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Investigations on Alterations of Hippocampal Circuit Function Following Mild Traumatic Brain Injury
Published on: November 19, 2012
Regional and Global Changes in Brain Structure 1-Year Post Pediatric "Mild" Traumatic Brain Injury
Upasana Nathaniel1, Tracey V Wick1, Josef L Ling1
1The Mind Research Network/Lovelace Biomedical Research Institute, Albuquerque, NM, USA.
Insights
Pediatric mild traumatic brain injuries (pmTBI) can alter brain development, with severity linked to brain age and hippocampal changes. Objective biomarkers are crucial for understanding long-term pmTBI effects.
Area of Science:
- Neuroscience
- Developmental Neuroscience
- Pediatric Traumatology
Background:
- Pediatric mild traumatic brain injury (pmTBI) is common, yet its long-term structural brain effects during neurodevelopment are poorly understood.
- Assessing pmTBI's impact requires accounting for dynamic neurodevelopmental changes and regional specificity.
Purpose of the Study:
- To investigate the long-term effects of pmTBI on global and regional brain structure.
- To determine how pmTBI influences neurodevelopmental trajectories in children and adolescents.
Main Methods:
- Prospective longitudinal study design with neuroimaging at 7 days, 4 months, and 1 year post-injury.
- Inclusion of 269 pmTBI cases and 232 age/sex-matched healthy controls.
- Assessment of brain age, hippocampal volume, subfields, and cortical thickness.
Main Results:
- pmTBI associated with increased brain age, frontal cortical thickness, and hippocampal atrophy up to 1 year post-injury.
- Injury severity showed a dose-dependent effect on hippocampal neurodevelopment, including the CA1 subfield.
- Post-concussive symptoms did not correlate with observed structural brain changes.
Conclusions:
- Injury severity in pmTBI is dose-dependently related to alterations in global and regional brain structure.
- Objective biomarkers are superior to subjective symptoms for evaluating long-term pmTBI consequences.
- Findings highlight the need for objective measures in understanding pediatric TBI impacts.
Objective:
Despite the high prevalence of pediatric "mild" traumatic brain injury (pmTBI), very little is known about the long-term effects of injury on brain structure and how injuries manifest in the context of dynamic and regionally specific neurodevelopmental changes.
Methods:
Prospective study design characterizing long-term effects of pmTBI on both global (brain age) and regional (hippocampal volume, hippocampal subfields, and cortical thickness) brain structure at approximately 7 days, 4 months, and 1-year post-injury. A large sample of age- and sex-matched healthy controls was imaged at identical temporal intervals to account for typical neurodevelopmental changes, and to assess how trauma potentially affects developmental trajectories.
Results:
A total of 269 pmTBI (age = 14.4 ± 2.9; 41.6% female) and 232 healthy controls (age = 14.1 ± 2.9; 44.8% female) were included in the final analyses (>70% 1-year retention). Results demonstrated that the presence of loss of consciousness and/or post-traumatic amnesia was associated with increased brain age up to 1-year post-injury, increased frontal cortical thickness at 4 months, as well as hippocampal atrophy across all time points relative to controls. "Mild" head trauma also interfered with hippocampal neurodevelopment in a dose-dependent fashion, including within the CA1 subfield. In contrast, post-concussive symptom burden was not associated with any structural abnormalities or alterations to neurodevelopment.
Interpretation:
Current findings suggest a dose-dependent relationship between injury severity and alterations in both global and regional brain structure within the spectrum of pmTBI. Our results emphasize the importance of using objective biomarkers rather than subjective self-reported symptoms to better understand the long-term effects of injury. ANN NEUROL 2025;98:341-353.
