A one year longitudinal study of cortical myelination changes following pediatric mild traumatic brain injury

Area of Science:

• Neuroscience
• Developmental Neuroscience
• Pediatric Neurology

Background:

• Cortical myelination is crucial for neurodevelopment and cognitive function.
• The effects of pediatric mild traumatic brain injury (pmTBI) on myelination trajectories remain largely unknown.
• Understanding these effects is vital for assessing long-term neurodevelopmental outcomes in children.

Purpose of the Study:

• To investigate the impact of pmTBI on cortical myelination in children.
• To compare myelination changes in pmTBI patients versus healthy controls (HC) over time.
• To examine the relationship between pmTBI, neurodevelopment, and myelin content.

Main Methods:

• Utilized the T1w/T2w ratio method to estimate myelin content in pediatric participants.
• Collected longitudinal data from 217 pmTBI patients and 180 age/sex-matched HC at three time points: 7 days, 4 months, and 1 year post-injury.
• Analyzed changes in myelin content across different brain regions, hemispheres, and in relation to age and sex.

Main Results:

• Myelin content increased with age and varied by hemisphere (left > right), particularly in the posterior parietal lobe.
• Females exhibited greater myelin content than males.
• Initial findings of reduced myelination in the posterior parietal cortex (4 months) and increased myelination in the left prefrontal cortex (1 year) post-pmTBI did not persist after sensitivity analyses.

Conclusions:

• Cortical myelination undergoes significant developmental changes irrespective of pmTBI.
• There was minimal evidence suggesting that pmTBI permanently alters cortical myelin development trajectories in children.
• Longitudinal monitoring revealed incomplete recovery from post-concussive symptoms, highlighting the need for continued clinical attention despite stable myelination patterns.