Neurophysiological and diffusion tensor imaging correlates of mild traumatic brain injury in children
Date
2018-07-24
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Abstract
Children typically recover quickly following a mild traumatic brain injury (mTBI), however up to 15% of children continue to experience symptoms past three months post injury. Currently, underlying mechanisms of persistent post-concussive symptoms (PPCS) in children are unknown. The present thesis uses transcranial magnetic stimulation (TMS) and diffusion tensor imaging (DTI) to characterize the structural and functional characteristics of PPCS in 98 children (aged 8-18) with mTBI, over time. The Post-concussive Symptom Inventory (PCSI) was used to classify post-concussive symptoms in participants as symptomatic or asymptomatic. Twenty-six healthy controls were included for comparison. Neurophysiological data assessing cortical inhibition and facilitation were evaluated alongside symptom status. Associations between symptom status and DTI measures of water diffusion and anisotropy were also assessed in the corticospinal tract (CST), motor fibers of the corpus callosum (CC), and uncinate fasciculus (UF). Differences in neurophysiology were noted between healthy controls and children with mTBI in both inhibitory and excitatory TMS paradigms, further differentiating by symptom status. Differences in inhibitory paradigms were also noted over time. Fractional anisotropy (FA) differed as well in the UF, but not in the CST or CC, of symptomatic children compared to controls. No differences in diffusion metrics were observed over time. In summary, these findings suggest an indirect association of neurophysiology and white matter structure in mTBI recovery. Further exploration of neurophysiological and imaging correlates of PPCS are required to improve recovery and treatment outcomes of mTBI.
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Kibng, R. (2018). Neurophysiological and diffusion tensor imaging correlates of mild traumatic brain injury in children (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/32711