Power Tarah, Catroppa Cathy, Coleman Lee, Ditchfield Michael, Anderson Vicki
University of Melbourne, Australia.
Brain Inj. 2007 Mar;21(3):279-92. doi: 10.1080/02699050701253095.
To determine the predictive value of structural neuroimaging in the clinical setting following TBI.
Prospective between-group design, comparing groups with regard to: (i) the presence or absence of cerebral pathology and (ii) the location of cerebral pathology. The predictive value of injury variables was investigated using hierarchical regressions.
Thirty-six children, between 6 and 14 years, who sustained a moderate to severe TBI 5 years previously participated in this study. Children's performances on five measures of attentional control were examined in relation to the presence, location and severity of their lesions, as coded by the Coffey classification system 1.
Frontal lesion severity was not predictive of performance on any of the measures. However, generalized (frontal and extrafrontal) and extrafrontal lesion severity was predictive of poor performance.
These findings support the argument that functional organization in children may differ from that in adults, suggesting that multiple cerebral regions, or a diffuse cerebral network, may mediate children's executive functions (EF). Results are also consistent with the hypothesis that the amount of damaged brain tissue, rather than its location, may be more predictive of neurobehavioural outcome following early TBI.
确定在创伤性脑损伤（TBI）后的临床环境中结构神经影像学的预测价值。
前瞻性组间设计，在以下方面比较各组：（i）是否存在脑部病变；（ii）脑部病变的位置。使用分层回归研究损伤变量的预测价值。
36名年龄在6至14岁之间、5年前遭受中度至重度TBI的儿童参与了本研究。根据科菲分类系统1对儿童的病变情况进行编码，研究其在五种注意力控制测量指标上的表现与病变的存在、位置和严重程度之间的关系。
额叶病变严重程度对任何测量指标的表现均无预测作用。然而，广泛性（额叶和额叶外）及额叶外病变严重程度可预测表现不佳。
这些发现支持了儿童的功能组织可能与成人不同的观点，表明多个脑区或弥散性脑网络可能介导儿童的执行功能（EF）。结果也与以下假设一致，即早期TBI后，受损脑组织的数量而非其位置可能更能预测神经行为结果。
