Neuropsychological function 23 years after mild traumatic brain injury: A comparison of outcome after paediatric and adult head injuries

Hessen, Erik; Nestvold, Knut; Anderson, Vicki

doi:10.1080/02699050701528454

Cited by 136 publications

(96 citation statements)

References 50 publications

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“…20 More recent evidence suggests that children and adolescents are more likely to endure prolonged symptom recovery [21][22][23] and are more vulnerable to poor outcomes. 24,25 Moreover, neuroimaging studies show persistent structural and functional changes in the brain following mild TBI in children. [26][27][28] Windows of vulnerability to brain trauma may be associated with critical periods of brain development occurring throughout childhood and adolescence.…”

Section: Introductionmentioning

confidence: 99%

Age at First Exposure to Football Is Associated with Altered Corpus Callosum White Matter Microstructure in Former Professional Football Players

Stamm

Koerte

Muehlmann

et al. 2015

Journal of Neurotrauma

159

131

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Youth football players may incur hundreds of repetitive head impacts (RHI) in one season. Our recent research suggests that exposure to RHI during a critical neurodevelopmental period prior to age 12 may lead to greater later-life mood, behavioral, and cognitive impairments. Here, we examine the relationship between age of first exposure (AFE) to RHI through tackle football and later-life corpus callosum (CC) microstructure using magnetic resonance diffusion tensor imaging (DTI). Forty retired National Football League (NFL) players, ages 40-65, were matched by age and divided into two groups based on their AFE to tackle football: before age 12 or at age 12 or older. Participants underwent DTI on a 3 Tesla Siemens (TIM-Verio) magnet. The whole CC and five subregions were defined and seeded using deterministic tractography. Dependent measures were fractional anisotropy (FA), trace, axial diffusivity, and radial diffusivity. Results showed that former NFL players in the AFE <12 group had significantly lower FA in anterior three CC regions and higher radial diffusivity in the most anterior CC region than those in the AFE ‡12 group. This is the first study to find a relationship between AFE to RHI and later-life CC microstructure. These results suggest that incurring RHI during critical periods of CC development may disrupt neurodevelopmental processes, including myelination, resulting in altered CC microstructure.

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Section: Introductionmentioning

confidence: 99%

Age at First Exposure to Football Is Associated with Altered Corpus Callosum White Matter Microstructure in Former Professional Football Players

Stamm

Koerte

Muehlmann

et al. 2015

Journal of Neurotrauma

159

131

View full text Add to dashboard Cite

show abstract

“…[7][8][9] In a small proportion of mTBI patients, estimated at between 5 and 15%, some of these symptoms have been reported to linger for up to 1 year or more after injury and can markedly lower self-reported quality-of-life measures. [10][11][12][13][14][15] Both clinical and experimental studies have shown that concussive force can elicit physical and/or structural changes in the brain. These changes can be focal, diffused through the brain, or a combination of the two.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Functional Pathways Altered after Mild Traumatic Brain Injury

Redell

Moore

Grill

et al. 2013

Journal of Neurotrauma

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Concussive injury (or mild traumatic brain injury; mTBI) can exhibit features of focal or diffuse injury patterns. We compared and contrasted the cellular and molecular responses after mild controlled cortical impact (mCCI; a focal injury) or fluid percussion injury (FPI; a diffuse injury) in rats. The rationale for this comparative analysis was to investigate the brain's response to mild diffuse versus mild focal injury to identify common molecular changes triggered by these injury modalities and to determine the functional pathways altered after injury that may provide novel targets for therapeutic intervention. Microarrays containing probes against 21,792 unique messenger RNAs (mRNAs) were used to investigate the changes in cortical mRNA expression levels at 3 and 24 h postinjury. Of the 354 mRNAs with significantly altered expression levels after mCCI, over 89% (316 mRNAs) were also contained within the mild FPI (mFPI) data set. However, mFPI initiated a more widespread molecular response, with over 2300 mRNAs differentially expressed. Bioinformatic analysis of annotated Gene Ontology molecular function and biological pathway terms showed a significant overrepresentation of genes belonging to inflammation, stress, and signaling categories in both data sets. We therefore examined changes in the protein levels of a panel of 23 cytokines and chemokines in cortical extracts using a Luminex-based bead immunoassay and detected significant increases in macrophage inflammatory protein (MIP)-1a (CCL3), GRO-KC (CXCL1), interleukin (IL)-1a, IL-1b, and IL-6. Immunohistochemical localization of MIP-1a and IL-1b showed marked increases at 3 h postinjury in the cortical vasculature and microglia, respectively, that were largely resolved by 24 h postinjury. Our findings demonstrate that both focal and diffuse mTBI trigger many shared pathobiological processes (e.g., inflammatory responses) that could be targeted for mechanism-based therapeutic interventions.

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“…As sub-optimal language skills may limit a child's attainment in life [40], further research studies, utilizing the fortuitous availability [1][2][3][4][5][6][7] K:/TPDR/TPDR_A_620576.3d (TPDR) [PREPRINTER stage] of pre-and post-morbid performance indicators and extending beyond 12 months post-injury, are needed to develop, case-by-case, a better understanding of the impact of mTBI upon the emergence of developmental language processes. Although the descriptive trend was not supported statistically, the vulnerability of language skill development subsequent to mTBI is highlighted.…”

Section: Resultsmentioning

confidence: 99%

“…His post-injury performance on the PPVT [1][2][3][4][5][6][7] K:/TPDR/TPDR_A_620576.3d (TPDR) [PREPRINTER stage] placed him in the above average range (4þ1 SD of test mean). His post-injury performance on the tests of high level language skill placed him within the average range on all tasks assessed (AE1 SD of tests' means).…”

Section: Descriptive Analysismentioning

confidence: 99%

“…Paediatric TBI research has focused predominantly on moderate and severe presentations of trauma, where neurocognitive impairments [6] as well as language deficits encompassing basic or general language functions requiring a low level cognitive manipulation (e.g. naming and repetition) and language functions requiring a high degree of cognitive manipulation (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Language function in a child following mild traumatic brain injury: Evidence from pre- and post-injury language testing

Lewis

Murdoch

2011

Developmental Neurorehabilitation

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Neuropsychological function 23 years after mild traumatic brain injury: A comparison of outcome after paediatric and adult head injuries

Abstract: The findings indicate that children sustaining complicated mild TBI may be more vulnerable to development of chronic mild neuropsychological dysfunction than adults sustaining similar head injuries.

Cited by 136 publications

References 50 publications

Age at First Exposure to Football Is Associated with Altered Corpus Callosum White Matter Microstructure in Former Professional Football Players

Age at First Exposure to Football Is Associated with Altered Corpus Callosum White Matter Microstructure in Former Professional Football Players

Analysis of Functional Pathways Altered after Mild Traumatic Brain Injury

Language function in a child following mild traumatic brain injury: Evidence from pre- and post-injury language testing

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