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Deep white matter volume loss and social reintegration after traumatic brain injury in children
Shawn D Gale1, George P Prigatano
1Division of Neurology, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.
Insights
Children with traumatic brain injury (TBI) showing poor social reintegration experienced greater white matter volume (WMV) loss, particularly in the corpus callosum. This WMV loss correlated with lower IQ and poorer psychosocial outcomes.
Area of Science:
- Neuroscience
- Pediatric Traumatic Brain Injury
- Neuropsychology
Background:
- Pediatric traumatic brain injury (TBI) can lead to long-term deficits.
- Assessing social reintegration is crucial for understanding recovery after TBI.
- White matter volume (WMV) loss is a common consequence of TBI.
Purpose of the Study:
- To investigate the relationship between social reintegration and white matter volume (WMV) loss in children with TBI.
- To determine if WMV loss is associated with neuropsychological test performance in this population.
Main Methods:
- Study included 28 children with post-acute TBI.
- Data collected included parental ratings of social reintegration, neuropsychological test scores, and voxel-based morphometry for WMV loss.
- Statistical analyses correlated WMV loss with cognitive and functional outcomes.
Main Results:
- Children with poorer social reintegration showed greater WMV loss, especially in the corpus callosum.
- Corpus callosum WMV loss correlated significantly with Full Scale IQ (WISC-IV) and social integration ratings.
- Factors like admitting Glasgow Coma Scale scores and WISC-IV Processing Speed Index scores contributed to social reintegration ratings.
Conclusions:
- Diffuse WMV loss, particularly in deep brain structures like the corpus callosum, may be linked to long-term psychosocial outcomes in children post-TBI.
- Parental perception of social reintegration is an important indicator of recovery.
- Further research is warranted to explore these relationships.
Objective:
To explore whether children judged by their parents as showing an "excellent" or "complete" social reintegration after pediatric traumatic brain injury have less white matter volume (WMV) loss and better neuropsychological test scores than children who do not achieve this same level of reintegration.
Setting:
Primary-care hospital/medical center.
Participants:
Twenty-eight children with post-acute traumatic brain injury evaluated as outpatients.
Measures:
Parental ratings of overall social reintegration, neuropsychological test performance, and voxel-based morphometry analysis of brain WMV loss.
Results:
In addition to showing worse neuropsychological test performance, children judged not to make a complete or excellent social reintegration had greater WMV loss, particularly within the corpus callosum. WMV loss in the corpus callosum correlated with the child's Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) Full Scale IQ (rho = .677, P = .000) and parental ratings of level of social integration (rho = .415, P = .028). Admitting Glasgow Coma Scale scores, mother's level of education, WISC-IV Processing Speed Index scores, and WMV loss in the region of the corpus callosum significantly contributed to parental ratings of a child's level of social reintegration.
Conclusions:
Preliminary findings suggested that diffuse WMV loss, particularly in deep brain regions (eg, corpus callosum), may relate to the child's long-term psychosocial outcome as viewed from the parents' perspective.
