Persistence of Disability 24 to 36 Months after Pediatric Traumatic Brain Injury: A Cohort Study

Rivara, Frederick P.; Vavilala, Monica S.; Durbin, Dennis R.; Temkin, Nancy; Wang, Jin; O’Connor, Stephen S.; Koepsell, Thomas D.; Dorsch, Andrea; Jaffe, Kenneth M.

doi:10.1089/neu.2012.2434

Cited by 76 publications

(57 citation statements)

References 36 publications

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“…There was no evidence of memory deficits, as measured by the discrimination index, or changes in depression-like behaviors. Although additional studies may be required to fully elucidate the behavioral sequelae of pediatric smTBI and rmTBI, our results reflect long-term adaptive and social deficits observed in a variety of pediatric TBI models both clinically [60-62] and experimentally [6, 63]. Our findings also provide the confirmatory evidence that the chosen model of pediatric mTBI is clinically relevant in producing long-term behavioral outcomes that are observed in the clinical cases.…”

Section: Discussionsupporting

confidence: 76%

Repeated Pediatric Concussions Evoke Long-Term Oligodendrocyte and White Matter Microstructural Dysregulation Distant from the Injury

et al. 2018

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Concussion or mild traumatic brain injury (mTBI) is often accompanied by long-term behavioral and neuropsychological deficits. Emerging data suggest that these deficits can be exacerbated following repeated injuries. However, despite the overwhelming prevalence of mTBI in children due to falls and sports-related activities, the effects of mTBI on white matter (WM) structure and its development in children have not been extensively examined. Moreover, the effect of repeated mTBI (rmTBI) on developing WM has not yet been studied, despite the possibility of exacerbated outcomes with repeat injuries. To address this knowledge gap, we investigated the long-term effects of single (s)mTBI and rmTBI on the WM in the pediatric brain, focusing on the anterior commissure (AC), a WM structure distant to the injury site, using diffusion tensor imaging (DTI) and immunohistochemistry (IHC). We hypothesized that smTBI and rmTBI to the developing mouse brain would lead to abnormalities in microstructural integrity and impaired oligodendrocyte (OL) development. We used a postnatal day 14 Ascl1-CreER: ccGFP mouse closed head injury (CHI) model with a bilateral repeated injury. We demonstrate that smTBI and rmTBI differentially lead to myelin-related diffusion changes in the WM and to abnormal OL development in the AC, which are accompanied by behavioral deficits 2 months after the initial injury. Our results suggest that mTBIs elicit long-term behavioral alterations and OL-associated WM dysregulation in the developing brain. These findings warrant additional research into the development of WM and OL as key components of pediatric TBI pathology and potential therapeutic targets.

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Section: Discussionsupporting

confidence: 76%

Repeated Pediatric Concussions Evoke Long-Term Oligodendrocyte and White Matter Microstructural Dysregulation Distant from the Injury

et al. 2018

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“…[10][11][12][13] Difficulties in social participation up to 36 months post-injury have also been reported. 14 Similarly, restricted involvement and changes in the intensity and diversity of participation in activities, in the home, school and community environments have been seen up to four years post-injury. 2,[15][16][17][18] To date, few of these studies have focused on early outcomes, which may provide a base for understanding ''brain effects'' as distinct from problems that relate more so to longer-term adjustment and re-integration difficulties.…”

Section: Introductionmentioning

confidence: 98%

Social and Behavioral Outcomes: Pre-Injury to Six Months following Childhood Traumatic Brain Injury

Catroppa

Crossley

Hearps

et al. 2015

Journal of Neurotrauma

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This study aimed to extend the limited research investigating social and behavioral outcomes following childhood traumatic brain injury (TBI). The study compared pre-and post-injury measures of these skills and investigated the role of pre-injury child status and pre-injury family functioning in the prediction of outcome at six months post-injury. A secondary aim was to compare rates of impairment at six months post-injury between children post-TBI and a typically developing (TD) control group. This study comprised 140 children, 97 survivors of TBI (67 males) and 43 TD children (24 males), matched for age, sex, and socio-economic status. All participants were ascertained between 2007 and 2010, and were between ages 5.5 and 15.0 years. Children with TBI represented consecutive hospital admissions and were recruited at time of injury into a longitudinal study. TD children were recruited from the community, through local schools chosen to provide a range of socio-economic backgrounds. Findings indicated a deterioration of social participation skills post-injury, particularly for those sustaining a more severe injury, and a consistently higher rate of impairment in social and behavioral outcomes in the TBI group. Pre-injury function, injury severity and restrictions to social participation (e.g., reduced sport activities) as recommended by clinicians contributed significantly to outcome. Difficulties are evident in the short-term post-childhood TBI in social and behavioral domains. It is essential to monitor children long-term, particularly as societal expectations and demands increase.

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“…Although school is often referred to as children’s work, it differs from adult work in that it is also an environment where a good deal of peer socialization and identity development occurs [2]. While the overall rates of moderate to severe traumatic brain injury (TBI) have fallen in the United States in the last decade [3], TBI is still a leading cause of morbidity in children because a heterogeneous range of long-term physical, emotional, behavioral, and cognitive impairments are common [4, 5]. …”

mentioning

confidence: 99%

Parent management of the school reintegration needs of children and youth following moderate or severe traumatic brain injury

Roscigno

Fleig

Knafl

2014

Disability and Rehabilitation

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Purpose School reintegration following children’s traumatic brain injury (TBI) is still poorly understood from families’ perspectives. We aimed to understand how both unique and common experiences during children’s school reintegration were explained by parents to influence the family. Methods Data came from an investigation using descriptive phenomenology (2005–2007) to understand parents’ experiences in the first 5 years following children’s moderate to severe TBI. Parents (N = 42 from 37 families in the United States) participated in two 90-minute interviews (first M = 15 months; second M = 27 months). Two investigators independently coded parents’ discussions of school reintegration using content analysis to understand the unique and common factors that parents perceived affected the family. Results Parents’ school negotiation themes included: 1) legal versus moral basis for helping the child; 2) inappropriate state and local services that did not consider needs specific to TBI; and, 3) involvement in planning, implementing, and evaluating the child’s education plan. Parents perceived that coordinated and collaboration leadership with school personnel lessened families’ workload. Families who home-schooled had unique challenges. Conclusions School reintegration can add to family workload by changing roles and relationships, and by adding to parents’ perceived stress in managing of the child’s condition.

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Persistence of Disability 24 to 36 Months after Pediatric Traumatic Brain Injury: A Cohort Study

Cited by 76 publications

References 36 publications

Repeated Pediatric Concussions Evoke Long-Term Oligodendrocyte and White Matter Microstructural Dysregulation Distant from the Injury

Repeated Pediatric Concussions Evoke Long-Term Oligodendrocyte and White Matter Microstructural Dysregulation Distant from the Injury

Social and Behavioral Outcomes: Pre-Injury to Six Months following Childhood Traumatic Brain Injury

Parent management of the school reintegration needs of children and youth following moderate or severe traumatic brain injury

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