Königs Marsh, van Heurn L W Ernest, Bakx Roel, Vermeulen R Jeroen, Goslings J Carel, Poll-The Bwee Tien, van der Wees Marleen, Catsman-Berrevoets Coriene E, Oosterlaan Jaap, Pouwels Petra J W
Clinical Neuropsychology Section, VU University Amsterdam, Amsterdam, The Netherlands.
Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.
Hum Brain Mapp. 2017 Jul;38(7):3603-3614. doi: 10.1002/hbm.23614. Epub 2017 Apr 21.
This study aimed to investigate the impact of mild to severe pediatric TBI on the structural connectome. Children aged 8-14 years with trauma control (TC) injury (n = 27) were compared to children with mild TBI and risk factors for complicated TBI (mild , n = 20) or moderate/severe TBI (n = 16) at 2.8 years post-injury. Probabilistic tractography on diffusion tensor imaging data was used in combination with graph theory to study structural connectivity. Functional outcome was measured using neurocognitive tests and parent and teacher questionnaires for behavioral functioning. The results revealed no evidence for an impact of mild TBI on the structural connectome. In contrast, the moderate/severe TBI group showed longer characteristic path length (P = 0.022, d = 0.82) than the TC group. Furthermore, longer characteristic path length was related to poorer intelligence and poorer working memory in children with TBI. In conclusion, children have abnormal organization of the structural connectome after moderate/severe TBI, which may be implicated in neurocognitive dysfunction associated with pediatric TBI. These findings should be interpreted in the context of our exploratory analyses, which indicate that the definition and weighting of connectivity (e.g., streamline density, fractional anisotropy) influence the properties of the reconstructed connectome and its sensitivity to the impact and outcome of pediatric TBI. Hum Brain Mapp 38:3603-3614, 2017. © 2017 Wiley Periodicals, Inc.
本研究旨在调查轻度至重度小儿创伤性脑损伤（TBI）对结构连接组的影响。将8 - 14岁患有创伤控制（TC）损伤的儿童（n = 27）与轻度TBI且有复杂TBI风险因素的儿童（轻度，n = 20）或中度/重度TBI儿童（n = 16）在受伤后2.8年进行比较。利用扩散张量成像数据的概率纤维束成像结合图论来研究结构连通性。使用神经认知测试以及家长和教师关于行为功能的问卷来测量功能结果。结果显示没有证据表明轻度TBI对结构连接组有影响。相比之下，中度/重度TBI组的特征路径长度比TC组更长（P = 0.022，d = 0.82）。此外，TBI儿童中较长的特征路径长度与较差的智力和较差的工作记忆有关。总之，儿童在中度/重度TBI后结构连接组存在异常组织，这可能与小儿TBI相关的神经认知功能障碍有关。这些发现应在我们的探索性分析背景下进行解释，探索性分析表明连通性的定义和权重（例如，流线密度、分数各向异性）会影响重建连接组的特性及其对小儿TBI的影响和结果的敏感性。《人类大脑图谱》38:3603 - 3614，2017年。© 2017威利期刊公司。
