دورية أكاديمية
Brain volume abnormalities and clinical outcomes following paediatric traumatic brain injury.
| العنوان: | Brain volume abnormalities and clinical outcomes following paediatric traumatic brain injury. |
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| المؤلفون: | Bourke NJ; Department of Brain Sciences, Imperial College London, London, UK.; UK Dementia Research Institute, Care Research and Technology Centre, Imperial College London, London, UK., Demarchi C; Department of Brain Sciences, Imperial College London, London, UK.; UK Dementia Research Institute, Care Research and Technology Centre, Imperial College London, London, UK.; Clinical Neuropsychology, Department of Psychological Services, Great Ormond Street Hospital, London, UK., De Simoni S; King's College London, Department of Psychology, Institute of Psychiatry Psychology and Neuroscience, De Crespigny Park, London SE5 8AF, UK., Samra R; Department of Brain Sciences, Imperial College London, London, UK., Patel MC; Imaging Department, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London W6 8RF, UK., Kuczynski A; Clinical Neuropsychology, Department of Psychological Services, Great Ormond Street Hospital, London, UK., Mok Q; Department of Paediatric Critical Care, UCL Great Ormond Street Institute of Child Health, London, UK., Wimalasundera N; Paediatric Rehabilitation, Royal Children's Hospital, Melbourne, Australia., Vargha-Khadem F; Cognitive Neuroscience and Neuropsychiatry, UCL Great Ormond Street Institute of Child Health, London, UK., Sharp DJ; Department of Brain Sciences, Imperial College London, London, UK.; UK Dementia Research Institute, Care Research and Technology Centre, Imperial College London, London, UK. |
| المصدر: | Brain : a journal of neurology [Brain] 2022 Aug 27; Vol. 145 (8), pp. 2920-2934. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 0372537 Publication Model: Print Cited Medium: Internet ISSN: 1460-2156 (Electronic) Linking ISSN: 00068950 NLM ISO Abbreviation: Brain Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Oxford : Oxford University Press Original Publication: London. |
| مواضيع طبية MeSH: | Brain Injuries* , Brain Injuries, Traumatic* , Nervous System Malformations* , White Matter*, Adolescent ; Adult ; Atrophy ; Brain ; Child ; Gray Matter ; Humans ; Magnetic Resonance Imaging ; Young Adult |
| مستخلص: | Long-term outcomes are difficult to predict after paediatric traumatic brain injury. The presence or absence of focal brain injuries often do not explain cognitive, emotional and behavioural disabilities that are common and disabling. In adults, traumatic brain injury produces progressive brain atrophy that can be accurately measured and is associated with cognitive decline. However, the effect of paediatric traumatic brain injury on brain volumes is more challenging to measure because of its interaction with normal brain development. Here we report a robust approach to the individualized estimation of brain volume following paediatric traumatic brain injury and investigate its relationship to clinical outcomes. We first used a large healthy control dataset (n > 1200, age 8-22) to describe the healthy development of white and grey matter regions through adolescence. Individual estimates of grey and white matter regional volume were then generated for a group of moderate/severe traumatic brain injury patients injured in childhood (n = 39, mean age 13.53 ± 1.76, median time since injury = 14 months, range 4-168 months) by comparing brain volumes in patients to age-matched controls. Patients were individually classified as having low or normal brain volume. Neuropsychological and neuropsychiatric outcomes were assessed using standardized testing and parent/carer assessments. Relative to head size, grey matter regions decreased in volume during normal adolescence development whereas white matter tracts increased in volume. Traumatic brain injury disrupted healthy brain development, producing reductions in both grey and white matter brain volumes after correcting for age. Of the 39 patients investigated, 11 (28%) had at least one white matter tract with reduced volume and seven (18%) at least one area of grey matter with reduced volume. Those classified as having low brain volume had slower processing speed compared to healthy controls, emotional impairments, higher levels of apathy, increased anger and learning difficulties. In contrast, the presence of focal brain injury and microbleeds were not associated with an increased risk of these clinical impairments. In summary, we show how brain volume abnormalities after paediatric traumatic brain injury can be robustly calculated from individual T1 MRI using a large normative dataset that allows the effects of healthy brain development to be controlled for. Using this approach, we show that volumetric abnormalities are common after moderate/severe traumatic brain injury in both grey and white matter regions, and are associated with higher levels of cognitive, emotional and behavioural abnormalities that are common after paediatric traumatic brain injury. (© The Author(s) 2022. Published by Oxford University Press on behalf of the Guarantors of Brain.) |
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| معلومات مُعتمدة: | G1002276 United Kingdom MRC_ Medical Research Council |
| فهرسة مساهمة: | Keywords: cognition; developmental; paediatric; traumatic brain injury; volume |
| تواريخ الأحداث: | Date Created: 20220707 Date Completed: 20220830 Latest Revision: 20230315 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC9420021 |
| DOI: | 10.1093/brain/awac130 |
| PMID: | 35798350 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1460-2156 |
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| DOI: | 10.1093/brain/awac130 |