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Guerrero-Gonzalez JM, Kirk GR, Birn R, Bigler ED, Bowen K, Broman AT, Rosario BL, Butt W, Beers SR, Bell MJ, Alexander AL, Ferrazzano PA. Multi-modal MRI of hippocampal morphometry and connectivity after pediatric severe TBI. Brain Imaging Behav 2024; 18:159-170. [PMID: 37955810 PMCID: PMC10844146 DOI: 10.1007/s11682-023-00818-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2023] [Indexed: 11/14/2023]
Abstract
This investigation explores memory performance using the California Verbal Learning Test in relation to morphometric and connectivity measures of the memory network in severe traumatic brain injury. Twenty-two adolescents with severe traumatic brain injury were recruited for multimodal MRI scanning 1-2 years post-injury at 13 participating sites. Analyses included hippocampal volume derived from anatomical T1-weighted imaging, fornix white matter microstructure from diffusion tensor imaging, and hippocampal resting-state functional magnetic resonance imaging connectivity as well as diffusion-based structural connectivity. A typically developing control cohort of forty-nine age-matched children also underwent scanning and neurocognitive assessment. Results showed hippocampus volume was decreased in traumatic brain injury with respect to controls. Further, hippocampal volume loss was associated with worse performance on memory and learning in traumatic brain injury subjects. Similarly, hippocampal fornix fractional anisotropy was reduced in traumatic brain injury with respect to controls, while decreased fractional anisotropy in the hippocampal fornix also was associated with worse performance on memory and learning in traumatic brain injury subjects. Additionally, reduced structural connectivity of left hippocampus to thalamus and calcarine sulcus was associated with memory and learning in traumatic brain injury subjects. Functional connectivity in the left hippocampal network was also associated with memory and learning in traumatic brain injury subjects. These regional findings from a multi-modal neuroimaging approach should not only be useful for gaining valuable insight into traumatic brain injury induced memory and learning disfunction, but may also be informative for monitoring injury progression, recovery, and for developing rehabilitation as well as therapy strategies.
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Affiliation(s)
- Jose M Guerrero-Gonzalez
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA.
| | - Gregory R Kirk
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
| | - Rasmus Birn
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Erin D Bigler
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT, USA
- Department of Neurology & Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | | | - Aimee T Broman
- Department of Biostatistics, University of Wisconsin-Madison, Madison, WI, USA
| | - Bedda L Rosario
- Department of Epidemiology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Warwick Butt
- Department of Critical Care, Faculty of Medicine, Melbourne University, Melbourne, Australia
| | - Sue R Beers
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael J Bell
- Department of Pediatrics, Children's National Medical Center, Washington, DC, USA
| | - Andrew L Alexander
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
| | - Peter A Ferrazzano
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
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Panchenko PE, Hippauf L, Konsman JP, Badaut J. Do astrocytes act as immune cells after pediatric TBI? Neurobiol Dis 2023; 185:106231. [PMID: 37468048 PMCID: PMC10530000 DOI: 10.1016/j.nbd.2023.106231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/28/2023] [Accepted: 07/15/2023] [Indexed: 07/21/2023] Open
Abstract
Astrocytes are in contact with the vasculature, neurons, oligodendrocytes and microglia, forming a local network with various functions critical for brain homeostasis. One of the primary responders to brain injury are astrocytes as they detect neuronal and vascular damage, change their phenotype with morphological, proteomic and transcriptomic transformations for an adaptive response. The role of astrocytic responses in brain dysfunction is not fully elucidated in adult, and even less described in the developing brain. Children are vulnerable to traumatic brain injury (TBI), which represents a leading cause of death and disability in the pediatric population. Pediatric brain trauma, even with mild severity, can lead to long-term health complications, such as cognitive impairments, emotional disorders and social dysfunction later in life. To date, the underlying pathophysiology is still not fully understood. In this review, we focus on the astrocytic response in pediatric TBI and propose a potential immune role of the astrocyte in response to trauma. We discuss the contribution of astrocytes in the local inflammatory cascades and secretion of various immunomodulatory factors involved in the recruitment of local microglial cells and peripheral immune cells through cerebral blood vessels. Taken together, we propose that early changes in the astrocytic phenotype can alter normal development of the brain, with long-term consequences on neurological outcomes, as described in preclinical models and patients.
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Affiliation(s)
| | - Lea Hippauf
- CNRS UMR 5536 RMSB-University of Bordeaux, Bordeaux, France
| | | | - Jerome Badaut
- CNRS UMR 5536 RMSB-University of Bordeaux, Bordeaux, France; Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA.
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Hu X, Meier M, Pruessner J. Challenges and opportunities of diagnostic markers of Alzheimer's disease based on structural magnetic resonance imaging. Brain Behav 2023; 13:e2925. [PMID: 36795041 PMCID: PMC10013953 DOI: 10.1002/brb3.2925] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/04/2023] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVES This article aimed to carry out a narrative literature review of early diagnostic markers of Alzheimer's disease (AD) based on both micro and macro levels of pathology, indicating the shortcomings of current biomarkers and proposing a novel biomarker of structural integrity that associates the hippocampus and adjacent ventricle together. This could help to reduce the influence of individual variety and improve the accuracy and validity of structural biomarker. METHODS This review was based on presenting comprehensive background of early diagnostic markers of AD. We have compiled those markers into micro level and macro level, and discussed the advantages and disadvantages of them. Eventually the ratio of gray matter volume to ventricle volume was put forward. RESULTS The costly methodologies and related high patient burden of "micro" biomarkers (cerebrospinal fluid biomarkers) hinder the implementation in routine clinical examination. In terms of "macro" biomarkers- hippocampal volume (HV), there is a large variation of it among population, which undermines its validity Considering the gray matter atrophies while the adjacent ventricular volume enlarges, we assume the hippocampal to ventricle ratio (HVR) is a more reliable marker than HV alone the emerging evidence showed hippocampal to ventricle ratio predicts memory functions better than HV alone in elderly sample. CONCLUSIONS The ratio between gray matter structures and adjacent ventricular volumes counts as a promising superior diagnostic marker of early neurodegeneration.
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Affiliation(s)
- Xiang Hu
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Maria Meier
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Jens Pruessner
- Department of Psychology, University of Konstanz, Konstanz, Germany
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4
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Mayer AR, Meier TB, Dodd AB, Stephenson DD, Robertson-Benta CR, Ling JM, Pabbathi Reddy S, Zotev V, Vakamudi K, Campbell RA, Sapien RE, Erhardt EB, Phillips JP, Vakhtin AA. Prospective Study of Gray Matter Atrophy Following Pediatric Mild Traumatic Brain Injury. Neurology 2023; 100:e516-e527. [PMID: 36522161 PMCID: PMC9931084 DOI: 10.1212/wnl.0000000000201470] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 09/09/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The clinical and physiologic time course for recovery following pediatric mild traumatic brain injury (pmTBI) remains actively debated. The primary objective of the current study was to prospectively examine structural brain changes (cortical thickness and subcortical volumes) and age-at-injury effects. A priori study hypotheses predicted reduced cortical thickness and hippocampal volumes up to 4 months postinjury, which would be inversely associated with age at injury. METHODS Prospective cohort study design with consecutive recruitment. Study inclusion adapted from American Congress of Rehabilitation Medicine (upper threshold) and Zurich Concussion in Sport Group (minimal threshold) and diagnosed by Emergency Department and Urgent Care clinicians. Major neurologic, psychiatric, or developmental disorders were exclusionary. Clinical (Common Data Element) and structural (3 T MRI) evaluations within 11 days (subacute visit [SA]) and at 4 months (early chronic visit [EC]) postinjury. Age- and sex-matched healthy controls (HC) to control for repeat testing/neurodevelopment. Clinical outcomes based on self-report and cognitive testing. Structural images quantified with FreeSurfer (version 7.1.1). RESULTS A total of 208 patients with pmTBI (age = 14.4 ± 2.9; 40.4% female) and 176 HC (age = 14.2 ± 2.9; 42.0% female) were included in the final analyses (>80% retention). Reduced cortical thickness (right rostral middle frontal gyrus; d = -0.49) and hippocampal volumes (d = -0.24) observed for pmTBI, but not associated with age at injury. Hippocampal volume recovery was mediated by loss of consciousness/posttraumatic amnesia. Significantly greater postconcussive symptoms and cognitive deficits were observed at SA and EC visits, but were not associated with the structural abnormalities. Structural abnormalities slightly improved balanced classification accuracy above and beyond clinical gold standards (∆+3.9%), with a greater increase in specificity (∆+7.5%) relative to sensitivity (∆+0.3%). DISCUSSION Current findings indicate that structural brain abnormalities may persist up to 4 months post-pmTBI and are partially mediated by initial markers of injury severity. These results contribute to a growing body of evidence suggesting prolonged physiologic recovery post-pmTBI. In contrast, there was no evidence for age-at-injury effects or physiologic correlates of persistent symptoms in our sample.
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Affiliation(s)
- Andrew R Mayer
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque.
| | - Timothy B Meier
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Andrew B Dodd
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - David D Stephenson
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Cidney R Robertson-Benta
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Josef M Ling
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Sharvani Pabbathi Reddy
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Vadim Zotev
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Kishore Vakamudi
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Richard A Campbell
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Robert E Sapien
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Erik B Erhardt
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - John P Phillips
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Andrei A Vakhtin
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
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Lopez DA, Christensen ZP, Foxe JJ, Ziemer LR, Nicklas PR, Freedman EG. Association between mild traumatic brain injury, brain structure, and mental health outcomes in the Adolescent Brain Cognitive Development Study. Neuroimage 2022; 263:119626. [PMID: 36103956 DOI: 10.1016/j.neuroimage.2022.119626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/20/2022] [Accepted: 09/10/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Children that experience a mild traumatic brain injury (mTBI) are at an increased risk of neural alterations that can deteriorate mental health. We test the hypothesis that mTBI is associated with psychopathology and that structural brain metrics (e.g., volume, area) meaningfully mediate the relation in an adolescent population. METHODS We analyzed behavioral and brain MRI data from 11,876 children who participated in the Adolescent Brain Cognitive Development (ABCD) Study. Mixed-effects models were used to examine the longitudinal association between mTBI and mental health outcomes. Bayesian methods were used to investigate brain regions that are intermediate between mTBI and symptoms of poor mental health. RESULTS There were 199 children with mTBI and 527 with possible mTBI across the three ABCD Study visits. There was a 7% (IRR = 1.07, 95% CI: 1.01, 1.13) and 15% (IRR = 1.16, 95% CI: 1.05, 1.26) increased risk of emotional or behavioral problems in children that experienced possible mTBI or mTBI, respectively. Possible mTBI was associated with a 17% (IRR: 1.17, 95% CI: 0.99, 1.40) increased risk of experiencing distress following a psychotic-like experience. We did not find any brain regions that meaningfully mediated the relationship between mTBI and mental health outcomes. Analysis of volumetric measures found that approximately 2% to 5% of the total effect of mTBI on mental health outcomes operated through total cortical volume. Image intensity measure analyses determined that approximately 2% to 5% of the total effect was mediated through the left-hemisphere of the dorsolateral prefrontal cortex. CONCLUSION Results indicate an increased risk of emotional and behavioral problems in children that experienced possible mTBI or mTBI. Mediation analyses did not elucidate the mechanisms underlying the association between mTBI and mental health outcomes.
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Affiliation(s)
- Daniel A Lopez
- Department of Neuroscience, The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA; Department of Public Health Sciences, Division of Epidemiology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Zachary P Christensen
- Department of Neuroscience, The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - John J Foxe
- Department of Neuroscience, The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - Laura R Ziemer
- Department of Neuroscience, The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - Paige R Nicklas
- Department of Neuroscience, The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - Edward G Freedman
- Department of Neuroscience, The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
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Braga MFM, Juranek J, Eiden LE, Li Z, Figueiredo TH, de Araujo Furtado M, Marini AM. GABAergic circuits of the basolateral amygdala and generation of anxiety after traumatic brain injury. Amino Acids 2022; 54:1229-1249. [PMID: 35798984 DOI: 10.1007/s00726-022-03184-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/20/2022] [Indexed: 11/25/2022]
Abstract
Traumatic brain injury (TBI) has reached epidemic proportions around the world and is a major public health concern in the United States. Approximately 2.8 million individuals sustain a traumatic brain injury and are treated in an Emergency Department yearly in the U.S., and about 50,000 of them die. Persistent symptoms develop in 10-15% of the cases including neuropsychiatric disorders. Anxiety is the second most common neuropsychiatric disorder that develops in those with persistent neuropsychiatric symptoms after TBI. Abnormalities or atrophy in the temporal lobe has been shown in the overwhelming number of TBI cases. The basolateral amygdala (BLA), a temporal lobe structure that consolidates, stores and generates fear and anxiety-based behavioral outputs, is a critical brain region in the anxiety circuitry. In this review, we sought to capture studies that characterized the relationship between human post-traumatic anxiety and structural/functional alterations in the amygdala. We compared the human findings with results obtained with a reproducible mild TBI animal model that demonstrated a direct relationship between the alterations in the BLA and an anxiety-like phenotype. From this analysis, both preliminary insights, and gaps in knowledge, have emerged which may open new directions for the development of rational and more efficacious treatments.
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Affiliation(s)
- Maria F M Braga
- Department of Anatomy, Physiology and Genetics and Program in Neuroscience, Uniformed Services University of the Health Science School of Medicine, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Jenifer Juranek
- Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, TX, 77030, USA
| | - Lee E Eiden
- Section On Molecular Neuroscience, National Institute of Mental Health, Intramural Research Program, Bethesda, MD, 20814, USA
| | - Zheng Li
- Section On Synapse Development and Plasticity, National Institute of Mental Health, Intramural Research Program, Bethesda, MD, 20814, USA
| | - Taiza H Figueiredo
- Department of Anatomy, Physiology and Genetics and Program in Neuroscience, Uniformed Services University of the Health Science School of Medicine, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Marcio de Araujo Furtado
- Department of Anatomy, Physiology and Genetics and Program in Neuroscience, Uniformed Services University of the Health Science School of Medicine, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Ann M Marini
- Department of Neurology and Program in Neuroscience, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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A Review of Family Environment and Neurobehavioral Outcomes Following Pediatric Traumatic Brain Injury: Implications of Early Adverse Experiences, Family Stress, and Limbic Development. Biol Psychiatry 2022; 91:488-497. [PMID: 34772505 DOI: 10.1016/j.biopsych.2021.08.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/21/2021] [Accepted: 08/11/2021] [Indexed: 12/30/2022]
Abstract
Pediatric traumatic brain injury (TBI) is a public health crisis, with neurobehavioral morbidity observed years after an injury associated with changes in related brain structures. A substantial literature base has established family environment as a significant predictor of neurobehavioral outcomes following pediatric TBI. The neural mechanisms linking family environment to neurobehavioral outcomes have, however, received less empiric study in this population. In contrast, limbic structural differences as well as challenges with emotional adjustment and behavioral regulation in non-TBI populations have been linked to a multitude of family environmental factors, including family stress, parenting style, and adverse childhood experiences. In this article, we systematically review the more comprehensive literature on family environment and neurobehavioral outcomes in pediatric TBI and leverage the work in both TBI and non-TBI populations to expand our understanding of the underlying neural mechanisms. Thus, we summarize the extant literature on the family environment's role in neurobehavioral sequelae in children with TBI and explore potential neural correlates by synthesizing the wealth of literature on family environment and limbic development, specifically related to the amygdala. This review underscores the critical role of environmental factors, especially those predating the injury, in modeling recovery outcomes post-TBI in childhood, and discusses clinical and research implications across pediatric populations. Given the public health crisis of pediatric TBI, along with the context of sparse available medical interventions, a broader understanding of factors contributing to outcomes is warranted to expand the range of intervention targets.
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8
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Baiden P, Morgan MA, Logan MW. Sports- and Physical Activity-Related Concussions, Binge Drinking and Marijuana Use among Adolescents: The Mediating Role of Depression and Suicidal Ideation. Subst Use Misuse 2022; 57:504-515. [PMID: 34967277 DOI: 10.1080/10826084.2021.2019779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Although past studies have examined the adverse impact of sports- and physical activity-related concussions (SPACs) on health and mental health outcomes, there is a dearth of research investigating the association between SPACs and binge drinking and marijuana use. OBJECTIVE The objective of this study is to examine the cross-sectional association between SPACs and binge drinking and marijuana use among adolescents and whether symptoms of depression and suicidal ideation mediate this association. METHODS Data for this study came from the 2017 and 2019 National Youth Risk Behavior Survey. An analytic sample of 17,175 adolescents aged 14-18 years (50.2% male) was analyzed using binary logistic regression. RESULTS Of the 17,175 adolescents, 13.7% engaged in binge drinking and 19.3% used marijuana 30 days preceding the survey date. Approximately one in seven (14.1%) adolescents had SPACs during the past year. Upon controlling for the effects of other factors, adolescents who had SPACs had 1.74 times higher odds of engaging in binge drinking (AOR = 1.74, p<.001, 95% CI = 1.47-2.06) and 1.42 times higher odds of using marijuana (AOR = 1.42, p<.001, 95% CI = 1.24-1.62) than those who did not have SPACs. Symptoms of depression and suicidal ideation explained 12% of the association between SPACs and binge drinking, and 19% of the association between SPACs and marijuana use. CONCLUSIONS Understanding the association between SPACs and substance use and mental health could contribute to early identification of adolescents who may engage in substance use.
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Affiliation(s)
- Philip Baiden
- School of Social Work, The University of Texas at Arlington, Arlington, Texas, USA
| | - Mark A Morgan
- Department of Criminal Justice & Security Studies, University of Dayton, Dayton, Ohio, USA
| | - Matthew W Logan
- School of Criminal Justice & Criminology, Texas State University, San Marcos, Texas, USA
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9
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Tuerk C, Dégeilh F, Catroppa C, Anderson V, Beauchamp MH. Pediatric Moderate-Severe Traumatic Brain Injury and Gray Matter Structural Covariance Networks: A Preliminary Longitudinal Investigation. Dev Neurosci 2021; 43:335-347. [PMID: 34515088 DOI: 10.1159/000518752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/23/2021] [Indexed: 11/19/2022] Open
Abstract
Pediatric traumatic brain injury (TBI) is prevalent and can disrupt ongoing brain maturation. However, the long-term consequences of pediatric TBI on the brain's network architecture are poorly understood. Structural covariance networks (SCN), based on anatomical correlations between brain regions, may provide important insights into brain topology following TBI. Changes in global SCN (default-mode network [DMN], central executive network [CEN], and salience network [SN]) were compared sub-acutely (<90 days) and in the long-term (approximately 12-24 months) after pediatric moderate-severe TBI (n = 16), and compared to typically developing children assessed concurrently (n = 15). Gray matter (GM) volumes from selected seeds (DMN: right angular gyrus [rAG], CEN: right dorsolateral prefrontal cortex [rDLPFC], SN: right anterior insula) were extracted from T1-weighted images at both timepoints. No group differences were found sub-acutely; at the second timepoint, the TBI group showed significantly reduced structural covariance within the DMN seeded from the rAG and the (1) right middle frontal gyrus, (2) left superior frontal gyrus, and (3) left fusiform gyrus. Reduced structural covariance was also found within the CEN, that is, between the rDLPFC and the (1) calcarine sulcus, and (2) right occipital gyrus. In addition, injury severity was positively associated with GM volumes in the identified CEN regions. Over time, there were no significant changes in SCN in either group. The findings, albeit preliminary, suggest for the first time a long-term effect of pediatric TBI on SCN. SCN may be a complementary approach to characterize the global effect of TBI on the developing brain. Future work needs to further examine how disruptions of these networks relate to behavioral and cognitive difficulties.
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Affiliation(s)
- Carola Tuerk
- Department of Psychology, University of Montreal, Montreal, Québec, Canada,
| | - Fanny Dégeilh
- Department of Psychology, University of Montreal, Montreal, Québec, Canada.,Sainte-Justine Hospital Research Center, Montreal, Québec, Canada
| | - Cathy Catroppa
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Vicki Anderson
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal, Montreal, Québec, Canada.,Sainte-Justine Hospital Research Center, Montreal, Québec, Canada
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Ryan NP, Catroppa C, Hughes N, Painter FL, Hearps S, Beauchamp MH, Anderson VA. Executive function mediates the prospective association between neurostructural differences within the central executive network and anti-social behavior after childhood traumatic brain injury. J Child Psychol Psychiatry 2021; 62:1150-1161. [PMID: 33624844 DOI: 10.1111/jcpp.13385] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Despite increasing evidence of a link between early life brain injury and anti-social behavior, very few studies have assessed factors that explain this association in children with traumatic brain injury (TBI). One hypothesis suggests that childhood TBI elevates risk for anti-social behavior via disruption to anatomically distributed neural networks implicated in executive functioning (EF). In this longitudinal prospective study, we employed high-resolution structural neuroimaging to (a) evaluate the impact of childhood TBI on regional morphometry of the central executive network (CEN) and (b) evaluate the prediction that lower EF mediates the prospective relationship between structural differences within the CEN and postinjury anti-social behaviors. METHODS This study involved 155 children, including 112 consecutively recruited, hospital-confirmed cases of mild-severe TBI and 43 typically developing control (TDC) children. T1-weighted brain magnetic resonance imaging (MRI) sequences were acquired sub-acutely in a subset of 137 children [TBI: n = 103; TDC: n = 34]. All participants were evaluated using direct assessment of EF 6 months postinjury, and parents provided ratings of anti-social behavior 12 months postinjury. RESULTS Severe TBI was associated with postinjury volumetric differences within the CEN and its putative hub regions. When compared with TD controls, the TBI group had significantly worse EF, which was associated with more frequent anti-social behaviors and abnormal CEN morphometry. Mediation analysis indicated that reduced EF mediated the prospective association between postinjury volumetric differences within the CEN and more frequent anti-social behavior. CONCLUSIONS Our longitudinal prospective findings suggest that detection of neurostructural abnormalities within the CEN may aid in the early identification of children at elevated risk for postinjury executive dysfunction, which may in turn contribute to chronic anti-social behaviors after early life brain injury. Findings underscore the potential value of early surveillance and preventive measures for children presenting with neurostructural and/or neurocognitive risk factors.
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Affiliation(s)
- Nicholas P Ryan
- School of Psychology, Deakin University, Geelong, Vic., Australia.,Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - Cathy Catroppa
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - Nathan Hughes
- Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | | | - Stephen Hearps
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal, Montreal, QC, Canada.,Research Centre, Ste-Justine Hospital, Montreal, QC, Canada
| | - Vicki A Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
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Ferrazzano P, Yeske B, Mumford J, Kirk G, Bigler ED, Bowen K, O'Brien N, Rosario B, Beers SR, Rathouz P, Bell MJ, Alexander AL. Brain Magnetic Resonance Imaging Volumetric Measures of Functional Outcome after Severe Traumatic Brain Injury in Adolescents. J Neurotrauma 2021; 38:1799-1808. [PMID: 33487126 PMCID: PMC8219192 DOI: 10.1089/neu.2019.6918] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Adolescent traumatic brain injury (TBI) is a major public health concern, resulting in >35,000 hospitalizations in the United States each year. Although neuroimaging is a primary diagnostic tool in the clinical assessment of TBI, our understanding of how specific neuroimaging findings relate to outcome remains limited. Our study aims to identify imaging biomarkers of long-term neurocognitive outcome after severe adolescent TBI. Twenty-four adolescents with severe TBI (Glasgow Coma Scale ≤8) enrolled in the ADAPT (Approaches and Decisions after Pediatric TBI) study were recruited for magnetic resonance imaging (MRI) scanning 1-2 years post-injury at 13 participating sites. Subjects underwent outcome assessments ∼1-year post-injury, including the Wechsler Abbreviated Scale of Intelligence (IQ) and the Pediatric Glasgow Outcome Scale-Extended (GOSE-Peds). A typically developing control cohort of 38 age-matched adolescents also underwent scanning and neurocognitive assessment. Brain-image segmentation was performed on T1-weighted images using Freesurfer. Brain and ventricular cerebrospinal fluid volumes were used to compute a ventricle-to-brain ratio (VBR) for each subject, and the corpus callosum cross-sectional area was determined in the midline for each subject. The TBI group demonstrated higher VBR and lower corpus callosum area compared to the control cohort. After adjusting for age and sex, VBR was significantly related with GOSE-Peds score in the TBI group (n = 24, p = 0.01, cumulative odds ratio = 2.18). After adjusting for age, sex, intracranial volume, and brain volume, corpus callosum cross-sectional area correlated significantly with IQ score in the TBI group (partial cor = 0.68, n = 18, p = 0.007) and with PSI (partial cor = 0.33, p = 0.02). No association was found between VBR and IQ or between corpus callosum and GOSE-Peds. After severe adolescent TBI, quantitative MRI measures of VBR and corpus callosum cross-sectional area are associated with global functional outcome and neurocognitive outcomes, respectively.
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Affiliation(s)
- Peter Ferrazzano
- Waisman Center, University of Wisconsin, Madison, Wisconsin, USA
- Department of Pediatrics, University of Wisconsin, Madison, Wisconsin, USA
| | - Benjamin Yeske
- Waisman Center, University of Wisconsin, Madison, Wisconsin, USA
| | - Jeanette Mumford
- Center for Healthy Minds, University of Wisconsin, Madison, Wisconsin, USA
| | - Gregory Kirk
- Waisman Center, University of Wisconsin, Madison, Wisconsin, USA
| | - Erin D. Bigler
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah, USA
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA
- Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | | | - Nicole O'Brien
- Department of Pediatrics, Division of Critical Care Medicine Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Bedda Rosario
- Department of Epidemiology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sue R. Beers
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Paul Rathouz
- Department of Population Health, University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - Michael J. Bell
- Department of Pediatrics, Children's National Medical Center, Washington, DC, USA
| | - Andrew L. Alexander
- Waisman Center, University of Wisconsin, Madison, Wisconsin, USA
- Waisman Center Brain Imaging Laboratory, University of Wisconsin, Madison, Wisconsin, USA
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
- Department of Psychiatry, University of Wisconsin, Madison, Wisconsin, USA
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12
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Meier TB, España LY, Kirk AJ, Nader AM, Powell JE, Nelson LD, Mayer AR, Brett BL. Association of Previous Concussion with Hippocampal Volume and Symptoms in Collegiate-Aged Athletes. J Neurotrauma 2021; 38:1358-1367. [PMID: 33397203 PMCID: PMC8082726 DOI: 10.1089/neu.2020.7143] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
There is concern that previous concussion and contact-sport exposure may have negative effects on brain structure and function. Accurately quantifying previous concussion is complicated by the fact that multiple definitions exist, with recent definitions allowing for diagnosis based on the presence of symptoms alone (Concussion in Sport Group criteria; CISG) rather than the presence of acute injury characteristics such as alterations in mental status (American Congress of Rehabilitation Medicine criteria; ACRM). The goals of the current work were to determine the effects of previous concussion and contact-sport exposure on gray matter structure and clinical measures in healthy, young-adult athletes and determine the extent to which these associations are influenced by diagnostic criteria used to retrospectively quantify concussions. One-hundred eight collegiate-aged athletes were enrolled; 106 athletes were included in final analyses (age, 21.37 ± 1.69; 33 female). Participants completed a clinical battery of self-report and neurocognitive measures and magnetic resonance imaging to quantify subcortical volumes and cortical thickness. Semistructured interviews were conducted to measure exposure to contact sports and the number of previous concussions based on CISG and ACRM criteria. There was a significant association of concussion-related and psychological symptoms with previous concussions based on ACRM (ps < 0.05), but not CISG, criteria. Hippocampal volume was inversely associated with the number of previous concussions for both criteria (ps < 0.05). Findings provide evidence that previous concussions are associated with smaller hippocampal volumes and greater subjective clinical symptoms in otherwise healthy athletes and highlight the importance of diagnostic criteria used to quantify previous concussion.
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Affiliation(s)
- Timothy B. Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Department of Cell Biology, Neurobiology, and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Lezlie Y. España
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Alexander J. Kirk
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Amy M. Nader
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jennifer E. Powell
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Lindsay D. Nelson
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Andrew R. Mayer
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Neurology and Psychiatry Departments, University of New Mexico School of Medicine, Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Benjamin L. Brett
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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13
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Spitzhüttl JS, Kronbichler M, Kronbichler L, Benzing V, Siegwart V, Schmidt M, Pastore-Wapp M, Kiefer C, Slavova N, Grotzer M, Steinlin M, Roebers CM, Leibundgut K, Everts R. Cortical Morphometry and Its Relationship with Cognitive Functions in Children after non-CNS Cancer. Dev Neurorehabil 2021; 24:266-275. [PMID: 33724900 DOI: 10.1080/17518423.2021.1898059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: Childhood cancer survivors (Ccs) are at risk for cognitive late-effects, which might result from cortical alterations, even if cancer does not affect the brain. The study aimed to examine gray and white matter volume and its relationship to cognition. Methods: Forty-three Ccs of non-central nervous system cancers and 43 healthy controls, aged 7-16 years, were examined. Cognitive functions and fine motor coordination were assessed and T1-weighted images were collected for voxel-based morphometry. Results: Executive functions (p = .024, d = .31) were poorer in Ccs than controls, however still within the normal range. The volume of the amygdala (p = .011, ŋ2 = .117) and the striatum (p = .03, ŋ2 = .102) was reduced in Ccs. No significant structure-function correlations were found, neither in patients nor controls. Conclusion: Non-CNS childhood cancer and its treatment impacts on brain structures relevant to emotion processing.
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Affiliation(s)
- Janine S Spitzhüttl
- Division of Neuropediatrics, Development and Rehabilitation Development, University Children's Hospital Bern, and University of Bern, Bern, Switzerland.,Department of Psychology, University of Bern, Bern, Switzerland.,Division of Pediatric Hematology and Oncology, University Children's Hospital Bern, and University of Bern, Bern, Switzerland
| | - Martin Kronbichler
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria.,Neuroscience Institute, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - Lisa Kronbichler
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria.,Neuroscience Institute, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - Valentin Benzing
- Division of Pediatric Hematology and Oncology, University Children's Hospital Bern, and University of Bern, Bern, Switzerland.,Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Valerie Siegwart
- Division of Neuropediatrics, Development and Rehabilitation Development, University Children's Hospital Bern, and University of Bern, Bern, Switzerland.,Division of Pediatric Hematology and Oncology, University Children's Hospital Bern, and University of Bern, Bern, Switzerland
| | - Mirko Schmidt
- Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Manuela Pastore-Wapp
- Support Center for Advanced Neuroimaging (SCAN), Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Claus Kiefer
- Support Center for Advanced Neuroimaging (SCAN), Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Nedelina Slavova
- Support Center for Advanced Neuroimaging (SCAN), Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Michael Grotzer
- Department of Pediatric Oncology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Maja Steinlin
- Division of Neuropediatrics, Development and Rehabilitation Development, University Children's Hospital Bern, and University of Bern, Bern, Switzerland
| | | | - Kurt Leibundgut
- Division of Pediatric Hematology and Oncology, University Children's Hospital Bern, and University of Bern, Bern, Switzerland
| | - Regula Everts
- Division of Neuropediatrics, Development and Rehabilitation Development, University Children's Hospital Bern, and University of Bern, Bern, Switzerland.,Division of Pediatric Hematology and Oncology, University Children's Hospital Bern, and University of Bern, Bern, Switzerland.,Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
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14
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Zivanovic N, Virani S, Rajaram AA, Lebel C, Yeates KO, Brooks BL. Cortical Volume and Thickness in Youth Several Years After Concussion. J Child Neurol 2021; 36:186-194. [PMID: 33059521 DOI: 10.1177/0883073820962930] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The long-term effects of pediatric concussion on brain morphometry remain poorly delineated. This study used magnetic resonance imaging (MRI) to investigate cortical volume and thickness in youth several years after concussion. METHODS Participants aged 8-19 years old with a history of concussion (n = 37) or orthopedic injury (n = 20) underwent MRI, rated their postconcussion symptoms, and completed cognitive testing on average 2.6 years (SD = 1.6) after injury. FreeSurfer was used to obtain cortical volume and thickness measurements as well as determine any significant correlations between brain morphometry, postconcussion symptoms (parent and self-report), and cognitive functioning. RESULTS No significant group differences were found for either cortical volume or thickness. Youth with a history of concussion had higher postconcussion symptom scores (both parent and self-report Postconcussion Symptom Inventory) than the orthopedic injury group, but symptom ratings did not significantly correlate with cortical volume or thickness. Across both groups, faster reaction time on a computerized neurocognitive test battery (CNS Vital Signs) was associated with a thinner cortex in the left pars triangularis of the inferior frontal gyrus and the left caudal anterior cingulate. Better verbal memory was associated with a thinner cortex in the left rostral middle frontal gyrus. CONCLUSION Findings do not support differences in cortical volume or thickness approximately 2.5 years postconcussion in youth, suggesting either long-term cortical recovery or no cortical differences as a result of injury. Further research using a longitudinal study design and larger samples is needed.
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Affiliation(s)
- Nikola Zivanovic
- 432222Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Shane Virani
- 70402Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Neurosciences Program, 157744Alberta Children's Hospital, Calgary, Alberta, Canada.,157744Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Alysha A Rajaram
- 432222Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Catherine Lebel
- 157744Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.,Department of Radiology, 2129University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Keith Owen Yeates
- 432222Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.,157744Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, Calgary, Alberta, Canada.,Department of Psychology, University of Calgary, Calgary, Alberta, Canada.,Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Brian L Brooks
- 432222Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.,Neurosciences Program, 157744Alberta Children's Hospital, Calgary, Alberta, Canada.,157744Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, Calgary, Alberta, Canada.,Department of Psychology, University of Calgary, Calgary, Alberta, Canada.,Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
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15
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Lengel D, Sevilla C, Romm ZL, Huh JW, Raghupathi R. Stem Cell Therapy for Pediatric Traumatic Brain Injury. Front Neurol 2020; 11:601286. [PMID: 33343501 PMCID: PMC7738475 DOI: 10.3389/fneur.2020.601286] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/10/2020] [Indexed: 12/11/2022] Open
Abstract
There has been a growing interest in the potential of stem cell transplantation as therapy for pediatric brain injuries. Studies in pre-clinical models of pediatric brain injury such as Traumatic Brain Injury (TBI) and neonatal hypoxia-ischemia (HI) have contributed to our understanding of the roles of endogenous stem cells in repair processes and functional recovery following brain injury, and the effects of exogenous stem cell transplantation on recovery from brain injury. Although only a handful of studies have evaluated these effects in models of pediatric TBI, many studies have evaluated stem cell transplantation therapy in models of neonatal HI which has a considerable overlap of injury pathology with pediatric TBI. In this review, we have summarized data on the effects of stem cell treatments on histopathological and functional outcomes in models of pediatric brain injury. Importantly, we have outlined evidence supporting the potential for stem cell transplantation to mitigate pathology of pediatric TBI including neuroinflammation and white matter injury, and challenges that will need to be addressed to incorporate these therapies to improve functional outcomes following pediatric TBI.
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Affiliation(s)
- Dana Lengel
- Graduate Program in Neuroscience, Drexel University College of Medicine, Philadelphia, PA, United States
| | - Cruz Sevilla
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, United States
| | - Zoe L Romm
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, United States
| | - Jimmy W Huh
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Ramesh Raghupathi
- Graduate Program in Neuroscience, Drexel University College of Medicine, Philadelphia, PA, United States.,Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, United States
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16
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Rausa VC, Shapiro J, Seal ML, Davis GA, Anderson V, Babl FE, Veal R, Parkin G, Ryan NP, Takagi M. Neuroimaging in paediatric mild traumatic brain injury: a systematic review. Neurosci Biobehav Rev 2020; 118:643-653. [PMID: 32905817 DOI: 10.1016/j.neubiorev.2020.08.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 08/02/2020] [Accepted: 08/29/2020] [Indexed: 01/05/2023]
Abstract
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.
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Affiliation(s)
- Vanessa C Rausa
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
| | - Jesse Shapiro
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia.
| | - Marc L Seal
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Victoria, Australia.
| | - Gavin A Davis
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
| | - Vicki Anderson
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia; Psychology Service, The Royal Children's Hospital, Melbourne, Australia.
| | - Franz E Babl
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Victoria, Australia.
| | - Ryan Veal
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
| | - Georgia Parkin
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
| | - Nicholas P Ryan
- Department of Paediatrics, University of Melbourne, Victoria, Australia; Cognitive Neuroscience Unit, Deakin University, Geelong, Australia.
| | - Michael Takagi
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia.
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17
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Hoskinson KR, Bigler ED, Abildskov TJ, Dennis M, Taylor HG, Rubin K, Gerhardt CA, Vannatta K, Stancin T, Yeates KO. The mentalizing network and theory of mind mediate adjustment after childhood traumatic brain injury. Soc Cogn Affect Neurosci 2020; 14:1285-1295. [PMID: 31993655 PMCID: PMC7137721 DOI: 10.1093/scan/nsaa006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 10/18/2019] [Accepted: 01/08/2020] [Indexed: 12/13/2022] Open
Abstract
Childhood traumatic brain injury (TBI) affects over 600 000 children per year in the United States. Following TBI, children are vulnerable to deficits in psychosocial adjustment and neurocognition, including social cognition, which persist long-term. They are also susceptible to direct and secondary damage to related brain networks. In this study, we examine whether brain morphometry of the mentalizing network (MN) and theory of mind (ToM; one component of social cognition) mediates the effects of TBI on adjustment. Children with severe TBI (n = 15, Mage = 10.32), complicated mild/moderate TBI (n = 30, Mage = 10.81) and orthopedic injury (OI; n = 42, Mage = 10.65) completed measures of ToM and executive function and underwent MRI; parents rated children’s psychosocial adjustment. Children with severe TBI demonstrated reduced right-hemisphere MN volume, and poorer ToM, vs children with OI. Ordinary least-squares path analysis indicated that right-hemisphere MN volume and ToM mediated the association between severe TBI and adjustment. Parallel analyses substituting the central executive network and executive function were not significant, suggesting some model specificity. Children at greatest risk of poor adjustment after TBI could be identified based in part on neuroimaging of social brain networks and assessment of social cognition and thereby more effectively allocate limited intervention resources.
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Affiliation(s)
- Kristen R Hoskinson
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Erin D Bigler
- Department of Psychological Science and Neuroscience Center, Brigham Young University, Provo, UT, USA
| | - Tracy J Abildskov
- Department of Psychological Science and Neuroscience Center, Brigham Young University, Provo, UT, USA
| | - Maureen Dennis
- Program in Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - H Gerry Taylor
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Kenneth Rubin
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Cynthia A Gerhardt
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Kathryn Vannatta
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Terry Stancin
- Department of Pediatrics, Case Western Reserve University and MetroHealth Medical Center, Cleveland, OH, USA
| | - Keith Owen Yeates
- Department of Psychology, Alberta Children's Hospital Research Institute, and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
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18
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Bohorquez-Montoya L, España LY, Nader AM, Furger RE, Mayer AR, Meier TB. Amygdala response to emotional faces in adolescents with persistent post-concussion symptoms. Neuroimage Clin 2020; 26:102217. [PMID: 32109760 PMCID: PMC7044530 DOI: 10.1016/j.nicl.2020.102217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/10/2020] [Accepted: 02/16/2020] [Indexed: 11/23/2022]
Abstract
Approximately 30% of adolescents with concussion develop persistent post-concussion symptoms (PPCS) that include emotional symptoms. Elevated amygdalae reactivity to emotional faces has been reported in a variety of psychopathologies characterized by emotional symptoms overlapping with those in PPCS. We tested the hypothesis that amygdalae reactivity to emotional faces in adolescents with PPCS+ is elevated compared to concussed adolescents without PPCS and healthy controls. Concussed adolescents (ages 14-18) with (PPCS+; n = 23) and without PPCS (PPCS-; n = 13) participated in visits at least 4 weeks post-injury. Adolescents without prior concussion served as controls (HC; n = 15). All participants completed a detailed clinical battery and a common emotional face processing task that involved matching of emotional faces or shapes. Compared to HC and PPCS-, adolescents with PPCS+ had elevated depression symptoms, anhedonia, general psychological symptoms, and anxiety symptoms. Contrary to our hypothesis, PPCS+ had lower amygdalae activity to the emotional faces versus shapes condition relative to HC and a trend for lower activity relative to PPCS-. There was a non-significant inverse association between anhedonia amygdalae activity in adolescents with PPCS. Results suggest that adolescents with PPCS have altered amygdalae activity during the processing of emotional face stimuli.
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Affiliation(s)
| | - Lezlie Y España
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Amy M Nader
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Robyn E Furger
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Andrew R Mayer
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, United States; Department of Neurology, University of New Mexico School of Medicine, Albuquerque, NM, United States; Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM, United States; Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States; Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI, United States; Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, United States.
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19
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Tate DF, Wilde EA, York GE, Bigler ED. Neuroimaging in Traumatic Brain Injury Rehabilitation. Concussion 2020. [DOI: 10.1016/b978-0-323-65384-8.00003-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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20
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Parivash SN, Goubran M, Mills BD, Rezaii P, Thaler C, Wolman D, Bian W, Mitchell LA, Boldt B, Douglas D, Wilson EW, Choi J, Xie L, Yushkevich PA, DiGiacomo P, Wongsripuemtet J, Parekh M, Fiehler J, Do H, Lopez J, Rosenberg J, Camarillo D, Grant G, Wintermark M, Zeineh M. Longitudinal Changes in Hippocampal Subfield Volume Associated with Collegiate Football. J Neurotrauma 2019; 36:2762-2773. [PMID: 31044639 PMCID: PMC7872005 DOI: 10.1089/neu.2018.6357] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Collegiate football athletes are subject to repeated traumatic brain injuriesthat may cause brain injury. The hippocampus is composed of several distinct subfields with possible differential susceptibility to injury. The aim of this study is to determine whether there are longitudinal changes in hippocampal subfield volume in collegiate football. A prospective cohort study was conducted over a 5-year period tracking 63 football and 34 volleyball male collegiate athletes. Athletes underwent high-resolution structural magnetic resonance imaging, and automated segmentation provided hippocampal subfield volumes. At baseline, football (n = 59) athletes demonstrated a smaller subiculum volume than volleyball (n = 32) athletes (-67.77 mm3; p = 0.012). A regression analysis performed within football athletes similarly demonstrated a smaller subiculum volume among those at increased concussion risk based on athlete position (p = 0.001). For the longitudinal analysis, a linear mixed-effects model assessed the interaction between sport and time, revealing a significant decrease in cornu ammonis area 1 (CA1) volume in football (n = 36) athletes without an in-study concussion compared to volleyball (n = 23) athletes (volume difference per year = -35.22 mm3; p = 0.005). This decrease in CA1 volume over time was significant when football athletes were examined in isolation from volleyball athletes (p = 0.011). Thus, this prospective, longitudinal study showed a decrease in CA1 volume over time in football athletes, in addition to baseline differences that were identified in the downstream subiculum. Hippocampal changes may be important to study in high-contact sports.
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Affiliation(s)
| | - Maged Goubran
- Department of Radiology, Stanford University, Stanford, California
| | - Brian D. Mills
- Department of Radiology, Stanford University, Stanford, California
| | - Paymon Rezaii
- Department of Neurosurgery, Stanford University, Stanford, California
| | - Christian Thaler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dylan Wolman
- Department of Radiology, Stanford University, Stanford, California
| | - Wei Bian
- Department of Radiology, Stanford University, Stanford, California
| | - Lex A. Mitchell
- Department of Radiology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Department of Radiology, Tripler Army Medical Center, Honolulu, Hawaii
| | - Brian Boldt
- Department of Radiology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Department of Radiology, Madigan Army Medical Center, Tacoma, Washington
| | - David Douglas
- Department of Radiology, Stanford University, Stanford, California
| | - Eugene W. Wilson
- Department of Radiology, Stanford University, Stanford, California
| | - Jay Choi
- Department of Radiology, Stanford University, Stanford, California
| | - Long Xie
- Penn Image Computing and Science Laboratory (PICSL), Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Paul A. Yushkevich
- Penn Image Computing and Science Laboratory (PICSL), Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Phil DiGiacomo
- Department of Radiology, Stanford University, Stanford, California
| | | | - Mansi Parekh
- Department of Radiology, Stanford University, Stanford, California
| | - Jens Fiehler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Huy Do
- Department of Radiology, Stanford University, Stanford, California
| | - Jaime Lopez
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, California
| | | | - David Camarillo
- Department of Bioengineering, Stanford University, Stanford, California
| | - Gerald Grant
- Department of Neurosurgery, Stanford University, Stanford, California
| | - Max Wintermark
- Department of Radiology, Stanford University, Stanford, California
| | - Michael Zeineh
- Department of Radiology, Stanford University, Stanford, California
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21
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Gallant C, Good D. Alcohol misuse and traumatic brain injury: a review of the potential roles of dopaminergic dysfunction and physiological underarousal post-injury. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 28:501-511. [PMID: 31561716 DOI: 10.1080/23279095.2019.1670181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Although many researchers have demonstrated an increase in alcohol use following traumatic brain injury (TBI), there is also a body of research indicating that alcohol misuse predisposes one to injury and precedes TBI. Accordingly, various mechanisms have been proposed (e.g., self-medication, dampened levels of arousal, dopaminergic dysfunction, etc.) and variable results have emerged. This paper reviews the empirical evidence, for and against, TBI as a risk factor for alcohol misuse. In particular, this paper focuses on the brain-behavior relationships involved and examines the roles of physiological underarousal and dopaminergic dysfunction in the development of alcohol misuse after injury. Alcohol misuse impedes community reintegration among TBI survivors and creates additional rehabilitative challenges. Thus, in order to inform and improve treatment outcomes among this vulnerable population, a deeper understanding of the neural mechanisms implicated is needed.
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Affiliation(s)
- Caitlyn Gallant
- Department of Psychology, Brock University, St. Catharines, ON, Canada
| | - Dawn Good
- Department of Psychology, Brock University, St. Catharines, ON, Canada.,Centre for Neuroscience, Brock University, St. Catharines, ON, Canada
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22
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Cannella LA, McGary H, Ramirez SH. Brain interrupted: Early life traumatic brain injury and addiction vulnerability. Exp Neurol 2019; 317:191-201. [PMID: 30862466 PMCID: PMC6544498 DOI: 10.1016/j.expneurol.2019.03.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/27/2019] [Accepted: 03/08/2019] [Indexed: 12/20/2022]
Abstract
Recent reports provide evidence for increased risk of substance use disorders (SUD) among patients with a history of early-life traumatic brain injury (TBI). Preclinical research utilizing animal models of TBI have identified injury-induced inflammation, blood-brain barrier permeability, and changes to synapses and neuronal networks within regions of the brain associated with the perception of reward. Importantly, these reward pathway networks are underdeveloped during childhood and adolescence, and early-life TBI pathology may interrupt ongoing maturation. As such, maladaptive changes induced by juvenile brain injury may underlie increased susceptibility to SUD. In this review, we describe the available clinical and preclinical evidence that identifies SUD as a persistent psychiatric consequence of pediatric neurotrauma by discussing (1) the incidence of early-life TBI, (2) how preclinical studies model TBI and SUD, (3) TBI-induced neuropathology and neuroinflammation in the corticostriatal regions of the brain, and (4) the link between childhood or adolescent TBI and addiction in adulthood. In summary, preclinical research utilizes an innovative combination of models of early-life TBI and SUD to recapitulate clinical features and to determine how TBI promotes a risk for the development of SUD. However, causal processes that link TBI and SUD remain unclear. Additional research to identify and therapeutically target underlying mechanisms of aberrant reward pathway development will provide a launching point for TBI and SUD treatment strategies.
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Affiliation(s)
- Lee Anne Cannella
- Department of Pathology and Laboratory Medicine, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; Center for Substance Abuse Research, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Hannah McGary
- Department of Pathology and Laboratory Medicine, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Servio H Ramirez
- Department of Pathology and Laboratory Medicine, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; Center for Substance Abuse Research, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; Shriners Hospitals Pediatric Research Center, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA.
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23
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Drapeau J, Gosselin N, Peretz I, McKerral M. Electrophysiological Responses to Emotional Facial Expressions Following a Mild Traumatic Brain Injury. Brain Sci 2019; 9:E142. [PMID: 31216634 PMCID: PMC6627801 DOI: 10.3390/brainsci9060142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 06/11/2019] [Accepted: 06/17/2019] [Indexed: 11/16/2022] Open
Abstract
The present study aimed to measure neural information processing underlying emotional recognition from facial expressions in adults having sustained a mild traumatic brain injury (mTBI) as compared to healthy individuals. We thus measured early (N1, N170) and later (N2) event-related potential (ERP) components during presentation of fearful, neutral, and happy facial expressions in 10 adults with mTBI and 11 control participants. Findings indicated significant differences between groups, irrespective of emotional expression, in the early attentional stage (N1), which was altered in mTBI. The two groups showed similar perceptual integration of facial features (N170), with greater amplitude for fearful facial expressions in the right hemisphere. At a higher-level emotional discrimination stage (N2), both groups demonstrated preferential processing for fear as compared to happiness and neutrality. These findings suggest a reduced early selective attentional processing following mTBI, but no impact on the perceptual and higher-level cognitive processes stages. This study contributes to further improving our comprehension of attentional versus emotional recognition following a mild TBI.
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Affiliation(s)
- Joanie Drapeau
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC H3S 2J4, Canada.
- Departement of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada.
- International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC H3C 3J7, Canada.
| | - Nathalie Gosselin
- Departement of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada.
- International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC H3C 3J7, Canada.
| | - Isabelle Peretz
- Departement of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada.
- International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC H3C 3J7, Canada.
| | - Michelle McKerral
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC H3S 2J4, Canada.
- Departement of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada.
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24
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Molteni E, Pagani E, Strazzer S, Arrigoni F, Beretta E, Boffa G, Galbiati S, Filippi M, Rocca MA. Fronto-temporal vulnerability to disconnection in paediatric moderate and severe traumatic brain injury. Eur J Neurol 2019; 26:1183-1190. [PMID: 30964589 DOI: 10.1111/ene.13963] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/03/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND In patients with moderate and severe paediatric traumatic brain injury (TBI), we investigated the presence and severity of white matter (WM) tract damage, cortical lobar and deep grey matter (GM) atrophies, their interplay and their correlation with outcome rating scales. METHODS Diffusion tensor (DT) and 3D T1-weighted MRI scans were obtained from 22 TBI children (13 boys; mean age at insult = 11.6 years; 72.7% in chronic condition) and 31 age-matched healthy children. Patients were tested with outcome rating scales and the Wechsler Intelligence Scale for Children (WISC). DT MRI indices were obtained from several supra- and infra-tentorial WM tracts. Cortical lobar and deep GM volumes were derived. Comparisons between patients and controls, and between patients in acute (<6 months from the event) vs. chronic (≥6 months) condition were performed. RESULTS Patients showed a widespread pattern of decreased WM FA and GM atrophy. Compared to acute, chronic patients showed severer atrophy in the right frontal lobe and reduced FA in the left inferior longitudinal fasciculus and corpus callosum (CC). Decreased axial diffusivity was observed in acute patients versus controls in the inferior fronto-occipital fasciculus and CC. Chronic patients showed increased axial diffusivity in the same structures. Uncinate fasciculus DT MRI abnormalities correlated with atrophy in the frontal and temporal lobes. Hippocampal atrophy correlated with reduced WISC scores, whereas putamen atrophy correlated with lower functional independence measure scores. CONCLUSIONS The study isolated a distributed fronto-temporal network of structures particularly vulnerable to axonal damage and atrophy that may contribute to cognitive deficits following TBI.
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Affiliation(s)
- E Molteni
- Acquired Brain Injury Unit, Scientific Institute IRCCS Eugenio Medea, Lecco, Italy
| | - E Pagani
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - S Strazzer
- Acquired Brain Injury Unit, Scientific Institute IRCCS Eugenio Medea, Lecco, Italy
| | - F Arrigoni
- Acquired Brain Injury Unit, Scientific Institute IRCCS Eugenio Medea, Lecco, Italy
| | - E Beretta
- Acquired Brain Injury Unit, Scientific Institute IRCCS Eugenio Medea, Lecco, Italy
| | - G Boffa
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - S Galbiati
- Acquired Brain Injury Unit, Scientific Institute IRCCS Eugenio Medea, Lecco, Italy
| | - M Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - M A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
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25
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King DJ, Ellis KR, Seri S, Wood AG. A systematic review of cross-sectional differences and longitudinal changes to the morphometry of the brain following paediatric traumatic brain injury. NEUROIMAGE-CLINICAL 2019; 23:101844. [PMID: 31075554 PMCID: PMC6510969 DOI: 10.1016/j.nicl.2019.101844] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 04/26/2019] [Accepted: 04/29/2019] [Indexed: 01/27/2023]
Abstract
Paediatric traumatic brain injury (pTBI) is a leading cause of disability for children and young adults. Children are a uniquely vulnerable group with the disease process that occurs following a pTBI interacting with the trajectory of normal brain development. Quantitative MRI post-injury has suggested a long-term, neurodegenerative effect of TBI on the morphometry of the brain, in both adult and childhood TBI. Changes to the brain beyond that of anticipated, age-dependant differences may allow us to estimate the state of the brain post-injury and produce clinically relevant predictions for long-term outcome. The current review synthesises the existing literature to assess whether, following pTBI, the morphology of the brain exhibits either i) longitudinal change and/or ii) differences compared to healthy controls and outcomes. The current literature suggests that morphometric differences from controls are apparent cross-sectionally at both acute and late-chronic timepoints post-injury, thus suggesting a non-transient effect of injury. Developmental trajectories of morphometry are altered in TBI groups compared to patients, and it is unlikely that typical maturation overcomes damage post-injury, or even 'catches up' with that of typically-developing peers. However, there is limited evidence for diverted developmental trajectories being associated with cognitive impairment post-injury. The current review also highlights the apparent challenges to the existing literature and potential methods by which these can be addressed.
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Affiliation(s)
- D J King
- School of Life and Health Sciences & Aston Brain Centre, Aston University, Birmingham, UK
| | - K R Ellis
- School of Life and Health Sciences & Aston Brain Centre, Aston University, Birmingham, UK
| | - S Seri
- School of Life and Health Sciences & Aston Brain Centre, Aston University, Birmingham, UK
| | - A G Wood
- School of Life and Health Sciences & Aston Brain Centre, Aston University, Birmingham, UK; Child Neuropsychology, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
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26
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Ewing-Cobbs L, DeMaster D, Watson CG, Prasad MR, Cox CS, Kramer LA, Fischer JT, Duque G, Swank PR. Post-Traumatic Stress Symptoms after Pediatric Injury: Relation to Pre-Frontal Limbic Circuitry. J Neurotrauma 2019; 36:1738-1751. [PMID: 30672379 DOI: 10.1089/neu.2018.6071] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Pre-frontal limbic circuitry is vulnerable to effects of stress and injury. We examined microstructure of pre-frontal limbic circuitry after traumatic brain injury (TBI) or extracranial injury (EI) and its relation to post-traumatic stress symptoms (PTSS). Participants aged 8 to 15 years who sustained mild to severe TBI (n = 53) or EI (n = 26) in motor vehicle incidents were compared with healthy children (n = 38) in a prospective longitudinal study. At the seven-week follow-up, diffusion tensor imaging was obtained in all groups; injured children completed PTSS ratings using a validated scale. Using probabilistic diffusion tensor tractography, pathways were seeded from bilateral amygdalae and hippocampi to estimate the trajectory of white matter connecting them to each other and to targeted pre-frontal cortical (PFC) regions. Microstructure was estimated using fractional anisotropy (FA) in white matter and mean diffusivity (MD) in gray matter. Pre-frontal limbic microstructure was similar across groups, except for reduced FA in the right hippocampus to orbital PFC pathway in the injured versus healthy group. We examined microstructure of components of pre-frontal limbic circuitry with concurrently obtained PTSS cluster scores in the injured children. Neither microstructure nor PTSS scores differed significantly in the TBI and EI groups. Across PTSS factors, specific symptom clusters were related positively to higher FA and MD. Higher hyperarousal, avoidance, and re-experiencing symptoms were associated with higher FA in amygdala to pre-frontal and hippocampus to amygdala pathways. Higher hippocampal MD had a central role in hyperarousal and emotional numbing symptoms. Age moderated the relation of white and gray matter microstructure with hyperarousal scores. Our findings are consistent with models of traumatic stress that implicate disrupted top-down PFC and hippocampal moderation of overreactive subcortical threat arousal systems. Alterations in limbic pre-frontal circuitry and PTSS place children with either brain or body injuries at elevated risk for both current and future psychological health problems.
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Affiliation(s)
- Linda Ewing-Cobbs
- 1 Children's Learning Institute and Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, Texas
| | - Dana DeMaster
- 1 Children's Learning Institute and Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, Texas
| | - Christopher G Watson
- 1 Children's Learning Institute and Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, Texas
| | - Mary R Prasad
- 1 Children's Learning Institute and Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, Texas
| | - Charles S Cox
- 2 Department of Pediatric Surgery, University of Texas Health Science Center at Houston, Houston, Texas
| | - Larry A Kramer
- 4 Department of Interventional Radiology, University of Texas Health Science Center at Houston, Houston, Texas
| | - Jesse T Fischer
- 5 Department of Psychology, University of Houston, Houston, Texas
| | - Gerardo Duque
- 1 Children's Learning Institute and Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, Texas
| | - Paul R Swank
- 3 School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas
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27
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Zamani A, Mychasiuk R, Semple BD. Determinants of social behavior deficits and recovery after pediatric traumatic brain injury. Exp Neurol 2019; 314:34-45. [PMID: 30653969 DOI: 10.1016/j.expneurol.2019.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/29/2018] [Accepted: 01/12/2019] [Indexed: 12/15/2022]
Abstract
Traumatic brain injury (TBI) during early childhood is associated with a particularly high risk of developing social behavior impairments, including deficits in social cognition that manifest as reduced social interactions, with profound consequences for the individuals' quality of life. A number of pre-injury, post-injury, and injury-related factors have been identified or hypothesized to determine the extent of social behavior problems after childhood TBI. These include variables associated with the individual themselves (e.g. age, genetics, the injury severity, and extent of white matter damage), proximal environmental factors (e.g. family functioning, parental mental health), and more distal environmental factors (e.g. socioeconomic status, access to resources). In this review, we synthesize the available evidence demonstrating which of these determinants influence risk versus resilience to social behavior deficits after pediatric TBI, drawing upon the available clinical and preclinical literature. Injury-related pathology in neuroanatomical regions associated with social cognition and behaviors will also be described, with a focus on findings from magnetic resonance imaging and diffusion tensor imaging. Finally, study limitations and suggested future directions are highlighted. In summary, while no single variable can alone accurately predict the manifestation of social behavior problems after TBI during early childhood, an increased understanding of how both injury and environmental factors can influence social outcomes provides a useful framework for the development of more effective rehabilitation strategies aiming to optimize recovery for young brain-injured patients.
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Affiliation(s)
- Akram Zamani
- Department of Neuroscience, Monash University, Prahran, VIC, Australia
| | - Richelle Mychasiuk
- Department of Neuroscience, Monash University, Prahran, VIC, Australia; Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Bridgette D Semple
- Department of Neuroscience, Monash University, Prahran, VIC, Australia; Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia.
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28
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Resch C, Anderson VA, Beauchamp MH, Crossley L, Hearps SJC, van Heugten CM, Hurks PPM, Ryan NP, Catroppa C. Age-dependent differences in the impact of paediatric traumatic brain injury on executive functions: A prospective study using susceptibility-weighted imaging. Neuropsychologia 2018; 124:236-245. [PMID: 30528585 DOI: 10.1016/j.neuropsychologia.2018.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 10/12/2018] [Accepted: 12/05/2018] [Indexed: 12/17/2022]
Abstract
Childhood and adolescence represent sensitive developmental periods for brain networks implicated in a range of complex skills, including executive functions (EF; inhibitory control, working memory, and cognitive flexibility). As a consequence, these skills may be particularly vulnerable to injuries sustained during these sensitive developmental periods. The present study investigated 1) whether age at injury differentially affects EF 6 months and 2 years after TBI in children aged 5-15 years, and 2) whether the association between brain lesions and EF depend on age at injury. Children with TBI (n = 105) were categorized into four age-at-injury groups based on previous studies and proposed timing of cerebral maturational spurts: early childhood (5-6 years, n = 14), middle childhood (7-9 years, n = 24), late childhood (10-12 years, n = 52), and adolescence (13-15 years, n = 15). EF were assessed with performance-based tasks and a parent-report of everyday EF. TBI patients' EF scores 6 months and 2 years post-injury were compared to those of typically developing (TD) controls (n = 42). Brain lesions were identified using susceptibility weighted imaging (SWI). Results indicated that inhibitory control performance 2 years post-injury was differentially affected by the impact of TBI depending on age at injury. Follow-up analyses did not reveal significant differences within the age groups, preventing drawing strong conclusions regarding the contribution of age at injury to EF outcome after TBI. Tentatively, large effect sizes suggest that vulnerability is most apparent in early childhood and adolescence. Everyday inhibitory control behaviour was worse for children with TBI than TD children across childhood and adolescence at the 2-year assessment. There was no evidence for impairment in working memory or cognitive flexibility after TBI at the group level. Given small group sizes, findings from analyses into correlations between EF and SWI lesions should be interpreted with caution. Extent, number and volume of brain lesions correlated with adolescent everyday EF behaviour 6 months post-injury. Taken together, the results emphasize the need for long-term follow-up after paediatric TBI during sensitive developmental periods given negative outcomes 2-year post injury. Inhibitory control seems to be particular vulnerable to the impact of TBI. Findings of associations between EF and SWI lesions need to be replicated with larger samples.
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Affiliation(s)
- Christine Resch
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands; Australian Centre for Child Neuropsychological Studies, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, 3052 Melbourne, Victoria, Australia.
| | - Vicki A Anderson
- Australian Centre for Child Neuropsychological Studies, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, 3052 Melbourne, Victoria, Australia; Department of Psychology, Royal Children's Hospital, Melbourne, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal, Pavillon Marie-Victorin, Department de Psychologie, C.P. 6128 Succursale Centre-Ville, Montreal, Quebec, Canada H3C 317; Ste-Justine Research Center, Montreal, Quebec, Canada.
| | - Louise Crossley
- Australian Centre for Child Neuropsychological Studies, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, 3052 Melbourne, Victoria, Australia.
| | - Stephen J C Hearps
- Australian Centre for Child Neuropsychological Studies, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, 3052 Melbourne, Victoria, Australia.
| | - Caroline M van Heugten
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Center, PO Box 616, 6200 MD, Maastricht, the Netherlands.
| | - Petra P M Hurks
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands.
| | - Nicholas P Ryan
- Australian Centre for Child Neuropsychological Studies, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, 3052 Melbourne, Victoria, Australia; Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, Australia.
| | - Cathy Catroppa
- Australian Centre for Child Neuropsychological Studies, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, 3052 Melbourne, Victoria, Australia; Department of Psychology, Royal Children's Hospital, Melbourne, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
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29
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Mayer AR, Kaushal M, Dodd AB, Hanlon FM, Shaff NA, Mannix R, Master CL, Leddy JJ, Stephenson D, Wertz CJ, Suelzer EM, Arbogast KB, Meier TB. Advanced biomarkers of pediatric mild traumatic brain injury: Progress and perils. Neurosci Biobehav Rev 2018; 94:149-165. [PMID: 30098989 DOI: 10.1016/j.neubiorev.2018.08.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/27/2018] [Accepted: 08/03/2018] [Indexed: 12/20/2022]
Abstract
There is growing public concern about neurodegenerative changes (e.g., Chronic Traumatic Encephalopathy) that may occur chronically following clinically apparent and clinically silent (i.e., sub-concussive blows) pediatric mild traumatic brain injury (pmTBI). However, there are currently no biomarkers that clinicians can use to objectively diagnose patients or predict those who may struggle to recover. Non-invasive neuroimaging, electrophysiological and neuromodulation biomarkers have promise for providing evidence of the so-called "invisible wounds" of pmTBI. Our systematic review, however, belies that notion, identifying a relative paucity of high-quality, clinically impactful, diagnostic or prognostic biomarker studies in the sub-acute injury phase (36 studies on unique samples in 28 years), with the majority focusing on adolescent pmTBI. Ultimately, well-powered longitudinal studies with appropriate control groups, as well as standardized and clearly-defined inclusion criteria (time post-injury, injury severity and past history) are needed to truly understand the complex pathophysiology that is hypothesized (i.e., still needs to be determined) to exist during the acute and sub-acute stages of pmTBI and may underlie post-concussive symptoms.
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Affiliation(s)
- Andrew R Mayer
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States; Neurology Department, University of New Mexico School of Medicine, Albuquerque, NM, 87131, United States; Psychiatry Department, University of New Mexico School of Medicine, Albuquerque, NM, 87131, United States; Psychology Department, University of New Mexico, Albuquerque, NM, 87131, United States.
| | - Mayank Kaushal
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, 53226, United States
| | - Andrew B Dodd
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Faith M Hanlon
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Nicholas A Shaff
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Rebekah Mannix
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, 02115, United States
| | - Christina L Master
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, PA, 19104, United States; Division of Orthopedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, United States
| | - John J Leddy
- UBMD Department of Orthopaedics and Sports Medicine, University at Buffalo, Buffalo, NY, 14214, United States
| | - David Stephenson
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Christopher J Wertz
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Elizabeth M Suelzer
- Medical College of Wisconsin Libraries, Medical College of Wisconsin, Milwaukee, WI, 53226, United States
| | - Kristy B Arbogast
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, PA, 19104, United States
| | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, 53226, United States; Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, 53226, United States
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30
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Lah S, Gott C, Parry L, Black C, Epps A, Gascoigne M. Selective, age-related autobiographical memory deficits in children with severe traumatic brain injury. J Neuropsychol 2017; 13:253-271. [DOI: 10.1111/jnp.12141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 11/08/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Suncica Lah
- School of Psychology; The University of Sydney; NSW Australia
- ARC Centre of Excellence in Cognition and its Disorders; Macquarie University; Sydney NSW Australia
| | - Chloe Gott
- ARC Centre of Excellence in Cognition and its Disorders; Macquarie University; Sydney NSW Australia
| | - Louise Parry
- Brain Injury Rehabilitation Program; Rehab2Kids, Sydney Children's Hospital (Randwick); NSW Australia
| | - Carly Black
- ARC Centre of Excellence in Cognition and its Disorders; Macquarie University; Sydney NSW Australia
| | - Adrienne Epps
- Brain Injury Rehabilitation Program; Rehab2Kids, Sydney Children's Hospital (Randwick); NSW Australia
| | - Michael Gascoigne
- School of Psychology; The University of Sydney; NSW Australia
- ARC Centre of Excellence in Cognition and its Disorders; Macquarie University; Sydney NSW Australia
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31
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Singh K, Trivedi R, Verma A, D'souza MM, Koundal S, Rana P, Baishya B, Khushu S. Altered metabolites of the rat hippocampus after mild and moderate traumatic brain injury - a combined in vivo and in vitro 1 H-MRS study. NMR IN BIOMEDICINE 2017; 30:e3764. [PMID: 28759166 DOI: 10.1002/nbm.3764] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 05/13/2017] [Accepted: 05/28/2017] [Indexed: 06/07/2023]
Abstract
Traumatic brain injury (TBI) has been shown to affect hippocampus-associated learning, memory and higher cognitive functions, which may be a consequence of metabolic alterations. Hippocampus-associated disorders may vary depending on the severity of injury [mild TBI (miTBI) and moderate TBI (moTBI)] and time since injury. The underlying hippocampal metabolic irregularities may provide an insight into the pathological process following TBI. In this study, in vivo and in vitro proton magnetic resonance spectroscopy (1 H-MRS) data were acquired from the hippocampus region of controls and TBI groups (miTBI and moTBI) at D0 (pre-injury), 4 h, Day 1 and Day 5 post-injury (PI). In vitro MRS results indicated trauma-induced changes in both miTBI and moTBI; however, in vivo MRS showed metabolic alterations in moTBI only. miTBI and moTBI showed elevated levels of osmolytes indicating injury-induced edema. Altered levels of citric acid cycle intermediates, glutamine/glutamate and amino acid metabolism indicated injury-induced aberrant bioenergetics, excitotoxicity and oxidative stress. An overall similar pattern of pathological process was observed in both miTBI and moTBI, with the distinction of depleted N-acetylaspartate levels (indicating neuronal loss) at 4 h and Day 1 and enhanced lactate production (indicating heightened energy depletion leading to the commencement of the anaerobic pathway) at Day 5 in moTBI. To the best of our knowledge, this is the first study to investigate the hippocampus metabolic profile in miTBI and moTBI simultaneously using in vivo and in vitro MRS.
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Affiliation(s)
- Kavita Singh
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Richa Trivedi
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Ajay Verma
- Centre for Biomedical Magnetic Resonance (CBMR), SGPGIMS Campus, Lucknow, Uttar Pradesh, India
| | - Maria M D'souza
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Sunil Koundal
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Poonam Rana
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Bikash Baishya
- Centre for Biomedical Magnetic Resonance (CBMR), SGPGIMS Campus, Lucknow, Uttar Pradesh, India
| | - Subash Khushu
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
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32
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Evidence of Hippocampal Structural Alterations in Gulf War Veterans With Predicted Exposure to the Khamisiyah Plume. J Occup Environ Med 2017; 59:923-929. [DOI: 10.1097/jom.0000000000001082] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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33
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Ryan NP, Catroppa C, Beare R, Silk TJ, Hearps SJ, Beauchamp MH, Yeates KO, Anderson VA. Uncovering the neuroanatomical correlates of cognitive, affective and conative theory of mind in paediatric traumatic brain injury: a neural systems perspective. Soc Cogn Affect Neurosci 2017; 12:1414-1427. [PMID: 28505355 PMCID: PMC5629820 DOI: 10.1093/scan/nsx066] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 04/17/2017] [Accepted: 04/23/2017] [Indexed: 12/14/2022] Open
Abstract
Deficits in theory of mind (ToM) are common after neurological insult acquired in the first and second decade of life, however the contribution of large-scale neural networks to ToM deficits in children with brain injury is unclear. Using paediatric traumatic brain injury (TBI) as a model, this study investigated the sub-acute effect of paediatric traumatic brain injury on grey-matter volume of three large-scale, domain-general brain networks (the Default Mode Network, DMN; the Central Executive Network, CEN; and the Salience Network, SN), as well as two domain-specific neural networks implicated in social-affective processes (the Cerebro-Cerebellar Mentalizing Network, CCMN and the Mirror Neuron/Empathy Network, MNEN). We also evaluated prospective structure-function relationships between these large-scale neural networks and cognitive, affective and conative ToM. 3D T1- weighted magnetic resonance imaging sequences were acquired sub-acutely in 137 children [TBI: n = 103; typically developing (TD) children: n = 34]. All children were assessed on measures of ToM at 24-months post-injury. Children with severe TBI showed sub-acute volumetric reductions in the CCMN, SN, MNEN, CEN and DMN, as well as reduced grey-matter volumes of several hub regions of these neural networks. Volumetric reductions in the CCMN and several of its hub regions, including the cerebellum, predicted poorer cognitive ToM. In contrast, poorer affective and conative ToM were predicted by volumetric reductions in the SN and MNEN, respectively. Overall, results suggest that cognitive, affective and conative ToM may be prospectively predicted by individual differences in structure of different neural systems-the CCMN, SN and MNEN, respectively. The prospective relationship between cerebellar volume and cognitive ToM outcomes is a novel finding in our paediatric brain injury sample and suggests that the cerebellum may play a role in the neural networks important for ToM. These findings are discussed in relation to neurocognitive models of ToM. We conclude that detection of sub-acute volumetric abnormalities of large-scale neural networks and their hub regions may aid in the early identification of children at risk for chronic social-cognitive impairment.
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Affiliation(s)
- Nicholas P. Ryan
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia
- Department of Psychology, Royal Children’s Hospital, Parkville, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Cathy Catroppa
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia
- Department of Psychology, Royal Children’s Hospital, Parkville, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Richard Beare
- Developmental Imaging, Murdoch Childrens Research Institute, Parkville, VIC, Australia
| | - Timothy J. Silk
- Developmental Imaging, Murdoch Childrens Research Institute, Parkville, VIC, Australia
- Department of Pediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Stephen J. Hearps
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia
| | - Miriam H. Beauchamp
- Department of Psychology, University of Montreal, Montreal, QC, Canada
- Ste-Justine Research Center, Montreal, QC, Canada
| | - Keith O. Yeates
- Hotchkiss Brain Institute, Alberta Children’s Hospital Research Institute, and Department of Psychology, The University of Calgary, Calgary, AB, Canada
| | - Vicki A. Anderson
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia
- Department of Psychology, Royal Children’s Hospital, Parkville, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
- Department of Pediatrics, University of Melbourne, Parkville, VIC, Australia
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34
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Anderson V, Beauchamp MH, Yeates KO, Crossley L, Ryan N, Hearps SJ, Catroppa C. Social Competence at Two Years after Childhood Traumatic Brain Injury. J Neurotrauma 2017; 34:2261-2271. [DOI: 10.1089/neu.2016.4692] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Vicki Anderson
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia
- Psychology Service, Royal Children's Hospital, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | - Miriam H. Beauchamp
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
- Research Center, Sainte-Justine Hospital, Montreal, Montreal, Quebec, Canada
| | - Keith Owen Yeates
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Louise Crossley
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Nicholas Ryan
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | - Stephen J.C. Hearps
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Cathy Catroppa
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia
- Psychology Service, Royal Children's Hospital, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
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35
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Yu K, Seal ML, Reyes J, Godfrey C, Anderson V, Adamson C, Ryan NP, Hearps SJC, Catroppa C. Brain volumetric correlates of inhibition and cognitive flexibility 16 years following childhood traumatic brain injury. J Neurosci Res 2017; 96:642-651. [PMID: 28675465 DOI: 10.1002/jnr.24087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 04/06/2017] [Accepted: 05/01/2017] [Indexed: 01/08/2023]
Abstract
Executive functions (EFs), such as inhibition and cognitive flexibility, are essential for everyday functioning, including regulation of socially appropriate emotional responses. These skills develop during childhood and continue maturing into early adulthood. The current study aimed to investigate the very long-term impact of childhood traumatic brain injury (TBI) on inhibition and cognitive flexibility, and to examine whether global white matter is associated with these abilities. Twenty-eight young adult survivors of childhood TBI (mean age at 16-year follow-up = 21.67 years, SD = 2.70) and 16 typically developing controls (TDCs), group-matched for age, sex, and socioeconomic status, completed tests of inhibition and cognitive flexibility and underwent structural MRI. Survivors of childhood TBI did not significantly differ from TDCs on EF or white matter volume. However, the relationship between EF and white matter volume differed between survivors of TBI and TDCs. Survivors of TBI did not mimic the brain behavior relationship that characterized EF in TDCs. The inverse brain behavior relationship, exhibited by childhood TBI survivors, suggests disruptions in the whole brain underpinning EF following childhood TBI.
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Affiliation(s)
- Kelleynne Yu
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Marc L Seal
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Jonathan Reyes
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Celia Godfrey
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Vicki Anderson
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.,Department of Psychology, Royal Children's Hospital, Parkville, Victoria, Australia.,Melbourne School of Psychological Sciences (MSPS), University of Melbourne, Parkville, Victoria, Australia
| | - Chris Adamson
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Nicholas P Ryan
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Melbourne School of Psychological Sciences (MSPS), University of Melbourne, Parkville, Victoria, Australia
| | - Stephen J C Hearps
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Cathy Catroppa
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.,Department of Psychology, Royal Children's Hospital, Parkville, Victoria, Australia.,Melbourne School of Psychological Sciences (MSPS), University of Melbourne, Parkville, Victoria, Australia
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36
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Drijkoningen D, Chalavi S, Sunaert S, Duysens J, Swinnen SP, Caeyenberghs K. Regional Gray Matter Volume Loss Is Associated with Gait Impairments in Young Brain-Injured Individuals. J Neurotrauma 2017; 34:1022-1034. [DOI: 10.1089/neu.2016.4500] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- David Drijkoningen
- University Medical Center Utrecht, Utrecht, the Netherlands
- Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuven, Belgium
| | - Sima Chalavi
- Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuven, Belgium
| | - Stefan Sunaert
- Department of Radiology, University Hospital, Leuven, Belgium
| | - Jacques Duysens
- Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuven, Belgium
| | - Stephan P. Swinnen
- Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuven, Belgium
- Leuven Research Institute for Neuroscience and Disease, Leuven, Belgium
| | - Karen Caeyenberghs
- Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuven, Belgium
- Australian Catholic University, Melbourne, Australia
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37
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Marwha D, Halari M, Eliot L. Meta-analysis reveals a lack of sexual dimorphism in human amygdala volume. Neuroimage 2016; 147:282-294. [PMID: 27956206 DOI: 10.1016/j.neuroimage.2016.12.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 11/27/2016] [Accepted: 12/08/2016] [Indexed: 12/31/2022] Open
Abstract
The amygdala plays a key role in many affective behaviors and psychiatric disorders that differ between men and women. To test whether human amygdala volume (AV) differs reliably between the sexes, we performed a systematic review and meta-analysis of AVs reported in MRI studies of age-matched healthy male and female groups. Using four search strategies, we identified 46 total studies (58 matched samples) from which we extracted effect sizes for the sex difference in AV. All data were converted to Hedges g values and pooled effect sizes were calculated using a random-effects model. Each dataset was further meta-regressed against study year and average participant age. We found that uncorrected amygdala volume is about 10% larger in males, with pooled sex difference effect sizes of g=0.581 for right amygdala (κ=28, n=2022), 0.666 for left amygdala (κ=28, n=2006), and 0.876 for bilateral amygdala (κ=16, n=1585) volumes (all p values < 0.001). However, this difference is comparable to the sex differences in intracranial volume (ICV; g=1.186, p<.001, 11.9% larger in males, κ=11) and total brain volume (TBV; g=1.278, p<0.001, 11.5% larger in males, κ=15) reported in subsets of the same studies, suggesting the sex difference in AV is a product of larger brain size in males. Among studies reporting AVs normalized for ICV or TBV, sex difference effect sizes were small and not statistically significant: g=0.171 for the right amygdala (p=0.206, κ=13, n=1560); 0.233 for the left amygdala (p=0.092, κ=12, n=1512); and 0.257 for bilateral volume (p=0.131, κ=5, n=1629). These values correspond to less than 0.1% larger corrected right AV and 2.5% larger corrected left AV in males compared to females. In summary, AV is not selectively enhanced in human males, as often claimed. Although we cannot rule out subtle male-female group differences, it is not accurate to refer to the human amygdala as "sexually dimorphic."
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Affiliation(s)
- Dhruv Marwha
- Department of Neuroscience, Chicago Medical School, Rosalind Franklin University of Medicine & Science, United States
| | - Meha Halari
- Department of Neuroscience, Chicago Medical School, Rosalind Franklin University of Medicine & Science, United States
| | - Lise Eliot
- Department of Neuroscience, Chicago Medical School, Rosalind Franklin University of Medicine & Science, United States.
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38
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Drapeau J, Gosselin N, Peretz I, McKerral M. Emotional recognition from dynamic facial, vocal and musical expressions following traumatic brain injury. Brain Inj 2016; 31:221-229. [DOI: 10.1080/02699052.2016.1208846] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Joanie Drapeau
- Centre de recherche interdisciplinaire en réadaptation (CRIR) – Centre de réadaptation Lucie-Bruneau (CRLB)
- Centre de recherche en neuropsychologie et cognition (CERNEC)
- Centre for Research on Brain, Language and Music (CRBLM) and International Laboratory for Brain, Music and Sound Research (BRAMS)
- Département de psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Nathalie Gosselin
- Centre de recherche en neuropsychologie et cognition (CERNEC)
- Centre for Research on Brain, Language and Music (CRBLM) and International Laboratory for Brain, Music and Sound Research (BRAMS)
- Département de psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Isabelle Peretz
- Centre for Research on Brain, Language and Music (CRBLM) and International Laboratory for Brain, Music and Sound Research (BRAMS)
- Département de psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Michelle McKerral
- Centre de recherche interdisciplinaire en réadaptation (CRIR) – Centre de réadaptation Lucie-Bruneau (CRLB)
- Centre de recherche en neuropsychologie et cognition (CERNEC)
- Département de psychologie, Université de Montréal, Montréal, Québec, Canada
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39
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Albicini M, McKinlay A. Internalizing disorders in adults with a history of childhood traumatic brain injury. J Clin Exp Neuropsychol 2016; 37:776-84. [PMID: 26299189 DOI: 10.1080/13803395.2015.1053843] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION While the presence of externalizing behavioral problems following traumatic brain injury (TBI) has been well established in the literature, less is known regarding internalizing disorders, and more specifically anxiety disorders, in such a population. This study explored the presence, rate, and incidence of internalizing behavior problems, including anxiety, depression, somatic complaints, avoidant personality symptomatology, and overall internalizing behavior problems in university students aged 18-25 years. METHOD A convenience sample of 247 university students (197 non-TBI, 47 mild TBI, 2 moderate TBI, 1 severe TBI) aged 18-25 years was utilized. Participants completed a self-report measure on behavioral functioning, the Adult Self Report (ASR), to identify internalizing behaviors, and a questionnaire to identify TBI history. RESULTS Raw scores of behavior indicated that participants with a history of childhood TBI reported significantly higher levels of withdrawal, somatic complaints, and internalizing behavioral problems than the non-TBI participants. When analyzing standardized T-scores for borderline and clinically elevated ASR syndromes and Diagnostic and Statistical Manual of Mental Disorders (DSM)-oriented scales, individuals in the TBI group were significantly more likely to have higher rates of borderline anxiety, somatic complaints, avoidant personality problems, and overall internalizing disorders, and clinically elevated somatic complaints. Adults with a history of childhood TBI were also significantly more likely to report at least 1 or more DSM disorders. CONCLUSION These results clearly suggest that individuals with a childhood history of TBI are at a heightened risk for a range of internalizing disorders in early adulthood, which is particularly troubling in a university sample pursuing tertiary education.
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Affiliation(s)
- Michelle Albicini
- a Faculty of Medicine, Nursing and Health Sciences, School of Psychology and Psychiatry , Monash University , Clayton , VIC , Australia
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Ryan NP, Catroppa C, Beare R, Silk TJ, Crossley L, Beauchamp MH, Yeates KO, Anderson VA. Theory of mind mediates the prospective relationship between abnormal social brain network morphology and chronic behavior problems after pediatric traumatic brain injury. Soc Cogn Affect Neurosci 2016; 11:683-92. [PMID: 26796967 DOI: 10.1093/scan/nsw007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 01/14/2016] [Indexed: 12/21/2022] Open
Abstract
Childhood and adolescence coincide with rapid maturation and synaptic reorganization of distributed neural networks that underlie complex cognitive-affective behaviors. These regions, referred to collectively as the 'social brain network' (SBN) are commonly vulnerable to disruption from pediatric traumatic brain injury (TBI); however, the mechanisms that link morphological changes in the SBN to behavior problems in this population remain unclear. In 98 children and adolescents with mild to severe TBI, we acquired 3D T1-weighted MRIs at 2-8 weeks post-injury. For comparison, 33 typically developing controls of similar age, sex and education were scanned. All participants were assessed on measures of Theory of Mind (ToM) at 6 months post-injury and parents provided ratings of behavior problems at 24-months post-injury. Severe TBI was associated with volumetric reductions in the overall SBN package, as well as regional gray matter structural change in multiple component regions of the SBN. When compared with TD controls and children with milder injuries, the severe TBI group had significantly poorer ToM, which was associated with more frequent behavior problems and abnormal SBN morphology. Mediation analysis indicated that impaired theory of mind mediated the prospective relationship between abnormal SBN morphology and more frequent chronic behavior problems. Our findings suggest that sub-acute alterations in SBN morphology indirectly contribute to long-term behavior problems via their influence on ToM. Volumetric change in the SBN and its putative hub regions may represent useful imaging biomarkers for prediction of post-acute social cognitive impairment, which may in turn elevate risk for chronic behavior problems.
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Affiliation(s)
- Nicholas P Ryan
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Melbourne, Australia, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia,
| | - Cathy Catroppa
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Melbourne, Australia, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia, Department of Psychology, Royal Children's Hospital, Melbourne, Australia
| | - Richard Beare
- Developmental Imaging, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Timothy J Silk
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Louise Crossley
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal, Montreal, Canada, Ste-Justine Research Center, Montreal, Quebec, Canada, and
| | - Keith Owen Yeates
- Department of Psychology, Hotchkiss, Brain Institute, and Alberta Children's Hospital Research Institute, The University of Calgary, Calgary, Alberta, Canada
| | - Vicki A Anderson
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Melbourne, Australia, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia, Department of Psychology, Royal Children's Hospital, Melbourne, Australia
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Abstract
Due to a high incidence of traumatic brain injury (TBI) in children and adolescents, age-specific studies are necessary to fully understand the long-term consequences of injuries to the immature brain. Preclinical and translational research can help elucidate the vulnerabilities of the developing brain to insult, and provide model systems to formulate and evaluate potential treatments aimed at minimizing the adverse effects of TBI. Several experimental TBI models have therefore been scaled down from adult rodents for use in juvenile animals. The following chapter discusses these adapted models for pediatric TBI, and the importance of age equivalence across species during model development and interpretation. Many neurodevelopmental processes are ongoing throughout childhood and adolescence, such that neuropathological mechanisms secondary to a brain insult, including oxidative stress, metabolic dysfunction and inflammation, may be influenced by the age at the time of insult. The long-term evaluation of clinically relevant functional outcomes is imperative to better understand the persistence and evolution of behavioral deficits over time after injury to the developing brain. Strategies to modify or protect against the chronic consequences of pediatric TBI, by supporting the trajectory of normal brain development, have the potential to improve quality of life for brain-injured children.
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Affiliation(s)
- Bridgette D Semple
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Jaclyn Carlson
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Linda J Noble-Haeusslein
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
- Department of Physical Therapy and Rehabilitation Science, University of California School of Medicine, 513 Parnassus Ave., HSE 814, San Francisco, CA, 94143, USA.
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Ryan NP, Bijnen L, Catroppa C, Beauchamp MH, Crossley L, Hearps S, Anderson V. Longitudinal outcome and recovery of social problems after pediatric traumatic brain injury (TBI): Contribution of brain insult and family environment. Int J Dev Neurosci 2015; 49:23-30. [DOI: 10.1016/j.ijdevneu.2015.12.004] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Revised: 11/10/2015] [Accepted: 12/18/2015] [Indexed: 10/22/2022] Open
Affiliation(s)
- Nicholas P. Ryan
- Australian Centre for Child Neuropsychological StudiesMurdoch Childrens Research InstituteMelbourneAustralia
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneAustralia
| | - Loeka Bijnen
- Australian Centre for Child Neuropsychological StudiesMurdoch Childrens Research InstituteMelbourneAustralia
| | - Cathy Catroppa
- Australian Centre for Child Neuropsychological StudiesMurdoch Childrens Research InstituteMelbourneAustralia
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneAustralia
| | - Miriam H. Beauchamp
- Australian Centre for Child Neuropsychological StudiesMurdoch Childrens Research InstituteMelbourneAustralia
- Department of PsychologyUniversity of MontrealMontrealCanada
- Ste‐Justine Research CenterMontrealQuebecCanada
| | - Louise Crossley
- Australian Centre for Child Neuropsychological StudiesMurdoch Childrens Research InstituteMelbourneAustralia
| | - Stephen Hearps
- Australian Centre for Child Neuropsychological StudiesMurdoch Childrens Research InstituteMelbourneAustralia
| | - Vicki Anderson
- Australian Centre for Child Neuropsychological StudiesMurdoch Childrens Research InstituteMelbourneAustralia
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneAustralia
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Klein RC, Acheson SK, Qadri LH, Dawson AA, Rodriguiz RM, Wetsel WC, Moore SD, Laskowitz DT, Dawson HN. Opposing effects of traumatic brain injury on excitatory synaptic function in the lateral amygdala in the absence and presence of preinjury stress. J Neurosci Res 2015; 94:579-89. [DOI: 10.1002/jnr.23702] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/23/2015] [Accepted: 11/25/2015] [Indexed: 01/18/2023]
Affiliation(s)
- Rebecca C. Klein
- Department of Psychiatry and Behavioral Sciences; Duke University Medical Center; Durham North Carolina
- VISN 6 MIRECC, Durham Veterans Affairs Medical Center; Durham North Carolina
| | - Shawn K. Acheson
- Department of Psychiatry and Behavioral Sciences; Duke University Medical Center; Durham North Carolina
- Neurobiology Research Laboratory, Durham Veterans Affairs Medical Center; Durham North Carolina
| | - Laura H. Qadri
- Department of Psychiatry and Behavioral Sciences; Duke University Medical Center; Durham North Carolina
| | - Alina A. Dawson
- Department of Neurology; Duke University Medical Center; Durham North Carolina
| | - Ramona M. Rodriguiz
- Department of Psychiatry and Behavioral Sciences; Duke University Medical Center; Durham North Carolina
- Mouse Behavioral and Neuroendocrine Analysis Core Facility; Duke University Medical Center; Durham North Carolina
| | - William C. Wetsel
- Department of Psychiatry and Behavioral Sciences; Duke University Medical Center; Durham North Carolina
- Mouse Behavioral and Neuroendocrine Analysis Core Facility; Duke University Medical Center; Durham North Carolina
- Departments of Neurobiology and Cell Biology; Duke University Medical Center; Durham North Carolina
| | - Scott D. Moore
- Department of Psychiatry and Behavioral Sciences; Duke University Medical Center; Durham North Carolina
- VISN 6 MIRECC, Durham Veterans Affairs Medical Center; Durham North Carolina
| | - Daniel T. Laskowitz
- Department of Neurology; Duke University Medical Center; Durham North Carolina
| | - Hana N. Dawson
- Department of Neurology; Duke University Medical Center; Durham North Carolina
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Foster PP. Mild traumatic brain injury and delayed alteration of memory processing. Front Neurosci 2015; 9:369. [PMID: 26528118 PMCID: PMC4604240 DOI: 10.3389/fnins.2015.00369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 09/23/2015] [Indexed: 11/17/2022] Open
Affiliation(s)
- Philip P Foster
- Department of Nanomedicine and Biomedical Engineering, The Brown Foundation, Institute of Molecular Medicine for the Prevention of Human Diseases, The University of Texas Health Science Center at Houston - Medical School Houston, TX, USA ; Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, The University of Texas Health Science Center at Houston - Medical School Houston, TX, USA
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Patten AR, Yau SY, Fontaine CJ, Meconi A, Wortman RC, Christie BR. The Benefits of Exercise on Structural and Functional Plasticity in the Rodent Hippocampus of Different Disease Models. Brain Plast 2015; 1:97-127. [PMID: 29765836 PMCID: PMC5928528 DOI: 10.3233/bpl-150016] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
In this review, the benefits of physical exercise on structural and functional plasticity in the hippocampus are discussed. The evidence is clear that voluntary exercise in rats and mice can lead to increases in hippocampal neurogenesis and enhanced synaptic plasticity which ultimately result in improved performance in hippocampal-dependent tasks. Furthermore, in models of neurological disorders, including fetal alcohol spectrum disorders, traumatic brain injury, stroke, and neurodegenerative disorders including Alzheimer's, Parkinson's and Huntington's disease exercise can also elicit beneficial effects on hippocampal function. Ultimately this review highlights the multiple benefits of exercise on hippocampal function in both the healthy and the diseased brain.
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Affiliation(s)
- Anna R. Patten
- Division of Medical Sciences, Island Medical Program, University of Victoria, Victoria, British Columbia, Canada
| | - Suk Yu Yau
- Division of Medical Sciences, Island Medical Program, University of Victoria, Victoria, British Columbia, Canada
| | - Christine J. Fontaine
- Division of Medical Sciences, Island Medical Program, University of Victoria, Victoria, British Columbia, Canada
| | - Alicia Meconi
- Division of Medical Sciences, Island Medical Program, University of Victoria, Victoria, British Columbia, Canada
| | - Ryan C. Wortman
- Division of Medical Sciences, Island Medical Program, University of Victoria, Victoria, British Columbia, Canada
| | - Brian R. Christie
- Division of Medical Sciences, Island Medical Program, University of Victoria, Victoria, British Columbia, Canada
- Department of Biology, University of Victoria, Victoria, British Columbia, Canada
- Brain Research Centre and Program in Neuroscience, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada
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Stamm JM, Koerte IK, Muehlmann M, Pasternak O, Bourlas AP, Baugh CM, Giwerc MY, Zhu A, Coleman MJ, Bouix S, Fritts NG, Martin BM, Chaisson C, McClean MD, Lin AP, Cantu RC, Tripodis Y, Stern RA, Shenton ME. Age at First Exposure to Football Is Associated with Altered Corpus Callosum White Matter Microstructure in Former Professional Football Players. J Neurotrauma 2015. [PMID: 26200068 DOI: 10.1089/neu.2014.3822] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Youth football players may incur hundreds of repetitive head impacts (RHI) in one season. Our recent research suggests that exposure to RHI during a critical neurodevelopmental period prior to age 12 may lead to greater later-life mood, behavioral, and cognitive impairments. Here, we examine the relationship between age of first exposure (AFE) to RHI through tackle football and later-life corpus callosum (CC) microstructure using magnetic resonance diffusion tensor imaging (DTI). Forty retired National Football League (NFL) players, ages 40-65, were matched by age and divided into two groups based on their AFE to tackle football: before age 12 or at age 12 or older. Participants underwent DTI on a 3 Tesla Siemens (TIM-Verio) magnet. The whole CC and five subregions were defined and seeded using deterministic tractography. Dependent measures were fractional anisotropy (FA), trace, axial diffusivity, and radial diffusivity. Results showed that former NFL players in the AFE <12 group had significantly lower FA in anterior three CC regions and higher radial diffusivity in the most anterior CC region than those in the AFE ≥12 group. This is the first study to find a relationship between AFE to RHI and later-life CC microstructure. These results suggest that incurring RHI during critical periods of CC development may disrupt neurodevelopmental processes, including myelination, resulting in altered CC microstructure.
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Affiliation(s)
- Julie M Stamm
- 1 CTE Center, Boston University School of Medicine , Boston, Massachusetts.,2 Department of Anatomy and Neurobiology, Boston University School of Medicine , Boston, Massachusetts.,3 Psychiatry Neuroimaging Laboratory, Harvard Medical School , Boston, Massachusetts
| | - Inga K Koerte
- 3 Psychiatry Neuroimaging Laboratory, Harvard Medical School , Boston, Massachusetts.,4 Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilian-University , Munich, Germany
| | - Marc Muehlmann
- 3 Psychiatry Neuroimaging Laboratory, Harvard Medical School , Boston, Massachusetts.,4 Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilian-University , Munich, Germany
| | - Ofer Pasternak
- 3 Psychiatry Neuroimaging Laboratory, Harvard Medical School , Boston, Massachusetts.,15 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School , Boston, Massachusetts
| | - Alexandra P Bourlas
- 1 CTE Center, Boston University School of Medicine , Boston, Massachusetts.,5 Alzheimer's Disease Center, Boston University School of Medicine , Boston, Massachusetts
| | - Christine M Baugh
- 1 CTE Center, Boston University School of Medicine , Boston, Massachusetts.,6 Interfaculty Initiative in Health Policy, Harvard University , Boston, Massachusetts
| | - Michelle Y Giwerc
- 3 Psychiatry Neuroimaging Laboratory, Harvard Medical School , Boston, Massachusetts
| | - Anni Zhu
- 3 Psychiatry Neuroimaging Laboratory, Harvard Medical School , Boston, Massachusetts
| | - Michael J Coleman
- 3 Psychiatry Neuroimaging Laboratory, Harvard Medical School , Boston, Massachusetts
| | - Sylvain Bouix
- 3 Psychiatry Neuroimaging Laboratory, Harvard Medical School , Boston, Massachusetts
| | - Nathan G Fritts
- 1 CTE Center, Boston University School of Medicine , Boston, Massachusetts
| | - Brett M Martin
- 7 Data Coordinating Center, Boston University School of Public Health , Boston, Massachusetts
| | - Christine Chaisson
- 1 CTE Center, Boston University School of Medicine , Boston, Massachusetts.,5 Alzheimer's Disease Center, Boston University School of Medicine , Boston, Massachusetts.,7 Data Coordinating Center, Boston University School of Public Health , Boston, Massachusetts.,8 Department of Biostatistics, Boston University School of Public Health , Boston, Massachusetts
| | - Michael D McClean
- 9 Department of Environmental Health, Boston University School of Public Health , Boston, Massachusetts
| | - Alexander P Lin
- 3 Psychiatry Neuroimaging Laboratory, Harvard Medical School , Boston, Massachusetts.,10 Center for Clinical Spectroscopy, Harvard Medical School , Boston, Massachusetts
| | - Robert C Cantu
- 1 CTE Center, Boston University School of Medicine , Boston, Massachusetts.,11 Department of Neurosurgery, Boston University School of Medicine , Boston, Massachusetts.,12 Sports Legacy Institute , Waltham, Massachusetts.,13 Department of Neurosurgery, Emerson Hospital , Concord, Massachusetts
| | - Yorghos Tripodis
- 1 CTE Center, Boston University School of Medicine , Boston, Massachusetts.,5 Alzheimer's Disease Center, Boston University School of Medicine , Boston, Massachusetts.,8 Department of Biostatistics, Boston University School of Public Health , Boston, Massachusetts
| | - Robert A Stern
- 1 CTE Center, Boston University School of Medicine , Boston, Massachusetts.,2 Department of Anatomy and Neurobiology, Boston University School of Medicine , Boston, Massachusetts.,5 Alzheimer's Disease Center, Boston University School of Medicine , Boston, Massachusetts.,11 Department of Neurosurgery, Boston University School of Medicine , Boston, Massachusetts.,14 Department of Neurology, Boston University School of Medicine , Boston, Massachusetts
| | - Martha E Shenton
- 3 Psychiatry Neuroimaging Laboratory, Harvard Medical School , Boston, Massachusetts.,15 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School , Boston, Massachusetts.,16 VA Boston Healthcare System , Brockton Division, Brockton, Massachusetts
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Briggs R, Brookes N, Tate R, Lah S. Duration of post-traumatic amnesia as a predictor of functional outcome in school-age children: a systematic review. Dev Med Child Neurol 2015; 57:618-627. [PMID: 25599763 DOI: 10.1111/dmcn.12674] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/06/2014] [Indexed: 11/30/2022]
Abstract
AIM In adults, duration of post-traumatic amnesia (PTA) is a powerful early predictor of functional outcomes in traumatic brain injury. The aim of this work was to assess the predictive validity of PTA duration for outcomes in children (6-18y). METHOD PsycINFO, MEDLINE, Web of Science, and Embase were searched for papers published to January 2014. Ten studies met inclusion criteria: they used standardized instruments to assess PTA and functional outcomes, and examined relationships between the two. Outcomes were classified according to (1) the International Classification of Functioning, Disability and Health (ICF) core sets for neurological conditions for post-acute care and (2) global functioning and quality of life. Methodological quality was rated for each study. RESULTS The search identified 10 studies of moderate mean quality (M=11.8 out of 18). Longer PTA duration related to worse functional outcomes: global functioning and in the two ICF categories ('body function', 'activities and participation'). Relationships between PTA duration and quality of life and the ICF category of 'body structure' were not examined. PTA duration was, in 46 out of 60 (76.67%) instances, a stronger predictor of outcomes than other indices of injury severity. CONCLUSION Longer PTA duration is a valid predictor of worse outcomes in school-age children. Thus, PTA should be routinely assessed in children after traumatic brain injury.
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Affiliation(s)
- Rachel Briggs
- School of Psychology, The University of Sydney, Sydney, NSW, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Naomi Brookes
- Brain Injury Rehabilitation Program, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Robyn Tate
- Rehabilitation Studies Unit, Northern Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Suncica Lah
- School of Psychology, The University of Sydney, Sydney, NSW, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
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Vasa RA, Suskauer SJ, Thorn JM, Kalb L, Grados MA, Slomine BS, Salorio CF, Gerring JP. Prevalence and predictors of affective lability after paediatric traumatic brain injury. Brain Inj 2015; 29:921-8. [PMID: 25950263 PMCID: PMC4807114 DOI: 10.3109/02699052.2015.1005670] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Paediatric severe traumatic brain injury (TBI) is associated with significant post-injury affective and behavioural problems. Few studies have examined the prevalence and characteristics of affective lability after paediatric TBI. METHODS Ninety-seven children with severe TBI were evaluated 1 year post-injury for the presence of affective lability using the Children's Affective Lability Scale (CALS). Demographic, clinical and brain lesion characteristics were also assessed. RESULTS Affective lability significantly increased after injury. Eighty-six children had a pre-injury CALS score of 1 SD or less from the group pre-injury mean (M = 8.11, SD = 9.31), of which 35 and 15 children had a 1 SD and 2 SD increase in their CALS score from pre- to post-injury, respectively. A variety of affective shifts manifested post-injury including anxiety, silliness, dysphoria and irritability. The most severe symptoms were irritability and unpredictable temper outbursts. Risk factors for affective lability included elevated pre-injury affective lability and psychosocial adversity as well as greater damage to the orbitofrontal cortex. Post-injury affective lability was most frequently associated with a post-injury diagnosis of attention-deficit hyperactivity disorder. CONCLUSIONS Affective lability is common after paediatric TBI and frequently manifests as irritability and unpredictable outbursts. Early intervention is needed to improve psychiatric outcomes.
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Affiliation(s)
- Roma A. Vasa
- Kennedy Krieger Institute, Baltimore, MD
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Stacy J. Suskauer
- Kennedy Krieger Institute, Baltimore, MD
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Julia M. Thorn
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Luther Kalb
- Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD
| | - Marco A. Grados
- Kennedy Krieger Institute, Baltimore, MD
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Beth S. Slomine
- Kennedy Krieger Institute, Baltimore, MD
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Cynthia F. Salorio
- Kennedy Krieger Institute, Baltimore, MD
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Joan P. Gerring
- Kennedy Krieger Institute, Baltimore, MD
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
- State University of New York School of Medicine at Syracuse
- New York State Office of Children and Family Services
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Mayer AR, Hanlon FM, Ling JM. Gray matter abnormalities in pediatric mild traumatic brain injury. J Neurotrauma 2015; 32:723-30. [PMID: 25313896 DOI: 10.1089/neu.2014.3534] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Pediatric mild traumatic brain injury (pmTBI) is the most prevalent neurological insult in children and is associated with both acute and chronic neuropsychiatric sequelae. However, little is known about underlying pathophysiology changes in gray matter diffusion and atrophy from a prospective stand-point. Fifteen semi-acute pmTBI patients and 15 well-matched healthy controls were evaluated with a clinical and neuroimaging battery, with a subset of participants returning for a second visit. Clinical measures included tests of attention, processing speed, executive function, working memory, memory, and self-reported post-concussive symptoms. Measures of diffusion (fractional anisotropy [FA]) and atrophy were also obtained for cortical and subcortical gray matter structures to characterize effects of injury as a function of time. Patients exhibited decreased scores in the domains of attention and processing speed relative to controls during the semi-acute injury stage, in conjunction with increased anisotropic diffusion in the left superior temporal gyrus and right thalamus. Evidence of increased diffusion in these regions was also present at four months post-injury, with performance on cognitive tests partially normalizing. In contrast, signs of cortical atrophy in bilateral frontal areas and other left-hemisphere cortical areas only emerged at four months post-injury for patients. Current results suggest potentially differential time-courses of recovery for neurobehavioral markers, anisotropic diffusion and atrophy following pmTBI. Importantly, these data suggest that relying on patient self-report or standard clinical assessments may underestimate the time for true injury recovery.
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Affiliation(s)
- Andrew R Mayer
- 1 The Mind Research Network/Lovelace Biomedical and Environmental Research Institute , Albuquerque, New Mexico
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