Examining Brain Structure after Pediatric Mild Traumatic Brain Injury

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Mild traumatic brain injuries (mTBIs) affect millions of children annually and present a huge burden to the public health care system. mTBIs often lead to emotional, cognitive, and physical difficulties, together known as post concussive symptoms (PCS), which usually resolve within 4 weeks of injury. In up to one third of all mTBI cases, PCS can be longer lasting and are referred to as persistent PCS (PPCS). In the pediatric population, since mTBI occurs when the brain is still developing, it can lead to altered developmental trajectories, and consequently affect children's cognitive functioning, symptomatology, and quality of life. This thesis aimed to use advanced neuroimaging techniques, [i.e., diffusion tensor imaging (DTI), neurite orientation dispersion and density imaging (NODDI), and voxel-based morphometry (VBM)] to study unexamined aspects of brain structure associated with mTBI, PPCS, and neurocognitive outcomes after mTBI. I used DTI and NODDI to examine white matter microstructure after mTBI at different time points after injury in comparison to orthopedic injury (OI) and used VBM to examine cerebellar gray matter volume and its association to neurocognitive outcomes of mTBI. The results revealed: 1) No post-acute differences in brain structure (white matter microstructure or gray matter) between children with mTBI or OI, 2) Age moderated differential trajectories of white matter change, 3- and 6-months post-injury in symptomatic children with mTBI compared to asymptomatic children with mTBI and an OI comparison group, 3) Higher gray matter volume in the motor regions of the cerebellum 3-months after injury in the mTBI compared to the OI group, 4) Disruptions in the association between reaction time and cerebellar volume in children with mTBI. This novel set of studies provides new knowledge about brain structure following pediatric mTBI and has important implications for improving our understanding of neurobiological correlates of pediatric mTBI.
Shukla, A. (2022). Examining brain structure after pediatric mild traumatic brain Injury (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.