The family environment as a moderator of psychosocial outcomes following traumatic brain injury in young children.

Yeates, Keith Owen; Taylor, H. Gerry; Walz, Nicolay Chertkoff; Stancin, Terry; Wade, Shari L.

doi:10.1037/a0018387

Cited by 227 publications

(234 citation statements)

References 56 publications

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“…Social/behavioral outcomes were predicted by family function, in keeping with previous reports from school-age samples and evaluation more proximal to time of injury. 10,12,15 Apparently, although injury factors, such as severity and brain pathology, are relevant to early outcome, they become less important with time since injury.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 Few studies, however, have prospectively followed survivors of early TBI into adolescence, and those available focus primarily on cognition. In addition, several factors have been identified that contribute to deficits after school-aged TBI (injury severity and age, premorbid child and family function), [9][10][11][12][13] but it is unclear whether these factors also explain outcomes for younger children.…”

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confidence: 99%

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Predictors of Cognitive Function and Recovery 10 Years After Traumatic Brain Injury in Young Children

et al. 2012

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BACKGROUND AND OBJECTIVES: Childhood traumatic brain injury (TBI) has implications for functional outcomes, but few studies have documented long-term outcomes. The purpose of this study was to plot recovery of cognitive and functional skills after early childhood TBI to 10 years postinjury and to identify the contribution of injury, environment, preinjury characteristics, and acute functional recovery. METHODS: Subjects were recruited consecutively to this prospective, longitudinal study, which used a between-factor design, with injury severity as the independent variable. Forty children with TBI aged 2 and 7 years were recruited on admission to a tertiary pediatric hospital, divided according to injury severity, and compared with 16 healthy controls acutely and 12 and 30 months and 10 years postinjury. Cognition, adaptive ability, executive function, and social/behavioral skills were examined. RESULTS: Children with severe TBI had poorest outcomes, with deficits greatest for cognition. Recovery trajectories were similar across severity groups but with significant gains in verbal skills from 12 and 30 months to 12 months and 10 years. Predictors of outcome included preinjury ability (for adaptive function) and family function (social/behavioral skills). CONCLUSIONS: Results confirm a high risk of persisting deficits after severe TBI in early childhood. Children with less severe TBI appear to recover to function normally. Contrary to speculation about “growing into deficits,” after protracted recovery to 30 months, young children make age-appropriate progress at least to 10 years postinsult. Environmental factors were found to contribute to adaptive and social/behavioral recovery.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Predictors of Cognitive Function and Recovery 10 Years After Traumatic Brain Injury in Young Children

et al. 2012

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“…Consequently, significant differences after rehabilitation of pre-school children compared to school-aged children referring to increased social and behavioural impairment have been analysed [20,40]. In contrast to this assumption, the association of injury severity and outcome deficits diminishes with increasing time since injury [28,36,41], suggesting other influencing factors like social and family environment [37,42].…”

Section: Paediatric Tbimentioning

confidence: 98%

Current Opinions on Epidemiology, Treatment and Outcome After Traumatic Brain Injury

Florian¹

2012

J Trauma Treat

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Traumatic Brain InjuryTraumatic Brain Injury (TBI) continues to be the major cause of disability and death throughout the world despite improvements of research and medical treatment [1]. Consequently, an overview on the current incidence of TBI as well as current treatment options and outcome seems considerably relevant.With 332 Traumatic Brain Injuries per 100,000 inhabitants in Germany every year [2], TBI is still the leading cause of mortality and morbidity worldwide [3] resulting in prolonged rehabilitation and long-term care [4]. In multiple traumatized patients, head injuries are evaluated as the most frequent injury, followed by lower and upper extremity trauma [5]. Examining current data, two major gender-and age-related incidences of TBI can be found: one occurs in the late teens to twenties [6] commonly due to motor vehicle accidents [4] with males being three times as often affected compared to females [7]. The second major incidence occurs in the geriatric population caused by falls due to geriatric co-morbidities [6]. While mortality decreased during the last decades based on medical improvements, the World Health Organization (WHO) predicts that TBI will be the third greatest cause of disease and injury by 2020 [8].Typical symptoms of TBI represent headache, nausea and vomiting, dizziness, blurred vision, paresis, aphasia, seizures and impaired coordination on the physical side [9]. Cognitive impairments include attention, memory and concentration disorders or decreased processing speed whereas behavioural symptoms present as depression, anxiety, agitation or aggression [9]. While these symptoms are present in different injury severities to some extent, most are described to resolve quickly especially after mild TBI [9]. Nevertheless, symptoms can still persist for months or even years regardless of the injury severity of TBI [10,11]. AbstractObjective: The objective of this article is to provide an overview on current incidences of traumatic brain injury (TBI) with special focus on current surgical and non-surgical treatment options as well as outcome.Method: A Medline database search was performed using various combinations of the search terms "traumatic brain injury", "TBI", "treatment", "outcome" "pediatric", "intracranial hypertension", "epidemiology" and "incidence". Results:We found an incidence of TBI of 332/100,000 inhabitants in Germany per year and 219-345/100,000 TBI occurring in children. TBI is still the leading cause of mortality and morbidity worldwide. The overall mortality after TBI is described with 1%.Typical symptoms of TBI represent headache, nausea and vomiting, dizziness, blurred vision, paresis, aphasia, seizures and impaired coordination on the physical side. Cognitive impairments include attention, memory and concentration disorders or decreased processing speed whereas behavioural symptoms present as depression, anxiety, agitation or aggression. Persistence of these symptoms results in a vicious cycle of impaired skill acquisition and an adaptive deficit with increased ...

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“…Aspects of the home environment, such as parental responsiveness, negativity, and discipline practices, are linked to a child' s behavioral recovery (Wade et al, 2011a;Wade et al, 2002). Economic and social disadvantage have been associated with poor cognitive and academic outcomes following severe TBI (Taylor et al, 2002;Yeates, Taylor, Walz, Stancin, and Wade, 2010). Well-functioning caregivers and available financial and social supports contribute to better recovery and outcomes (Sander et al, 2002;Sander et al, 2009).…”

Section: Social-environmental Factorsmentioning

confidence: 99%

Prospective study of myelin water fraction changes after mild traumatic brain injury in collegiate contact sports

Spader

Dean

LaFrance

et al. 2019

Journal of Neurosurgery

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OBJECTIVEMild traumatic brain injury (mTBI) in athletes, including concussion, is increasingly being found to have long-term sequelae. Current imaging techniques have not been able to identify early damage caused by mTBI that is predictive of long-term symptoms or chronic traumatic encephalopathy. In this preliminary feasibility study, the authors investigated the use of an emerging magnetic resonance imaging (MRI) technique, multicomponent driven equilibrium single pulse observation of T1 and T2 (mcDESPOT), in visualizing acute and chronic white matter changes after mTBI in collegiate football and rugby players.METHODSThis study was a nonrandomized, nonblinded prospective trial designed to quantify changes in the myelin water fraction (MWF), used as a surrogate MRI measure of myelin content, in a group of male collegiate football and rugby players, classified here as a contact sport player (CSP) cohort, at the time of mTBI diagnosis and 3 months after injury when the acute symptoms of the injury had resolved. In addition, differences in the MWF between the CSP cohort and a control cohort of noncontact sport players (NCSPs) were quantified. T-tests and a threshold-free cluster enhancement (TFCE) statistical analysis technique were used to identify brain structures with significant changes in the MWF between the CSP and NCSP cohorts and between immediately postinjury and follow-up images obtained in the CSP cohort.RESULTSBrain MR images of 12 right-handed male CSPs were analyzed and compared with brain images of 10 right-handed male NCSPs from the same institution. A comparison of CSP and NCSP baseline images using TFCE showed significantly higher MWFs in the bilateral basal ganglia, anterior and posterior corpora callosa, left corticospinal tract, and left anterior and superior temporal lobe (p < 0.05). At the 3-month follow-up examination, images from the CSP cohort still showed significantly higher MWFs than those identified on baseline images from the NCSP cohort in the bilateral basal ganglia, anterior and posterior corpora callosa, and left anterior temporal lobe, and also in the bilateral corticospinal tracts, parahippocampal gyrus, and bilateral juxtapositional (previously known as supplemental motor) areas (p < 0.05). In the CSP cohort, a t-test comparing the MWF at the time of injury and 3 months later showed a significant increase in the overall MWF at follow-up (p < 0.005). These increases were greatest in the bilateral basal ganglia and deep white matter. MWF decreases were seen in more superficial white matter (p < 0.005).CONCLUSIONSIn this preliminary study, MWF was found to be increased in the brains of CSPs compared with the brains of controls, suggesting acute/chronic MWF alterations in CSPs from previous injuries. Increases in the MWF were also demonstrated in the brains of CSPs 3 months after the players sustained an mTBI. The full clinical significance of an increased MWF and whether this reflects axon neuropathology or disorderly remyelination leading to hypermyelination has yet to be determined.

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The family environment as a moderator of psychosocial outcomes following traumatic brain injury in young children.

Cited by 227 publications

References 56 publications

Predictors of Cognitive Function and Recovery 10 Years After Traumatic Brain Injury in Young Children

Predictors of Cognitive Function and Recovery 10 Years After Traumatic Brain Injury in Young Children

Current Opinions on Epidemiology, Treatment and Outcome After Traumatic Brain Injury

Prospective study of myelin water fraction changes after mild traumatic brain injury in collegiate contact sports

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