@article{ref1,
title="Can quantitative susceptibility mapping help diagnose and predict recovery of concussion in children? An A-CAP study",
journal="Journal of neurology, neurosurgery, and psychiatry",
year="2022",
author="Sader, Nicholas and Gobbi, David and Goodyear, Brad and Frayne, Richard and Ware, Ashley L. and Beauchamp, Miriam H. and Craig, William R. and Doan, Quynh and Zemek, Roger and Riva-Cambrin, Jay and Yeates, Keith Owen",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Quantitative susceptibility mapping (QSM) is an MRI technique that is a potential biomarker for concussion. We performed QSM in children following concussion or orthopaedic injury (OI), to assess QSM performance as a diagnostic and prognostic biomarker. <br><br>METHODS: Children aged 8-17 years with either concussion (N=255) or OI (N=116) were recruited from four Canadian paediatric emergency departments and underwent QSM postacutely (2-33 days postinjury) using 3 Tesla MRI. QSM Z-scores within nine regions of interest (ROI) were compared between groups. QSM Z-scores were also compared with the 5P score, the current clinical benchmark for predicting persistent postconcussion symptoms (PPCS), at 4 weeks postinjury, with PPCS defined using reliable change methods based on both participant and parent reports. <br><br>RESULTS: Concussion and OI groups did not differ significantly in QSM Z-scores for any ROI. Higher QSM Z-scores within frontal white matter (WM) independently predicted PPCS based on parent ratings of cognitive symptoms (p=0.001). The combination of frontal WM QSM Z-score and 5P score was better at predicting PPCS than 5P score alone (p=0.004). The area under the curve was 0.72 (95% CI 0.63 to 0.81) for frontal WM susceptibility, 0.69 (95% CI 0.59 to 0.79) for the 5P score and 0.74 (95% CI 0.65 to 0.83) for both. <br><br>CONCLUSION: The findings suggest that QSM is a potential MRI biomarker that can help predict PPCS in children with concussion, over and above the current clinical benchmark, and thereby aid in clinical management. They also suggest a frontal lobe substrate for PPCS, highlighting the potential for QSM to clarify the neurophysiology of paediatric concussion.<p /> <p>Language: en</p>",
language="en",
issn="0022-3050",
doi="10.1136/jnnp-2022-329487",
url="http://dx.doi.org/10.1136/jnnp-2022-329487"
}