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dc.contributor.advisorRiva-Cambrin, Jay
dc.contributor.advisorYeates, Keith
dc.contributor.authorSader, Nicholas
dc.date2021-11
dc.date.accessioned2021-07-19T21:11:06Z
dc.date.available2021-07-19T21:11:06Z
dc.date.issued2021-07-15
dc.identifier.citationSader, N. (2021). Can Quantitative Susceptibility Mapping Help Diagnose and Predict Recovery of Concussion in Children? (Unpublished master's thesis). University of Calgary, Calgary, AB.en_US
dc.identifier.urihttp://hdl.handle.net/1880/113649
dc.description.abstractBackground: Following mild traumatic brain injury (mTBI), also termed concussion, 15-30% of children experience symptoms lasting four weeks or more that reduce their quality of life. Conventional clinical neuroimaging is insensitive to mTBI; however, given the possibility of a neuroinflammatory response following concussion, there is potential for an MRI sequence called quantitative susceptibility mapping (QSM) as a biomarker for injury. In the largest cohort to date, we compared QSM in pediatric concussion patients versus a comparison group of children with orthopedic injuries (OI) and assessed QSM’s performance relative to the current clinical benchmark (5P risk score) for predicting persistent post-concussion symptoms (PPCS). Methods: Children (N=967) aged 8-16.99 years with mTBI or OI were recruited from 5 Canadian pediatric emergency departments. Participants completed QSM at a post-acute assessment (2-33 days post-injury). QSM z-score metrics of susceptibility within 9 regions of interest (ROI) were derived from 371 children (mTBI=255, OI=116). PPCS at 1-month post-injury was defined using reliable change methods. Results: Multivariable linear regression analyses did not reveal a statistically significant difference in susceptibility between mTBI and OI children in any ROI. Multivariable logistic regression analyses revealed increased frontal WM susceptibility was significantly associated with predicting parent-rated reliable change in persistent concussion cognitive symptoms (p=0.001). Frontal WM susceptibility also was nominally significant in a model with all nine regions included (p=0.013). The model with frontal WM and the 5P risk score performed better at predicting parent-rated reliable change in cognitive symptoms than the model with the 5P risk score alone (p=0.002). The area under the curve (AUC) was 0.71(95%CI: 0.62-0.80) for frontal WM susceptibility, 0.67(95%CI: 0.56-0.78) for the 5P risk score, and 0.73(95%CI: 0.64-0.82) for both. Conclusion: We believe this may be the first study to demonstrate a potential imaging biomarker that predicts persistent symptoms using reliable change in children with concussion compared to the current clinical benchmark. Our findings not only suggest a potential neuropathological substrate associated with persistent symptoms, but also highlights the potential for using neuroimaging to assist in the clinical management of concussion in children.en_US
dc.language.isoengen_US
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.en_US
dc.subject.classificationNeuroscienceen_US
dc.subject.classificationEpidemiologyen_US
dc.titleCan Quantitative Susceptibility Mapping Help Diagnose and Predict Recovery of Concussion in Children?en_US
dc.typemaster thesisen_US
dc.publisher.facultyCumming School of Medicineen_US
dc.publisher.institutionUniversity of Calgaryen
thesis.degree.nameMaster of Science (MSc)en_US
thesis.degree.disciplineMedicine – Community Health Sciencesen_US
thesis.degree.grantorUniversity of Calgaryen_US
dc.contributor.committeememberGobbi, David
dc.contributor.committeememberGoodyear, Brad
ucalgary.item.requestcopytrueen_US


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University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.