Deep white matter volume loss and social reintegration after traumatic brain injury in children.

OBJECTIVE

To explore whether children judged by their parents as showing an "excellent" or "complete" social reintegration after pediatric traumatic brain injury have less white matter volume (WMV) loss and better neuropsychological test scores than children who do not achieve this same level of reintegration.

SETTING

Primary-care hospital/medical center.

PARTICIPANTS

Twenty-eight children with post-acute traumatic brain injury evaluated as outpatients.

MEASURES

Parental ratings of overall social reintegration, neuropsychological test performance, and voxel-based morphometry analysis of brain WMV loss.

RESULTS

In addition to showing worse neuropsychological test performance, children judged not to make a complete or excellent social reintegration had greater WMV loss, particularly within the corpus callosum. WMV loss in the corpus callosum correlated with the child's Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) Full Scale IQ (rho = .677, P = .000) and parental ratings of level of social integration (rho = .415, P = .028). Admitting Glasgow Coma Scale scores, mother's level of education, WISC-IV Processing Speed Index scores, and WMV loss in the region of the corpus callosum significantly contributed to parental ratings of a child's level of social reintegration.

CONCLUSIONS

Preliminary findings suggested that diffuse WMV loss, particularly in deep brain regions (eg, corpus callosum), may relate to the child's long-term psychosocial outcome as viewed from the parents' perspective.