Rausa Vanessa C, Shapiro Jesse, Seal Marc L, Davis Gavin A, Anderson Vicki, Babl Franz E, Veal Ryan, Parkin Georgia, Ryan Nicholas P, Takagi Michael
Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia.
Neurosci Biobehav Rev. 2020 Nov;118:643-653. doi: 10.1016/j.neubiorev.2020.08.017. Epub 2020 Sep 6.
Neuroimaging is being increasingly applied to the study of paediatric mild traumatic brain injury (mTBI) to uncover the neurobiological correlates of delayed recovery post-injury. The aims of this systematic review were to: (i) evaluate the neuroimaging research investigating neuropathology post-mTBI in children and adolescents from 0-18 years, (ii) assess the relationship between advanced neuroimaging abnormalities and PCS in children, (iii) assess the quality of the evidence by evaluating study methodology and reporting against best practice guidelines, and (iv) provide directions for future research. A literature search of MEDLINE, PsycINFO, EMBASE, and PubMed was conducted. Abstracts and titles were screened, followed by full review of remaining articles where specific eligibility criteria were applied. This systematic review identified 58 imaging studies which met criteria. Based on several factors including methodological heterogeneity and relatively small sample sizes, the literature currently provides insufficient evidence to draw meaningful conclusions about the relationship between MRI findings and clinical outcomes. Future research is needed which incorporates prospective, longitudinal designs, minimises potential confounds and utilises multimodal imaging techniques.
神经影像学正越来越多地应用于小儿轻度创伤性脑损伤（mTBI）的研究，以揭示损伤后恢复延迟的神经生物学关联。本系统评价的目的是：（i）评估关于0至18岁儿童和青少年mTBI后神经病理学的神经影像学研究；（ii）评估儿童高级神经影像学异常与脑震荡后综合征（PCS）之间的关系；（iii）通过评估研究方法并对照最佳实践指南进行报告来评估证据质量；（iv）为未来研究提供方向。对MEDLINE、PsycINFO、EMBASE和PubMed进行了文献检索。筛选了摘要和标题，随后对适用特定纳入标准的其余文章进行了全面审查。本系统评价确定了58项符合标准的影像学研究。基于包括方法学异质性和相对较小样本量在内的几个因素，目前的文献提供的证据不足，无法就MRI结果与临床结局之间的关系得出有意义的结论。需要开展纳入前瞻性纵向设计、尽量减少潜在混杂因素并使用多模态成像技术的未来研究。
