TY  - JOUR
PY  - 2016//
TI  - Cortical excitability after pediatric mild traumatic brain injury
JO  - Brain stimulation
A1  - Seeger, Trevor A.
A1  - Kirton, Adam
A1  - Esser, Michael J.
A1  - Gallagher, Clare
A1  - Dunn, Jeff
A1  - Zewdie, Ephrem
A1  - Damji, Omar
A1  - Ciechanski, Patrick
A1  - Barlow, Karen M.
SP  - 305
EP  - 314
VL  - 10
IS  - 2
N2  - INTRODUCTION: Mild traumatic brain injury (mTBI) outcomes are variable, and 10-15% may suffer from prolonged symptoms beyond 3 months that impair the child's return to normal activities. Neurophysiological mechanisms of mTBI are incompletely understood, particularly in children, but alterations in cortical excitability have been proposed to underlie post-concussion syndrome. Improved understanding is required to advance interventions and improve outcomes. <br><br>OBJECTIVE/HYPOTHESIS: To determine if cortical excitability is altered in children with mTBI, and its association with clinical symptoms. <br><br>METHODS: This was a cross-sectional controlled cohort study. School-aged children (8-18 years) with mTBI were compared to healthy controls. Cortical excitability was measured using multiple TMS paradigms in children with (symptomatic) and without (recovered) persistent symptoms one-month post-injury. Primary outcome was the cortical silent period (cSP), a potential neurophysiological biomarker of GABAergic inhibition. Secondary outcomes included additional TMS neurophysiology, safety and tolerability. Associations between neurophysiology parameters and clinical symptoms were evaluated. <br><br>RESULTS: Fifty-three children with mTBI (55% male; mean age 14.1 SD: 2.4 years; 35 symptomatic and 27 asymptomatic participants) and 28 controls (46% male; mean age 14.3 SD: 3.1 years) were enrolled. cSP duration was similar between groups (F (2, 73) = 0.55, p = 0.582). Log10 long interval intracortical inhibition (LICI) was reduced in symptomatic participants compared to healthy controls (F (2, 59) = 3.83, p = 0.027). Procedures were well tolerated with no serious adverse events. <br><br>CONCLUSIONS: TMS measures of cortical excitability are altered at one month in children with mTBI. Long interval cortical inhibition is decreased in children who remain symptomatic at one month post-injury.<br><br>Copyright © 2016 Elsevier Inc. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 1935-861X
UR  - http://dx.doi.org/10.1016/j.brs.2016.11.011
ID  - ref1
ER  -