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Imaging in Pediatric Concussion: A Systematic Review.

Julia Schmidt1,2, Kathryn S Hayward3,4,5, Katlyn E Brown3

  • 1Department of Physical Therapy, The University of British Columbia, Vancouver, Canada; julia.schmidt@ubc.ca.

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Neuroimaging in pediatric mild traumatic brain injury (mTBI) is under-explored. This review found heterogeneous findings across studies, highlighting the need for standardized research in pediatric concussion.

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Area of Science:

  • Pediatric neurology
  • Neuroimaging
  • Traumatic brain injury

Background:

  • Pediatric mild traumatic brain injury (mTBI) is a prevalent yet poorly understood condition.
  • Neuroimaging plays a crucial role in assessing brain injury and predicting outcomes in pediatric mTBI.
  • Current neuroimaging research in this population remains largely underexplored.

Purpose of the Study:

  • To systematically review and investigate neuroimaging findings in children and adolescents diagnosed with mTBI.
  • To explore associations between neuroimaging results and measures of behavior, symptoms, and injury characteristics.

Main Methods:

  • A systematic review of studies published up to July 6, 2016, was conducted.
  • Studies included children/youth aged 5-18 years with a diagnosis of mTBI and utilized neuroimaging techniques.
  • Data extraction and quality appraisal were performed independently by two authors.

Main Results:

  • Twenty-two studies involving 448 participants were included, with a mean age of 12.7 years.
  • Diffusion tensor imaging (DTI) was the most common method (41%), revealing heterogeneous findings across different brain regions.
  • Group differences were noted in areas like the corticospinal tract and corpus callosum, with increased fractional anisotropy in 88% of DTI studies.

Conclusions:

  • The heterogeneity in participant characteristics and imaging methods limited statistical analysis.
  • Standardized research approaches, including common data elements, are crucial for advancing the understanding of pediatric concussion.
  • Future research should focus on harmonizing methodologies to enable robust comparisons and insights into pediatric mTBI.