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Updated: Mar 2, 2026
Systems Analysis of the Neuroinflammatory and Hemodynamic Response to Traumatic Brain Injury
Published on: May 27, 2022
Diverging volumetric trajectories following pediatric traumatic brain injury
Emily L Dennis1, Joshua Faskowitz1, Faisal Rashid1
1Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA 90292, USA.
Insights
Pediatric traumatic brain injury (TBI) recovery varies. Some children show prolonged white matter atrophy, while others may recover, indicating distinct recovery trajectories after moderate-severe TBI.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Radiology
Background:
- Traumatic brain injury (TBI) significantly impacts pediatric neurodevelopment.
- Recovery from pediatric TBI is heterogeneous, with outcomes not solely predicted by injury severity.
- Understanding longitudinal brain changes is crucial for predicting recovery and developing targeted therapies.
Purpose of the Study:
- To investigate regional brain volume changes over 18 months in pediatric moderate-severe TBI (msTBI) patients.
- To compare longitudinal volumetric changes between msTBI subgroups with normal and disrupted white matter (WM) structure.
- To identify factors influencing delayed or promoted recovery in pediatric TBI.
Main Methods:
- Utilized tensor-based morphometry (TBM) to analyze longitudinal brain volume changes.
- Assessed 21 msTBI patients and 26 healthy controls at two time points (2-5 months and 14-17 months post-injury).
- Compared a subgroup of msTBI patients with slow interhemispheric transfer time (TBI-slow) to those with normal transfer time (TBI-normal).
Main Results:
- The TBI-slow group exhibited significant longitudinal decreases in WM volume, including the corpus callosum and hypothalamus.
- The TBI-normal group demonstrated increased WM volume, suggesting potential recovery.
- Results indicate prolonged WM atrophy in the first 18 months post-injury for the TBI-slow subgroup.
Conclusions:
- Distinct longitudinal brain volume changes exist between pediatric TBI recovery subgroups.
- The TBI-slow group shows persistent WM atrophy, while the TBI-normal group may be on a path to recovery.
- Findings highlight the importance of WM integrity in predicting long-term outcomes after pediatric msTBI.
Abstract:
Traumatic brain injury (TBI) is a significant public health concern, and can be especially disruptive in children, derailing on-going neuronal maturation in periods critical for cognitive development. There is considerable heterogeneity in post-injury outcomes, only partially explained by injury severity. Understanding the time course of recovery, and what factors may delay or promote recovery, will aid clinicians in decision-making and provide avenues for future mechanism-based therapeutics. We examined regional changes in brain volume in a pediatric/adolescent moderate-severe TBI (msTBI) cohort, assessed at two time points. Children were first assessed 2-5 months post-injury, and again 12 months later. We used tensor-based morphometry (TBM) to localize longitudinal volume expansion and reduction. We studied 21 msTBI patients (5 F, 8-18 years old) and 26 well-matched healthy control children, also assessed twice over the same interval. In a prior paper, we identified a subgroup of msTBI patients, based on interhemispheric transfer time (IHTT), with significant structural disruption of the white matter (WM) at 2-5 months post injury. We investigated how this subgroup (TBI-slow, N = 11) differed in longitudinal regional volume changes from msTBI patients (TBI-normal, N = 10) with normal WM structure and function. The TBI-slow group had longitudinal decreases in brain volume in several WM clusters, including the corpus callosum and hypothalamus, while the TBI-normal group showed increased volume in WM areas. Our results show prolonged atrophy of the WM over the first 18 months post-injury in the TBI-slow group. The TBI-normal group shows a different pattern that could indicate a return to a healthy trajectory.
