Longitudinal Functional Connectome in Pediatric Concussion: An Advancing Concussion Assessment in Pediatrics Study

Area of Science:

• Neuroscience
• Pediatric Neurology
• Radiology

Background:

• Concussion (mild traumatic brain injury) impacts children's brain structure and function.
• Functional connectivity in pediatric concussion, particularly the functional connectome, remains poorly understood.

Purpose of the Study:

• To investigate longitudinal changes in the functional connectome after pediatric concussion.
• To compare functional brain network alterations in children with concussion versus mild orthopedic injury.

Main Methods:

• Prospective, longitudinal study of 967 children (8-16.99 years) with concussion or mild orthopedic injury.
• Resting-state functional MRI scans (post-acute and chronic) analyzed using graph theory metrics.
• Linear mixed-effects modeling to assess group differences over time, controlling for multiple comparisons.

Main Results:

• Reduced global clustering coefficient in older children and females with persistent concussion symptoms at 3 months post-injury.
• Altered local network metrics (degree centrality, efficiency, clustering coefficient) in posterior brain regions, varying by sex and time post-injury.
• Functional network alterations were more pronounced chronically than post-acutely, with sex and symptom recovery influencing outcomes.

Conclusions:

• Pediatric concussion leads to significant, long-term alterations in functional brain networks.
• Neurobiological changes continue up to 6 months post-injury, with earlier emergence in females.
• Altered connectivity in visual and attentional networks suggests susceptibility of these regions to concussion.