Neurology: White matter lesions are related to behavioral performance after brain trauma in adolescents and children

Diffusion MRI (dMRI) has completely changed the ability to non-invasively observe the white matter (WM) pathway and its behavioral effects in healthy and diseased populations
.

Many dMRI studies have shown that young patients with traumatic brain injury (TBI) show abnormal WM tissues in some fiber bundles, such as the corpus callosum

These studies also reported a significant, moderate to high correlation between symptoms and WM tissue reduction, such as increased severity of white matter destruction predicting poor behavior in young TBI patients
.

The plasticity of the human brain during development supports learning and adaptation, but its hidden cost may be increased vulnerability to injury
.

Although the research results are promising, these studies are limited by sample size (median of TBI patients = 21) and cannot test specific hypotheses about the impact of demographic and clinical variables on WM organization

ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) is a worldwide cooperative analysis alliance that uses large joint samples to achieve sufficient power to solve open problems
.

The ENIGMA Pediatric Moderate/Severe Traumatic Disease (msTBI) working group has been established to investigate the WM microstructure change pattern after traumatic disease

In this way, Emily L Dennis and others of the University of Utah in the United States used ENIGMA to explore:

(1) In children with moderate to severe trauma, white matter tissue is injured;
(2) The influence of age and gender on white matter tissue after injury;
(3) The correlation between white matter tissue and neurobehavioral outcomes
.

They included 507 children and adolescents (244 complicated mild to severe TBI [msTBI] and 263 controls)
.

Patients were divided into three time periods after injury: acute/subacute-<2 months, post-acute-2-6 months, and chronic-6 months or more

The severity of injury is an important factor in the degree of change in WM, but as the time after injury increases, the difference in dMRI measurements is less explained

The fractional anisotropy of female patients with traumatic diseases was significantly lower than that of the control group (𝞫=0.
043), which was consistent with more behavioral problems reported by parents (𝞫=-0.
0027)

 

 

Original source:

White Matter Disruption in Pediatric Traumatic Brain Injury: Results from ENIGMA Pediatric Moderate to Severe Traumatic Brain InjuryEmily L Dennis, Karen Caeyenberghs, Kristen R Hoskinson, et al.

Neurology May 2021, 10.
1212/WNL.

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