Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
J Neurotrauma. 2020 Sep 1;37(17):1892-1901. doi: 10.1089/neu.2019.6850. Epub 2020 May 11.
Studies of brain morphometry may illuminate the effects of pediatric mild traumatic brain injury (TBI; e.g., concussion). However, no published studies have examined cortical thickness in the early injury phases of pediatric mild TBI using an appropriate comparison group. The current study used an automated approach (i.e., FreeSurfer) to determine whether cortical thickness differed in children following a mild TBI or a mild orthopedic injury (OI), and to examine whether post-acute cortical thickness predicted post-acute and chronic post-concussive symptoms (PCS). Children ages 8.00-16.99 years with mild TBI ( = 136) or OI ( = 70) were recruited at emergency department visits to two children's hospitals, during which parents rated children's pre-injury symptoms retrospectively. Children completed a post-acute (3-24 days post-injury) assessment, which included a 3 Tesla MRI, and 3- and 6-month post-injury assessments. Parents and children rated PCS at each assessment. Cortical thickness was estimated using FreeSurfer. Linear mixed effects and multi-variable negative binomial regression models were used to test study aims, with false discovery rate (FDR) correction for multiple comparisons. Groups differed significantly on left parietal cortical thickness (TBI > OI) after FDR correction. Cortical thickness also varied by brain subregion and age, but not sex. Groups differed significantly on PCS post-acutely (TBI > OI), but not at 3 or 6 months. Right frontal thickness was positively related to post-acute PCS in both groups. Right cingulum thickness predicted chronic PCS in the OI group only. Results highlight the complexity of predicting outcomes of pediatric mild TBI from post-acute neuroimaging biomarkers.
脑形态计量学研究可能阐明儿科轻度创伤性脑损伤（TBI；例如，脑震荡）的影响。然而，尚无研究使用适当的对照组检查儿科轻度 TBI 早期损伤阶段的皮质厚度。本研究使用自动方法（即 FreeSurfer）来确定在轻度 TBI 或轻度骨科损伤（OI）后儿童的皮质厚度是否不同，并检查急性后皮质厚度是否预测急性后和慢性脑震荡后症状（PCS）。在两家儿童医院的急诊科就诊时招募了 8.00-16.99 岁的患有轻度 TBI（n=136）或 OI（n=70）的儿童，在此期间，父母对儿童的受伤前症状进行了回顾性评估。儿童在受伤后 3-24 天（急性后）进行了评估，其中包括 3 Tesla MRI，以及受伤后 3 个月和 6 个月的评估。父母和儿童在每次评估时都对 PCS 进行了评分。使用 FreeSurfer 估计皮质厚度。使用线性混合效应和多变量负二项式回归模型来检验研究目的，并对多重比较进行错误发现率（FDR）校正。在 FDR 校正后，左顶叶皮质厚度（TBI > OI）的组间差异具有统计学意义。皮质厚度还因脑区和年龄而异，但与性别无关。急性后两组的 PCS 差异具有统计学意义（TBI > OI），但在 3 个月或 6 个月时没有差异。在两组中，右侧额部厚度与急性后 PCS 呈正相关。右侧扣带厚度仅在 OI 组中预测慢性 PCS。结果突出了从急性后神经影像学生物标志物预测儿科轻度 TBI 结果的复杂性。
