Ten-year outcome of early childhood traumatic brain injury: Diffusion tensor imaging of the ventral striatum in relation to executive functioning
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Insights
Long-term traumatic brain injury (TBI) in children impairs verbal fluency and executive functions, linked to reduced white matter integrity in the ventral striatum. These cognitive deficits persist years after the initial injury.
Area of Science:
- Neuroscience
- Developmental Psychology
- Radiology
Background:
- Traumatic brain injury (TBI) can have lasting effects on cognitive function.
- Understanding the long-term neurological consequences of pediatric TBI is crucial for effective intervention.
- White matter integrity plays a vital role in cognitive processing.
Purpose of the Study:
- To evaluate the long-term effects of TBI on verbal fluency and ventral striatum (VS) structural integrity.
- To investigate the relationship between cognitive performance and structural integrity in pediatric TBI survivors.
- To test the hypothesis that TBI leads to poorer cognitive outcomes and reduced structural integrity.
Main Methods:
- Diffusion tensor imaging (DTI) was used to assess white matter integrity, specifically in the ventral striatum (VS).
- The study compared 21 pediatric patients (aged 10-18) with moderate-to-severe TBI (5-15 years post-injury) to 16 typically developing controls.
- Participants completed sub-tests from the Delis-Kaplan Executive Functioning System (D-KEFS).
Main Results:
- Children with TBI showed significantly lower fractional anisotropy (FA) and poorer executive functioning.
- Higher apparent diffusion coefficient (ADC) values were observed in the TBI group, indicating reduced white matter integrity.
- DTI metrics in the VS correlated with specific D-KEFS performance, including inhibition errors and category switching.
Conclusions:
- TBI has a chronic impact on ventral striatum (VS) white matter integrity.
- These structural changes in the VS are associated with persistent executive functioning deficits in pediatric TBI survivors.
- The findings highlight the long-term neurological and cognitive consequences of TBI in children.
Primary Objective:
The long-term effects of TBI on verbal fluency and related structures, as well as the relation between cognition and structural integrity, were evaluated. It was hypothesized that the group with TBI would evidence poorer performance on cognitive measures and a decrease in structural integrity.
Research Design:
Between a paediatric group with TBI and a group of typically-developing children, the long-term effects of traumatic brain injury were investigated in relation to both structural integrity and cognition. Common metrics for diffusion tensor imaging (DTI) were used as indicators of white matter integrity.
Methods And Procedures:
Using DTI, this study examined ventral striatum (VS) integrity in 21 patients aged 10-18 years sustaining moderate-to-severe traumatic brain injury (TBI) 5-15 years earlier and 16 demographically comparable subjects. All participants completed Delis-Kaplan Executive Functioning System (D-KEFS) sub-tests.
Main Outcomes And Results:
The group with TBI exhibited lower fractional anisotropy (FA) and executive functioning performance and higher apparent diffusion coefficient (ADC). DTI metrics correlated with D-KEFS performance (right VS FA with Inhibition errors, right VS ADC with Letter Fluency, left VS FA and ADC with Category Switching).
Conclusions:
TBI affects VS integrity, even in a chronic phase, and may contribute to executive functioning deficits.
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