Cortical excitability after pediatric mild traumatic brain injury

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dc.contributor.authorSeeger, Trevor A.
dc.contributor.authorKirton, Adam
dc.contributor.authorEsser, Michael J.
dc.contributor.authorGallagher, Clare
dc.contributor.authorDunn, Jeff F.
dc.contributor.authorZewdie, Ephrem Takele
dc.contributor.authorDamji, Omar
dc.contributor.authorCiechanski, Patrick
dc.contributor.authorBarlow, Karen M.
dc.date.accessioned2018-10-31T20:36:55Z
dc.date.available2018-10-31T20:36:55Z
dc.date.issued2016-11-19
dc.description.abstractIntroduction: Mild traumatic brain injury (mTBI) outcomes are variable, and 10e15% may suffer from prolonged symptoms beyond 3 months that impair the child's return to normal activities. Neurophysiological mechanisms of mTBI are incompletely understood, particularly in children, but alterations in cortical excitability have been proposed to underlie post-concussion syndrome. Improved understanding is required to advance interventions and improve outcomes. Objective/Hypothesis: To determine if cortical excitability is altered in children with mTBI, and its association with clinical symptoms. Methods: This was a cross-sectional controlled cohort study. School-aged children (8e18 years) with mTBI were compared to healthy controls. Cortical excitability was measured using multiple TMS paradigms in children with (symptomatic) and without (recovered) persistent symptoms one-month post-injury. Primary outcome was the cortical silent period (cSP), a potential neurophysiological biomarker of GABAergic inhibition. Secondary outcomes included additional TMS neurophysiology, safety and tolerability. Associations between neurophysiology parameters and clinical symptoms were evaluated. Results: Fifty-three children with mTBI (55% male; mean age 14.1 SD: 2.4 years; 35 symptomatic and 27 asymptomatic participants) and 28 controls (46% male; mean age 14.3 SD: 3.1 years) were enrolled. cSP duration was similar between groups (F (2, 73) ¼ 0.55, p ¼ 0.582). Log10 long interval intracortical inhibition (LICI) was reduced in symptomatic participants compared to healthy controls (F (2, 59) ¼ 3.83, p ¼ 0.027). Procedures were well tolerated with no serious adverse events. Conclusions: TMS measures of cortical excitability are altered at one month in children with mTBI. Long interval cortical inhibition is decreased in children who remain symptomatic at one month post-injury.en_US
dc.identifier.citationSeeger, T. A., Kirton A., Esser, M. J., Gallagher, C., Dunn, J. F., Zewdie E. T., ... Barlow K. M. (2017). Cortical excitability after pediatric mild traumatic brain injury. "Brain Stimulation", 10(2), 305-314.en_US
dc.identifier.doi10.1016/j.brs.2016.11.011en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/33901
dc.identifier.issn1935-861X
dc.identifier.urihttp://hdl.handle.net/1880/108941
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.publisher.departmentClinical Neurosciencesen_US
dc.publisher.departmentPaediatricsen_US
dc.publisher.facultyCumming School of Medicineen_US
dc.publisher.policyhttp://www.sherpa.ac.uk/romeo/issn/1935-861X/en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.subjectTranscranial magnetic stimulusen_US
dc.subjectMild traumatic brain injuryen_US
dc.subjectCortical silent perioden_US
dc.subjectPediatricsen_US
dc.subjectLong interval intracortical inhibitionen_US
dc.titleCortical excitability after pediatric mild traumatic brain injuryen_US
dc.typejournal articleen_US
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