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Investigations on Alterations of Hippocampal Circuit Function Following Mild Traumatic Brain Injury
Published on: November 19, 2012
Arrested development and disrupted callosal microstructure following pediatric traumatic brain injury: relation to
Linda Ewing-Cobbs1, Mary R Prasad, Paul Swank
1Department of Pediatrics, University of Texas-Houston Health Science Center at Houston, 77030, USA. Linda.Ewing-Cobbs@uth.tmc.edu
Insights
Chronic pediatric traumatic brain injury (TBI) impacts brain development, showing arrested growth in the corpus callosum. Diffusion tensor imaging revealed microstructural damage, with radial diffusivity being a key indicator of injury severity and impact on cognitive function.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Brain Injury Research
Background:
- Chronic pediatric traumatic brain injury (TBI) leads to lasting neurobehavioral deficits.
- The corpus callosum (CC) is crucial for interhemispheric communication and is vulnerable to TBI.
- Diffusion tensor imaging (DTI) is a sensitive tool for assessing white matter integrity.
Purpose of the Study:
- To investigate microstructural changes in the corpus callosum of children with chronic TBI using DTI.
- To correlate these DTI metrics with age and neuropsychological outcomes.
- To identify sensitive DTI markers for TBI-related damage in pediatric populations.
Main Methods:
- DTI analysis of six corpus callosum regions in 41 children with TBI and 31 controls.
- Measurement of midsagittal cross-sectional area, fractional anisotropy (FA), radial diffusivity, and axial diffusivity.
- Logistic regression to determine sensitivity of DTI metrics to TBI and correlation with neuropsychological tests.
Main Results:
- Older children with TBI showed arrested development in posterior CC area compared to controls.
- TBI was associated with reduced FA and increased radial diffusivity in posterior CC regions and genu.
- Radial diffusivity was more sensitive than FA in specific CC regions; both correlated with cognitive and motor skills in the TBI group.
Conclusions:
- Reduced CC size and altered microstructure in TBI suggest arrested development, impaired organization, and disrupted myelination.
- Increased radial diffusivity is a sensitive DTI marker for neuronal damage extent after pediatric TBI.
- FA and radial diffusivity are significantly correlated with neuropsychological deficits in children with TBI.
Abstract:
Chronic pediatric traumatic brain injury (TBI) is associated with significant and persistent neurobehavioral deficits. Using diffusion tensor imaging (DTI), we examined area, fractional anisotropy (FA), radial diffusion, and axial diffusion from six regions of the corpus callosum (CC) in 41 children and adolescents with TBI and 31 comparison children. Midsagittal cross-sectional area of the posterior body and isthmus was similar in younger children irrespective of injury status; however, increased area was evident in the older comparison children but was obviated in older children with TBI, suggesting arrested development. Similarly, age was correlated significantly with indices of tissue microstructure only for the comparison group. TBI was associated with significant reduction in FA and increased radial diffusivity in the posterior third of the CC and in the genu. The axial diffusivity did not differ by either age or group. Logistic regression analyses revealed that FA and radial diffusivity were equally sensitive to post-traumatic changes in 4 of 6 callosal regions; radial diffusivity was more sensitive for the rostral midbody and splenium. IQ, working memory, motor, and academic skills were correlated significantly with radial diffusion and/or FA from the isthmus and splenium only in the TBI group. Reduced size and microstructural changes in posterior callosal regions after TBI suggest arrested development, decreased organization, and disrupted myelination. Increased radial diffusivity was the most sensitive DTI-based surrogate marker of the extent of neuronal damage following TBI; FA was most strongly correlated with neuropsychological outcomes.
