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Premature white matter microstructure in female children with a history of concussion
Eman Nishat1, Sonja Stojanovski1, Shannon E Scratch2
1Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada; Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada.
Insights
Childhood concussion impacts brain development, particularly in girls. This study found higher white matter neurite density in girls with concussion, linked to cognitive performance, suggesting premature brain maturation.
Area of Science:
- Neuroscience
- Developmental Neuroscience
- Pediatric Neurology
Background:
- Childhood concussion can disrupt neurodevelopment and cognitive function.
- Females often experience persistent post-concussion symptoms, yet sex-specific effects on pediatric brain microstructure are understudied.
Purpose of the Study:
- To investigate the sex-specific impact of concussion on white matter and cortical microstructure in children.
- To examine the relationship between brain microstructure and cognitive performance in children with a history of concussion.
Main Methods:
- Utilized diffusion-weighted MRI to assess neurite density (ND) in white matter and cortex of 9-10-year-old children.
- Employed multivariate regression and partial least square correlation to analyze group (concussion vs. control), sex, age, and cognitive performance relationships.
- Included 336 children with concussion history and 7,368 controls from the Adolescent Brain Cognitive Development Study.
Main Results:
- Neurite density (ND) increased with age across all tissue types, indicating brain maturation.
- Females with a concussion history exhibited higher ND in deep and superficial white matter compared to controls.
- Significant associations between white matter ND and cognitive performance were observed in females with concussion, but not in males.
Conclusions:
- Childhood concussion has a greater long-term impact on white matter microstructure in females than males.
- The observed increase in ND in females with concussion may indicate accelerated or premature white matter maturation.
- Sex-specific differences in brain microstructure post-concussion are associated with cognitive outcomes in children.
Abstract:
Childhood concussion may interfere with neurodevelopment and influence cognition. Females are more likely to experience persistent symptoms after concussion, yet the sex-specific impact of concussion on brain microstructure in children is understudied. This study examined white matter and cortical microstructure, based on neurite density (ND) from diffusion-weighted MRI, in 9-to-10-year-old children in the Adolescent Brain Cognitive Development Study with (n = 336) and without (n = 7368) a history of concussion, and its relationship with cognitive performance. Multivariate regression was used to investigate relationships between ND and group, sex, and age in deep and superficial white matter, subcortical structures, and cortex. Partial least square correlation was performed to identify associations between ND and performance on NIH Toolbox tasks in children with concussion. All tissue types demonstrated higher ND with age, reflecting brain maturation. Group comparisons revealed higher ND in deep and superficial white matter in females with concussion. In female but not male children with concussion, there were significant associations between ND and performance on cognitive tests. These results demonstrate a greater long-term impact of childhood concussion on white matter microstructure in females compared to males that is associated with cognitive function. The increase in ND in females may reflect premature white matter maturation.
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