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Examination of the Association Between History of Self-Reported Mild Traumatic Brain Injury and Neurocognitive
Wenjing Meng1, Florin Vaida, Nicola L de Souza
1Author Affiliations: Department of Family Medicine and Public Health, Division of Biostatistics & Bioinformatics, University of California, San Diego, La Jolla, California (Ms Meng and Dr Vaida); Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah (Dr de Souza); Department of Neurology, George E. Whalen Veterans Affairs Medical Center, University of Utah School of Medicine, Salt Lake City, Utah (Dr Dennis); George E. Wahlen VA Medical Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah (Dr Wilde Mr Abildskov); Department of Psychiatry, University of California, San Diego, La Jolla, California (Dr Jacobus); Department of Integrative Biology and Physiology; Department of Molecular and Medical Pharmacology; Bioinformatics Interdepartmental Program; Brain Research Institute, University of California, Los Angeles, California (Dr Yang); Department of Integrative Biology and Physiology, Bioinformatics Interdepartmental Program, University of California, Los Angeles, California (Mr Cheng); San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California (Mr Delfel); Department of Radiology, University of California, San Diego, La Jolla, California (Dr Hesselink); Departments of Psychiatry and Neurology, School of Medicine; Department of Psychology and Neuroscience, University of Utah, Brigham Young University, Provo, Utah(Dr Bigler); and Department of Psychiatry, University of California, San Diego; Rady Children's Hospital, San Diego, California (Dr Max).
Insights
Pediatric mild traumatic brain injury (mTBI) did not show lasting neurocognitive differences compared to children with orthopedic injuries or no injuries after accounting for confounding factors. Careful control group selection and adjustment for demographics are crucial in mTBI research.
Area of Science:
- Pediatric neurology
- Neuroscience
- Developmental psychology
Background:
- Mild traumatic brain injury (mTBI) is common in children, but its long-term effects on neurocognitive functioning remain a subject of investigation.
- Understanding these effects is crucial for appropriate clinical management and educational support.
Purpose of the Study:
- To investigate potential differences in neurocognitive functioning between children with pediatric mild traumatic brain injury (mTBI) and control groups.
- To assess the impact of demographic, socioeconomic, and genetic factors on these potential differences.
Main Methods:
- Cross-sectional analysis of baseline data from the Adolescent Brain Cognitive Development (ABCD) Study.
- Comparison of 450 children with mTBI against 1604 children with orthopedic injury (OI) and 9814 children with no injury (NI).
- Neurocognitive performance assessed using the NIH Toolbox Cognition Battery, Rey Auditory Verbal Learning Test, and Little Man Task, with analyses adjusted for multiple confounders.
Main Results:
- Unadjusted analyses initially indicated higher cognitive scores in children with mTBI compared to the no-injury group.
- After adjusting for demographic, socioeconomic, and genetic factors, no significant differences in General Ability, Executive Function, or Learning/Memory were found between mTBI and control groups.
- Sensitivity analyses controlling for behavior and white matter microstructure yielded consistent findings.
Conclusions:
- Pediatric mild traumatic brain injury (mTBI) is not associated with significant neurocognitive differences when accounting for key confounding variables.
- The study underscores the critical importance of controlling for demographic, socioeconomic, and genetic factors in research on pediatric mTBI.
- Appropriate selection of control groups is essential for accurate interpretation of neurocognitive outcomes in pediatric mTBI studies.
Objective:
To examine whether pediatric mild traumatic brain injury (mTBI) is associated with differences in neurocognitive functioning among children.
Setting:
Baseline data from the Adolescent Brain Cognitive Development (ABCD) Study.
Participants:
Children with mTBI were compared to two control groups: children with orthopedic injury (OI) and children with no injury (NI). After excluding those with moderate/severe TBI, 450 children were classified as having mTBI, 1604 with OI, and 9814 with NI.
Design:
This is a cross-sectional analysis using the baseline data from a longitudinal observational study. Neurocognitive performance was assessed using task-based cognitive tests, including the National Institutes of Health Toolbox Cognition Battery (NIHTBX), Rey Auditory Verbal Learning Test, and the Little Man Task. Multiple imputation was used to address missing data. Linear regression models were used to compare cognitive performance across groups, adjusting for age, sex, race, ethnicity, parental income, parental education, and genetic ancestry.
Main Measures:
The primary outcomes include the principal component scores representing General Ability, Executive Function , and Learning/Memory .
Results:
Unadjusted analyses showed children with mTBI had significantly higher scores than NI children on all three principal components. However, no significant differences remained after adjusting for confounders. No differences were found between mTBI and OI groups. Sensitivity analyses further adjusting for behavior and white matter microstructure resulted in same findings.
Conclusion:
After adjusting for demographic and genetic factors, no significant differences were found between children with mTBI and OI/NI. The findings highlight the importance of accounting for demographic, socioeconomic, and genetic confounders, as well as selecting appropriate control groups, when analyzing cognitive differences of children with mTBI.
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