Research Reports - Structural abnormality in children with mild traumatic brain injury

Hum Brain Mapp. 2014 Nov 3

Yuan W(1), Wade SL, Babcock L

The traumatic biomechanical forces associated with mild traumatic brain injury
(mTBI) typically impart diffuse, as opposed to focal, brain injury potentially
disrupting the structural connectivity between neural networks. Graph theoretical
analysis using diffusion tensor imaging was used to assess injury-related
differences in structural connectivity between 23 children (age 11-16 years) with
mTBI and 20 age-matched children with isolated orthopedic injuries (OI) scanned
within 96 h postinjury. The distribution of hub regions and the associations
between alterations in regional network measures and symptom burden, as assessed
by the postconcussion symptom scale score (PCSS), were also examined. In
comparison to the OI group, the mTBI group was found to have significantly higher
small-worldness (P < 0.0001), higher normalized clustering coefficients
(P < 0.0001), higher normalized characteristic path length (P = 0.007), higher
modularity (P = 0.0005), and lower global efficiency (P < 0.0001). A series of
hub regions in the mTBI group were found to have significant alterations in
regional network measures including nodal degree, nodal clustering coefficient,
and nodal between-ness centrality. Correlation analysis showed that PCSS total
score acquired at the time of imaging was significantly associated with the nodal
degree of two hubs, the superior frontal gyrus at orbital section and the middle
frontal gyrus. These findings provide new evidence of acute white matter
alteration at both global and regional network level following mTBI in children
furthering our understanding of underlying mechanisms of acute neurological
insult associated with mTBI.

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