Citation

Ferrazzano P, Yeske B, Mumford J, Kirk G, Bigler EDPD, Bowen K, O'Brien N, Rosario BL, Beers SR, Rathouz P, Bell MJ, Alexander AL. J. Neurotrauma 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2019.6918

PMID

unavailable

Abstract

Adolescent traumatic brain injury (TBI) is a major public health concern, resulting in over 35,000 hospitalizations in the U.S. each year.(1) While neuroimaging is a primary diagnostic tool in the clinical assessment of TBI, our understanding of how specific neuroimaging findings relate to outcome remains limited. Our study aims to identify imaging biomarkers of long-term neurocognitive outcome after severe adolescent TBI. Twenty-four adolescents with severe TBI (Glasgow Coma Scale ≤8) enrolled in the Approaches and Decisions after Pediatric TBI (ADAPT) study were recruited for MRI scanning 1-2 years post-injury at 13 participating sites. Subjects underwent outcome assessments approximately 1-year post-injury, including the Wechsler Abbreviated Scale of Intelligence (IQ) and the Pediatric Glasgow Outcome Scale-Extended (GOS-E Peds). A typically developing control cohort of 38 age-matched children also underwent scanning and neurocognitive assessment. Brain image segmentation was performed on T1-weighted images using Freesurfer. Brain and ventricular CSF volumes were used to compute a Ventricle-to-Brain Ratio (VBR) for each subject, and the corpus callosum cross-sectional area was determined in the midline for each subject. The TBI group demonstrated higher VBR and lower corpus callosum area compared to the control cohort. After adjusting for age and sex, VBR was significantly related with GOS-E Peds score in the TBI group (n=24, p=0.01, cumulative odds ratio = 2.18). After adjusting for age, sex, intracranial volume and brain volume, corpus callosum cross-sectional area correlated significantly with IQ score in the TBI group (partial cor = 0.68, n=18, p=0.007) and with PSI (partial cor = 0.33, p = 0.02). No association was found between VBR and IQ or between corpus callosum and GOS-E Peds. After severe adolescent TBI, the quantitative MRI measures of VBR and corpus callosum cross-sectional area are associated with global functional outcome and neurocognitive outcomes, respectively.

Language: en

Keywords

PEDIATRIC BRAIN INJURY; TRAUMATIC BRAIN INJURY; MRI; HEAD TRAUMA; COGNITIVE FUNCTION