Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Psychological Sciences, Monash University, Melbourne, Victoria, Australia.
J Neurotrauma. 2020 Jan 1;37(1):163-169. doi: 10.1089/neu.2018.6235. Epub 2019 Aug 5.
Pediatric concussion is a major public health concern. Despite the prevalence of behavior problems following concussion and their potential role in prolonged symptoms, little is known about how child and adolescent behavior may impact post-concussion recovery. We sought to examine change in behavioral and emotional functioning in a sample of children ages 5 to <18 years with concussion. This study reports on data collected as part of a larger single-site prospective longitudinal cohort study. Participants were recruited from the Emergency Department (ED) of a tertiary children's hospital and completed the Child Behavior Checklist (CBCL) at 2 weeks (acute; T2) and 3 months (post-acute; T4) post-injury. Children with concussion ( = 231) showed a significant reduction in internalizing ( < 0.001, = 0.27), externalizing ( < 0.001, = 0.23), and total behavior problems ( < 0.001, = 0.36) at 3 months compared with 2 weeks post-injury. Multiple regression models found a significant interaction between age and sex with higher rates of internalizing ( = 0.048, η = 0.02) and total ( = 0.040, η = 0.02) behavior problems as age increased in females. The results show that pediatric concussion is associated with temporary behavioral disturbances that are likely to improve considerably in the months following injury. Nonetheless, as age increases, females may be at increased risk for experiencing ongoing internalizing problems several months after concussion and may require targeted clinical intervention.
儿童脑震荡是一个主要的公共卫生关注点。尽管脑震荡后行为问题普遍存在，且它们可能在延长症状中发挥作用，但对于儿童和青少年的行为如何影响脑震荡后的恢复知之甚少。我们试图在一个年龄在 5 至 <18 岁的脑震荡儿童样本中研究行为和情绪功能的变化。本研究报告了作为一项更大的单站点前瞻性纵向队列研究的一部分收集的数据。参与者从一家三级儿童医院的急诊部招募，并在受伤后 2 周（急性；T2）和 3 个月（亚急性；T4）时完成儿童行为检查表（CBCL）。脑震荡儿童（n=231）在 3 个月时表现出明显的内化（ < 0.001， = 0.27）、外化（ < 0.001， = 0.23）和总行为问题（ < 0.001， = 0.36）减少，与受伤后 2 周相比。多元回归模型发现年龄和性别之间存在显著的交互作用，女性年龄增加时，内化（ = 0.048，η = 0.02）和总（ = 0.040，η = 0.02）行为问题的发生率更高。结果表明，儿童脑震荡与暂时的行为障碍有关，这些障碍在受伤后几个月内可能会显著改善。尽管如此，随着年龄的增长，女性在脑震荡后几个月内可能会面临持续内化问题的风险增加，可能需要针对性的临床干预。
