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Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury
Published on: January 20, 2023
Long-Term Neurodevelopmental Outcome of Children With Mild Traumatic Brain Injury
Cece C Kooper1, Marlies A van Houten2, Nicky Niele3
1Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC Location University of Amsterdam, Emma Neuroscience Group, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands.
Insights
Pediatric mild traumatic brain injury (mTBI) can lead to lasting neurocognitive and behavioral issues in children, impacting school performance. Early identification is crucial for managing these long-term effects.
Area of Science:
- Pediatric neurology
- Neuroscience
- Developmental psychology
Background:
- Mild traumatic brain injury (mTBI) in children can have significant long-term consequences.
- Understanding the neurocognitive, behavioral, and academic outcomes of pediatric mTBI is essential.
Purpose of the Study:
- To investigate the long-term neurocognitive, behavioral, and school functioning outcomes in children following mTBI.
- To identify clinical risk factors associated with adverse outcomes in pediatric mTBI.
Main Methods:
- A prospective multicenter study followed 89 children with mTBI for 3.6 years post-injury.
- Outcomes were assessed using intelligence tests, behavioral questionnaires, neurocognitive tests, and school performance data.
- A control group of 89 neurologically healthy children was matched for key demographic variables.
Main Results:
- Children with mTBI showed average intelligence but experienced more behavioral problems (inattention, hyperactivity) and poorer neurocognitive function (information processing stability, visual working memory).
- Longitudinal school data indicated deficits in technical reading up to two years post-injury.
- Clinical risk factors did not predict adverse outcomes in this cohort.
Conclusions:
- Pediatric mTBI is associated with persistent neurocognitive and behavioral deficits, and academic underperformance for up to two years.
- Clinical risk factors are not reliable predictors of long-term neurodevelopmental prognosis after pediatric mTBI.
- Early identification of children at risk for adverse outcomes post-mTBI is critical.
Background:
To investigate the long-term outcome of pediatric mild traumatic brain injury (mTBI) in terms of neurocognitive, behavioral, and school functioning and to identify clinical risk factors for adverse outcomes.
Methods:
This study describes the follow-up of a prospective multicenter sample of 89 children with mTBI 3.6 years postinjury and 89 neurologically healthy children matched for sex, age, and socioeconomic status. Neurodevelopmental outcomes were assessed using an intelligence test, behavioral questionnaires, computerized neurocognitive tests, and longitudinal (pre- and postinjury) standardized school performance data.
Results:
Children with mTBI exhibited intelligence in the average range but had more behavioral problems related to inattentiveness (P = 0.004, d = 0.47) and hyperactive impulsivity (P = 0.01, d = 0.40) and showed poorer neurocognitive performance in information processing stability (P = 0.003, d = -0.55) and Visual Working Memory (P = 0.04, d = -0.39) compared with matched peers. Longitudinal school performance data revealed poorer performance in Technical Reading up to two years postinjury (P = 0.005, d = -0.42) when compared with normative data. Clinical risk factors did not reveal predictive value for adverse outcomes in children with mTBI.
Conclusions:
This study indicates that children with mTBI are at risk of long-term deficits in neurocognitive and behavioral functioning, with longitudinal evidence suggesting shortfalls in school performance up to two years postinjury. Clinical risk factors do not provide a solid basis for long-term neurodevelopmental prognosis. Findings emphasize the importance of, and challenges for, early identification of children at risk for adverse neurodevelopmental outcome after mTBI.
