Browsing by Author "Deighton, Stephanie"

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    Functional Outcomes after Pediatric Mild Traumatic Brain Injury
    (2018-09-11) Deighton, Stephanie; Yeates, Keith; Brooks, Brian; von Ranson, Kristin
    Although most children recover quickly after a mild traumatic brain injury (TBI), a sizeable minority suffer negative long-term consequences. Thus, the objective of this study was to investigate functional outcomes in children after mild TBI and to examine post-acute post-concussive symptoms (PCS) and neurocognitive test performance as predictors. Children, ages 8 to 16, were recruited (135 with mild TBI and 70 with orthopedic injury). Participants and their parents provided ratings of functioning at baseline, 3 and 6 months post-injury. Although groups differed in functioning shortly after injury, no differences were apparent at 3 or 6 months. Post-acute PCS were significant predictors of parent- and child-reported functioning at 3 and 6 months. Neurocognitive test performance predicted child-reported functioning (but not parent-reported) when considered independently, but did not add incrementally to prediction above PCS. The findings suggest that higher levels of PCS put children at risk for poor functioning after an injury.
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    Resting state functional magnetic resonance imaging after pediatric mild TBI: Association of whole brain functional connectivity with diagnosis and post-concussive symptoms
    (2022-08) Deighton, Stephanie; Yeates, Keith; Bray, Signe Lauren; Protzner, Andrea B.; Schneider, Kathryn Janet
    Accurate diagnosis and prognosis is important after pediatric mild traumatic brain injury (TBI), but limited objective measures exist for either purpose. Advanced neuroimaging has garnered increased interest as a means to better understand mild TBI, with the potential to support objective assessment. Broadly, the goal of this dissertation was to examine resting state functional magnetic resonance imaging (RS fMRI) after pediatric mild TBI. Study 1 is a scoping review that aimed to examine the literature on RS fMRI after pediatric and adolescent mild TBI to summarize findings, determine research themes, review methodological approaches, and identify areas for further research. Study 2 is an original research study that aimed to predict group status [i.e., mild TBI versus orthopedic injury (OI)] as well as post-concussive symptoms (PCS) from whole brain functional connectivity (FC) patterns in participants aged 8.00 to 16.99 years (N = 430). Study 1 identified 16 articles with four main research themes: 1) RS fMRI differences between mild TBI and comparison groups; 2) changes in RS fMRI over time; 3) RS fMRI differences in subsamples of mild TBI; and 4) relations of RS fMRI to outcome measures (e.g., symptoms, behaviour, and cognition). Overall, a clear pattern of findings of RS fMRI after mild TBI was difficult to discern, likely due to heterogeneity in study methods and a high proportion of cross-sectional studies with small sample sizes. Study 2 found that significant models of group (mild TBI versus OI) could be built from whole brain RS FC profiles. These FC profiles were characterized primarily by widespread differences in connectivity between networks, largely involving the default mode network, mesolimbic network, executive function/task positive networks, and the cerebellum. However, the observed prediction accuracy did not exceed the proportion of mild TBI cases in the sample. Additionally, no significant models of cognitive or somatic PCS could be built. While these findings provide insight into RS FC profiles that differentiate mild TBI from OI, the models have limited clinical utility, and PCS shortly after injury was not reflected in RS FC. While the results of this dissertation provide an important first step in understanding RS fMRI after pediatric mild TBI, more longitudinal research is needed.