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Investigations on Alterations of Hippocampal Circuit Function Following Mild Traumatic Brain Injury
Published on: November 19, 2012
Neurocognitive Network Organization in Children with Traumatic Brain Injury
Cece C Kooper1,2, Marsh Königs1,2,3, Marjan E Steenweg4
1Emma Neuroscience Group, Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
Insights
Pediatric traumatic brain injury (TBI) disrupts children's neurocognitive networks, leading to less centralized organization. This network disruption impacts intelligence and is strongly linked to externalizing behavior problems post-injury.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Cognitive Psychology
Background:
- Pediatric traumatic brain injury (TBI) is a primary cause of acquired disability in children.
- TBI can result in neurocognitive deficits impacting daily functioning.
- Understanding TBI's effect on brain networks is crucial for predicting outcomes.
Purpose of the Study:
- To investigate the impact of pediatric TBI on neurocognitive network organization.
- To examine the relationship between neurocognitive network organization and intelligence.
- To explore the association between neurocognitive network organization and behavior problems in children with TBI.
Main Methods:
- An observational, multicenter study included 113 children with TBI and 113 matched neurologically healthy (NH) children.
- Neurocognitive functioning was assessed 6 months post-TBI using computerized tests and Wechsler scales.
- Graph theory analysis was applied to neurocognitive data to evaluate network organization, specifically centralization.
Main Results:
- Children with TBI exhibited lower performance in speed, attention, and working memory compared to NH children.
- The neurocognitive network in children with TBI showed significantly lower centralization than in NH children.
- Neurocognitive network organization was related to intelligence (R²=29.7%) and internalizing behaviors (R²=6.0%), but more strongly to externalizing behaviors (R²=21.6%).
Conclusions:
- Pediatric TBI alters neurocognitive network organization, characterized by reduced centralization.
- Neurocognitive network organization is a significant factor in understanding outcomes after pediatric TBI.
- Network analysis provides valuable insights into behavioral problems, especially externalizing behaviors, following pediatric TBI.
Abstract:
Pediatric traumatic brain injury (TBI) is the leading cause of acquired disability in children, potentially leading to neurocognitive deficits that affect daily functioning. This study explored the impact of pediatric TBI on neurocognitive network organization and its relation to intelligence and behavior problems. This observational multicenter study prospectively included 113 children with mild to severe TBI and 113 neurologically healthy (NH) children, matched for sex, age and socio-economic status. Six months post-TBI, neurocognitive functioning was assessed using computerized tests, intelligence outcome was assessed with Wechsler tests, and behavior problems were assessed through questionnaires. Conventional analysis of neurocognitive data involved calculating test performance scores, while network analysis involved the use of graph theory on individual neurocognitive data to explore neurocognitive network organization. Results of the conventional analysis showed that children with TBI had lower performance than NH children in Speed, Stability, Attention & Control, Verbal Working Memory, and Visual Working Memory (0.009 ≤ p ≤ 0.047, -0.42 ≤ d ≤ -0.29, small effect sizes). Network analysis showed lower centralization in the neurocognitive network organization of children with TBI compared to NH children (p = 0.04, d = -0.38). No differences were found in other network parameters (p ≥ 0.20). Neurocognitive network organization in children with TBI was related to intelligence (R2 = 29.7%) and internalizing behavior problems (R2 = 6.0%). Neurocognitive network organization was related stronger to externalizing behavior problems (R2 = 21.6%, 95% CI = 13.7-34.6%) than measures of conventional neurocognitive performance (R2 = 9.4%). This study indicates that pediatric TBI disrupts the neurocognitive network and is characterized by a less centralized organization compared to peers. Neurocognitive network organization may contribute to our understanding of outcomes following TBI, particularly regarding externalizing behavior problems.
