Ryan Nicholas P, Catroppa Cathy, Cooper Janine M, Beare Richard, Ditchfield Michael, Coleman Lee, Silk Timothy, Crossley Louise, Rogers Kirrily, Beauchamp Miriam H, Yeates Keith O, Anderson Vicki A
Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Flemington Road, Parkville, 3052 Melbourne, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Flemington Road, Parkville, 3052 Melbourne, Australia; Department of Psychology, Royal Children׳s Hospital, Melbourne, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
Neuropsychologia. 2015 Jan;66:32-8. doi: 10.1016/j.neuropsychologia.2014.10.040. Epub 2014 Nov 6.
Theory of Mind (ToM) forms an integral component of socially skilled behavior, and is critical for attaining developmentally appropriate goals. The protracted development of ToM is mediated by increasing connectivity between regions of the anatomically distributed 'mentalizing network', and may be vulnerable to disruption from pediatric traumatic brain injury (TBI). The present study aimed to evaluate the post-acute effects of TBI on first-order ToM, and examine relations between ToM and both local and global indices of macrostructural damage detected using susceptibility-weighted imaging (SWI). 104 children and adolescents with TBI and 43 age-matched typically developing (TD) controls underwent magnetic resonance imaging including a susceptibility-weighted imaging (SWI) sequence 2-8 weeks post-injury and were assessed on cognitive ToM tasks at 6-months after injury. Compared to TD controls and children with mild-moderate injuries, children with severe TBI showed significantly poorer ToM. Moreover, impairments in ToM were related to diffuse neuropathology, and parietal lobe lesions. Our findings support the vulnerability of the immature social brain network to disruption from TBI, and suggest that global macrostructural damage commonly associated with traumatic axonal injury (TAI) may contribute to structural disconnection of anatomically distributed regions that underlie ToM. This study suggests that SWI may be a valuable imaging biomarker to predict outcome and recovery of social cognition after pediatric TBI.
心理理论（ToM）是社交技能行为的一个重要组成部分，对于实现与发育阶段相适应的目标至关重要。ToM的长期发展是由解剖学上分布的“心理化网络”各区域之间不断增加的连通性所介导的，并且可能容易受到小儿创伤性脑损伤（TBI）的干扰。本研究旨在评估TBI对一阶ToM的急性后期影响，并研究ToM与使用磁敏感加权成像（SWI）检测到的宏观结构损伤的局部和整体指标之间的关系。104名患有TBI的儿童和青少年以及43名年龄匹配的发育正常（TD）对照在受伤后2 - 8周接受了包括磁敏感加权成像（SWI）序列在内的磁共振成像检查，并在受伤后6个月接受了认知ToM任务评估。与TD对照和轻度至中度损伤的儿童相比，重度TBI儿童的ToM明显更差。此外，ToM的损伤与弥漫性神经病理学和顶叶病变有关。我们的研究结果支持未成熟的社会脑网络易受TBI干扰的观点，并表明通常与创伤性轴索损伤（TAI）相关的整体宏观结构损伤可能导致ToM所依赖的解剖学上分布区域的结构断开。这项研究表明，SWI可能是一种有价值的成像生物标志物，可用于预测小儿TBI后社会认知的结果和恢复情况。
