Implications of Reduced Callosal Area for Social Skills after Severe Traumatic Brain Injury in Children

Abstract

The corpus callosum has been shown to be particularly vulnerable to the effects of traumatic brain injury (TBI) in childhood, and severe injury frequently results in a smaller corpus callosum post-injury. However, the long-term effects of TBI on the integrity of the callosum, as well as the potential functional significance of callosal injury are poorly understood. Some studies suggest the corpus callosum may be involved in social skills, which are often reduced following TBI. In this study, callosal size was investigated in 37 individuals 10 years post-childhood TBI, and its relationship with social competence was examined. The results indicate that individuals who sustain severe TBI in childhood display reduced callosal size 10 years post-injury. In addition, callosal size correlated significantly with social skills, suggesting that callosal atrophy may be related to poorer social skills after TBI. These findings highlight the persistence of callosal abnormalities, which may be a result of interrupted neural development after childhood TBI. The results further underscore the potential importance of the corpus callosum for social competence after TBI.

Corpus Callosum and Inferior Forebrain White Matter Microstructure Are Related to Functional Outcome from Raised Intracranial Pressure in Child Traumatic Brain Injury

“…As such, in contrast to other studies of late effects of chronic TBI [16,17,18,19,20,21,22,23], our comparison group consisted of those cases who also required emergency PICU care and mechanical ventilation, but did not have raised ICP. Our interest is in the added burden of disease brought about by secondary injury such as raised ICP [15,45] and, in particular, how to develop outcome tools that measure the endpoints of the deranged acute physiology we try to limit or intervene in.…”

“…The decrease indicates either direct CC injury and the failure to develop, or the late effect of injury in extracallosal structures resulting in a reduced number of projections to the CC [17]. Cross-sectional studies of chronic TBI cases show a reduced CC size and microstructural changes [1,15,18,19,20,21,22,23,24]. Detailed analyses indicate that the posterior part appears particularly vulnerable [16,17,18,22,23].…”

“…Cross-sectional studies of chronic TBI cases show a reduced CC size and microstructural changes [1,15,18,19,20,21,22,23,24]. Detailed analyses indicate that the posterior part appears particularly vulnerable [16,17,18,22,23]. However, it is difficult to disentangle whether the cause of this long-term isthmus/splenium posterior deficit is due to an arrest in rapid development of this part of the CC [16,22,23], due to a direct focal posterior CC injury occurring at the time of TBI [1,13], or due to injury to posterior projections of the CC.…”

Suicidal Behavior Is Associated with Reduced Corpus Callosum Area

“…Corpus callosum measurement (2), the manually segmented CC outline was then automatically divided into three or five sub-regions as previously described (13,38,39). Specifically, the traced CC was divided in three equal-length parallel horizontal divisions (sub-regions) by using the 'Division' feature within the ROI module of the Analyze TM software and the area within each division was calculated.…”

Demonstration of Differentially Degenerated Corpus Callosam in Patients With Moderate Traumatic Brain Injury: With a Premise of Cortical-callosal Relationship

“…CC has been shown to be among the most affected structures (13) depending on the amount of time after injury, severity, and subject age (9,(14)(15)(16)(17)(18)(19)(20)(21). Callosal damage has also been observed in children and adolescents with TBI (22,23).…”