tests of attention. The results further revealed no evidence for attention deficits after mild RF2 TBI, while indicating that children with mild RF+ TBI or moderate/severe TBI have increased lapses of attention.…”

Section: Discussionmentioning

confidence: 98%

“…8 The disparate findings in the literature may originate partly from the use of traditional paper-and-pencil tests, which often lack the ability to isolate aspects of attention from processing speed and visuomotor coordination, 8,10 while these functions have consistently been found to be affected after TBI. 11,12 The Attention Network Test (ANT) has been developed to measure the efficiency of alerting, orienting, and executive attention and overcomes drawbacks of traditional measures by correcting for processing speed and minimizing the load on visuomotor functions. 13 One study used the ANT to investigate attention in adolescents with mild TBI, identifying a deficit in executive attention 1 month postinjury.…”

Section: What This Study Addsmentioning

confidence: 99%

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Pediatric Traumatic Brain Injury and Attention Deficit

Königs

Heij

Sluijs³

et al. 2015

Pediatrics

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BACKGROUND: We investigated the impact of pediatric traumatic brain injury (TBI) on attention, a prerequisite for behavioral and neurocognitive functioning.METHODS: Children aged 6 to 13 years who were diagnosed with TBI (n = 113; mean 1.7 years postinjury) were compared with children with a trauma control injury (not involving the head) (n = 53). TBI severity was defined as mild TBI with or without risk factors for complicated TBI (mild RF+ TBI, n = 52; mild RF2 TBI, n = 24) or moderate/severe TBI (n = 37). Behavioral functioning was assessed by using parent and teacher questionnaires, and the Attention Network Test assessed alerting, orienting, and executive attention. Ex-Gaussian modeling determined the contribution of extremely slow responses (lapses of attention) to mean reaction time (MRT). RESULTS:The TBI group showed higher parent and teacher ratings of attention and internalizing problems, higher parent ratings of externalizing problems, and lower intelligence than the control group (P , .05, d $ 0.34). No effect of TBI on alerting, orienting, and executive attention was observed (P $ .55). MRT was slower in the TBI group (P = .008, d = 0.45), traced back to increased lapses of attention (P = .002, d = 0.52). The mild RF2 TBI group was unaffected, whereas the mild RF+ TBI and moderate/severe TBI groups showed elevated parent ratings of behavior problems, lower intelligence, and increased lapses of attention (P # .03, d $ 0.48). Lapses of attention fully explained the negative relation between intelligence and parent-rated attention problems in the TBI group (P = .02).CONCLUSIONS: Lapses of attention represent a core attention deficit in children with mild RF+ TBI (even in the absence of intracranial pathology) or moderate/severe TBI, and relate to daily life problems after pediatric TBI. WHAT'S KNOWN ON THIS SUBJECT:Attention is a prerequisite for neurocognitive and behavioral functioning, having a crucial role in academic and social child development. Children with traumatic brain injury have pronounced deficits in attention, but the nature and consequences of these deficits remain unclear.WHAT THIS STUDY ADDS: Lapses of attention represent a core attention deficit after pediatric mild traumatic brain injury with risk factors for complicated traumatic brain injury, or moderate/severe traumatic brain injury. Importantly, lapses of attention explain the relation between intelligence and parent-rated attention problems.

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Section: Discussionmentioning

confidence: 98%

Section: What This Study Addsmentioning

confidence: 99%

Pediatric Traumatic Brain Injury and Attention Deficit

Königs

Heij

Sluijs³

et al. 2015

Pediatrics

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“…manifest throughout the first month of recovery following brain injury (Carmichael, 2003b;Kuhtz-Buschbeck et al, 2003;Sbordone et al, 1995;Wade et al, 1985). As a result, it is not surprising that the majority of studies tracking neuroplastic responses to brain injury have focused on this critical postinjury time period.…”

Section: Nagamoto-combs Et Almentioning

confidence: 99%

Long-Term Gliosis and Molecular Changes in the Cervical Spinal Cord of the Rhesus Monkey after Traumatic Brain Injury

Nagamoto-Combs

Morecraft

Darling

et al. 2010

Journal of Neurotrauma

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Recovery of fine motor skills after traumatic brain injury (TBI) is variable, with some patients showing progressive improvements over time while others show poor recovery. We therefore studied possible cellular mechanisms accompanying the recovery process in a non-human primate model system, in which the lateral frontal motor cortex areas controlling the preferred upper limb were unilaterally lesioned, and the animals eventually regained fine hand motor function. Immunohistochemical staining of the cervical spinal cord, the site of compensatory sprouting and degeneration of corticospinal axons, showed profound increases in immunoreactivities for major histocompatibility complex class II molecule (MHC-II) and extracellular signalregulated kinases (ERK1=2) up to 12 months post lesion, particularly within the lateral corticospinal tract (LCST). Double immunostaining demonstrated that phosphorylated ERK1=2 colocalized within the MCH-II þ microglia, suggesting a trophic role of long-term microglia activation after TBI at the site of compensatory sprouting. Active sprouting was observed in the LCST as well as in the spinal gray matter of the lesioned animals, as illustrated by increases in growth associated protein 43. Upregulation of Nogo receptor and glutamate transporter expression was also observed in this region after TBI, suggesting possible mechanisms for controlling aberrant sprouting and=or synaptic formation en route and interstitial glutamate concentration changes at the site of axon degeneration, respectively. Taken together, these changes in the non-human primate spinal cord support a long-term trophic=tropic role for reactive microglia, in particular, during functional and structural recovery after TBI.

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“…Chaplin et al showed impairment in integrative gross motor and speeded fine motor function in a sample of 14 children 16 months after severe TBI [18]. KuhtzBuschbeck et al demonstrated deficits in fine motor skills, speed, and coordination in 23 children 8 months after TBI [19]. Gray et al showed subclinical bradykinesia with impaired complex and simple reaction time in a sample of 24 persons 1 year after TBI [20].…”

Section: Introductionmentioning

confidence: 99%

Motor impairment after severe traumatic brain injury: A longitudinal multicenter study

Walker

Pickett²

2007

JRRD

196

141

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Abstract-Neuromotor impairment is a common sequela of severe traumatic brain injury (TBI) but has been understudied relative to neurocognitive outcomes. This multicenter cohort study describes the longitudinal course of neurological examination-based motor abnormalities after severe TBI. Subjects were enrolled from the four lead Department of Veterans Affairs and Defense and Veterans Brain Injury Center sites. The study cohort consisted of 102 consecutive patients (active duty, veteran, or military dependent) with severe TBI who consented during acute rehabilitation for data collection and completed all follow-up evaluations. Paresis, ataxia, and postural instability measures showed a pattern of improvement over time, with the greatest improvement occurring between the inpatient (baseline) and 6-month follow-up assessments. Involuntary movement disorders were rare at all time points. Two years following acute rehabilitation, more than one-third of subjects continued to display a neuromotor abnormality on basic neurological examination. Persistence of tandem gait abnormality was particularly common.

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Sensorimotor recovery in children after traumatic brain injury: analyses of gait, gross motor, and fine motor skills

Cited by 59 publications

References 36 publications

Pediatric Traumatic Brain Injury and Attention Deficit

Pediatric Traumatic Brain Injury and Attention Deficit

Long-Term Gliosis and Molecular Changes in the Cervical Spinal Cord of the Rhesus Monkey after Traumatic Brain Injury

Motor impairment after severe traumatic brain injury: A longitudinal multicenter study

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