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Ryan NP, Koester D, Crossley L, Botchway E, Hearps S, Catroppa C, Anderson V. Delineating the impact of childhood traumatic brain injury (TBI) on long-term depressive symptom severity: Does sub-acute brain morphometry prospectively predict 2-year outcome? Neuroimage Clin 2024; 41:103565. [PMID: 38241755 PMCID: PMC10831307 DOI: 10.1016/j.nicl.2024.103565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/25/2023] [Accepted: 01/08/2024] [Indexed: 01/21/2024]
Abstract
Despite evidence of a link between childhood TBI and heightened risk for depressive symptoms, very few studies have examined early risk factors that predict the presence and severity of post-injury depression beyond 1-year post injury. This longitudinal prospective study examined the effect of mild-severe childhood TBI on depressive symptom severity at 2-years post-injury. It also evaluated the potential role of sub-acute brain morphometry and executive function (EF) in prospectively predicting these long-term outcomes. The study involved 81 children and adolescents with TBI, and 40 age-and-sex matched typically developing (TD) controls. Participants underwent high-resolution structural magnetic resonance imaging (MRI) sub-acutely at five weeks post-injury (M = 5.55; SD = 3.05 weeks) and EF assessments were completed at 6-months post-injury. Compared to TD controls, the TBI group had significantly higher overall internalizing symptoms and were significantly more likely to exhibit clinically significant depressive symptoms at 2-year follow-up. The TBI group also displayed significantly lower EF and altered sub-acute brain morphometry in EF-related brain networks, including the default-mode network (DMN), salience network (SN) and central executive network (CEN). Mediation analyses revealed significant indirect effects of CEN morphometry on depression symptom severity, such that lower EF mediated the prospective association between altered CEN morphometry and higher depression symptoms in the TBI group. Parallel mediation analyses including grey matter morphometry of a non-EF brain network (i.e., the mentalising network) were not statistically significant, suggesting some model specificity. The findings indicate that screening for early neurostructural and neurocognitive risk factors may help identify children at elevated risk of depressive symptoms following TBI. For instance, children at greatest risk of post-injury depression symptoms could be identified based in part on neuroimaging of networks implicated in EF and post-acute assessments of executive function, which could support more effective allocation of limited intervention resources.
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Affiliation(s)
- Nicholas P Ryan
- School of Psychology, Deakin University, 221 Burwood Highway, Burwood 3125, Victoria, Australia; Brain & Mind Research, Murdoch Children's Research Institute, 50 Flemington Road, Parkville 3052, Victoria, Australia; Psychology Service, Royal Children's Hospital, Murdoch Children's Research Institute, 50 Flemington Road, Parkville 3052, Victoria, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Road, Parkville 3052, Victoria, Australia.
| | - Dawn Koester
- School of Psychology, Deakin University, 221 Burwood Highway, Burwood 3125, Victoria, Australia
| | - Louise Crossley
- Brain & Mind Research, Murdoch Children's Research Institute, 50 Flemington Road, Parkville 3052, Victoria, Australia
| | - Edith Botchway
- Brain & Mind Research, Murdoch Children's Research Institute, 50 Flemington Road, Parkville 3052, Victoria, Australia
| | - Stephen Hearps
- Brain & Mind Research, Murdoch Children's Research Institute, 50 Flemington Road, Parkville 3052, Victoria, Australia
| | - Cathy Catroppa
- Brain & Mind Research, Murdoch Children's Research Institute, 50 Flemington Road, Parkville 3052, Victoria, Australia; Psychology Service, Royal Children's Hospital, Murdoch Children's Research Institute, 50 Flemington Road, Parkville 3052, Victoria, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Road, Parkville 3052, Victoria, Australia
| | - Vicki Anderson
- Brain & Mind Research, Murdoch Children's Research Institute, 50 Flemington Road, Parkville 3052, Victoria, Australia; Psychology Service, Royal Children's Hospital, Murdoch Children's Research Institute, 50 Flemington Road, Parkville 3052, Victoria, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Road, Parkville 3052, Victoria, Australia
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Ryan NP, Catroppa C, Ward SC, Yeates KO, Crossley L, Hollenkamp M, Hearps S, Beauchamp MH, Anderson VA. Association of neurostructural biomarkers with secondary attention-deficit/hyperactivity disorder (ADHD) symptom severity in children with traumatic brain injury: a prospective cohort study. Psychol Med 2023; 53:5291-5300. [PMID: 36004807 PMCID: PMC10476057 DOI: 10.1017/s0033291722002598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 07/11/2022] [Accepted: 07/22/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Despite a well-established link between childhood traumatic brain injury (TBI) and elevated secondary attention-deficit/hyperactivity disorder (s-ADHD) symptomology, the neurostructural correlates of these symptoms are largely unknown. Based on the influential 'triple-network model' of ADHD, this prospective longitudinal investigation aimed to (i) assess the effect of childhood TBI on brain morphometry of higher-order cognitive networks proposed to play a key role in ADHD pathophysiology, including the default-mode network (DMN), salience network (SN) and central executive network (CEN); and (ii) assess the independent prognostic value of DMN, SN and CEN morphometry in predicting s-ADHD symptom severity after childhood TBI. METHODS The study sample comprised 155 participants, including 112 children with medically confirmed mild-severe TBI ascertained from consecutive hospital admissions, and 43 typically developing (TD) children matched for age, sex and socio-economic status. High-resolution structural brain magnetic resonance imaging (MRI) sequences were acquired sub-acutely in a subset of 103 children with TBI and 34 TD children. Parents completed well-validated measures of ADHD symptom severity at 12-months post injury. RESULTS Relative to TD children and those with milder levels of TBI severity (mild, complicated mild, moderate), children with severe TBI showed altered brain morphometry within large-scale, higher-order cognitive networks, including significantly diminished grey matter volumes within the DMN, SN and CEN. When compared with the TD group, the TBI group showed significantly higher ADHD symptomatology and higher rates of clinically elevated symptoms. In multivariable models adjusted for other well-established risk factors, altered DMN morphometry independently predicted higher s-ADHD symptomatology at 12-months post-injury, whilst SN and CEN morphometry were not significant independent predictors. CONCLUSIONS Our prospective study findings suggest that neurostructural alterations within higher-order cognitive circuitry may represent a prospective risk factor for s-ADHD symptomatology at 12-months post-injury in children with TBI. High-resolution structural brain MRI has potential to provide early prognostic biomarkers that may help early identification of high-risk children with TBI who are likely to benefit from early surveillance and preventive measures to optimise long-term neuropsychiatric outcomes.
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Affiliation(s)
- Nicholas P. Ryan
- Cognitive Neuroscience Unit, Deakin University, Geelong, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Australia
| | - Cathy Catroppa
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Australia
| | | | - Keith Owen Yeates
- Department of Psychology, Hotchkiss Brain Institute, and Alberta Children's Hospital Research Institute, The University of Calgary, Calgary, Alberta, Canada
| | - Louise Crossley
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | | | - Stephen Hearps
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Miriam H. Beauchamp
- Department of Psychology, University of Montreal, Montreal, Canada
- Ste-Justine Research Center, Montreal, Quebec, Canada
| | - Vicki A. Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Australia
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Arioli M, Cattaneo Z, Parimbelli S, Canessa N. Relational vs representational social cognitive processing: a coordinate-based meta-analysis of neuroimaging data. Soc Cogn Affect Neurosci 2023; 18:7003414. [PMID: 36695428 PMCID: PMC9976764 DOI: 10.1093/scan/nsad003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 06/30/2022] [Accepted: 01/24/2023] [Indexed: 01/26/2023] Open
Abstract
The neurocognitive bases of social cognition have been framed in terms of representing others' actions through the mirror system and their mental states via the mentalizing network. Alongside representing another person's actions or mental states, however, social cognitive processing is also shaped by their (mis)match with one's own corresponding states. Here, we addressed the distinction between representing others' states through the action observation or mentalizing networks (i.e. representational processing) and detecting the extent to which such states align with one's own ones (i.e. relational processing, mediated by social conflict). We took a meta-analytic approach to unveil the neural bases of both relational and representational processing by focusing on previously reported brain activations from functional magnetic resonance imaging studies using false-belief and action observation tasks. Our findings suggest that relational processing for belief and action states involves, respectively, the left and right temporo-parietal junction, likely contributing to self-other differentiation. Moreover, distinct sectors of the posterior fronto-medial cortex support social conflict processing for belief and action, possibly through the inhibition of conflictual representations. These data might pave the way for further studies addressing social conflict as an important component of normal and pathological processing, and inform the design of rehabilitative treatments for social deficits.
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Affiliation(s)
- Maria Arioli
- Department of Human and Social Sciences, University of Bergamo, Bergamo 24100, Italy
| | - Zaira Cattaneo
- Department of Human and Social Sciences, University of Bergamo, Bergamo 24100, Italy.,IRCCS Mondino Foundation, Pavia 27100, Italy
| | - Simone Parimbelli
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Superiore IUSS, Pavia 27100, Italy
| | - Nicola Canessa
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Superiore IUSS, Pavia 27100, Italy.,Istituti Clinici Scientifici Maugeri IRCCS, Cognitive Neuroscience Laboratory of Pavia Institute, Pavia 27100, Italy
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4
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Social Functioning and Autistic Behaviors in Youth Following Acquired Brain Injury. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111648. [PMID: 36360376 PMCID: PMC9688193 DOI: 10.3390/children9111648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/17/2022] [Accepted: 10/25/2022] [Indexed: 01/25/2023]
Abstract
Children and adolescents who survive the pediatric intensive care unit (PICU) with an acquired brain injury (ABI) often demonstrate a variety of physical, cognitive, emotional/behavioral, and social sequelae termed post-intensive care syndrome (PICS). Social communication and interaction challenges have also been observed clinically, and there is growing literature documenting these occurrences in youth following ABI. The extent of these social changes varies among patients, and a subset of patients go on to exhibit social and behavioral profiles closely resembling those of autistic youth. We reviewed empirical research regarding social functioning in youth following ABI, as well as the overlap between individuals with ABI and autistic youth, published from January 2009 to August 2022 on PubMed and Scopus databases. Clinical case examples from a well-established post-PICU follow-up program are also provided to exemplify the complexity of this phenomenon.
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Fu X, Hung A, de Silva AD, Busch T, Mattson WI, Hoskinson KR, Taylor HG, Nelson EE. Development of the mentalizing network structures and theory of mind in extremely preterm youth. Soc Cogn Affect Neurosci 2022; 17:977-985. [PMID: 35428893 PMCID: PMC9629469 DOI: 10.1093/scan/nsac027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 03/10/2022] [Accepted: 04/15/2022] [Indexed: 01/12/2023] Open
Abstract
Adolescents born preterm (<37 weeks of gestation) are at elevated risk for deficits in social cognition and peer relationships. Theory of Mind (ToM) is a complex form of social cognition important for regulating social interactions. ToM and the underlying mentalizing network continue to develop across adolescence. The present study recruited 48 adolescents (12-17 years old) who were either born extremely preterm (EPT; <28 weeks of gestation) or full-term (FT) at birth. Cortical thickness, gray matter volume and surface area were measured in four regions of the mentalizing network: the temporoparietal junction, anterior temporal cortex, posterior superior temporal sulcus and frontal pole (mBA10). We also assessed the adolescents' performance on a ToM task. Findings revealed both group differences and group-by-age interaction effects in the gray matter indices within the temporal lobe regions of the mentalizing network. The EPT group also performed significantly worse than the FT group on the ToM task. The cortical structural measures that discriminated the EPT and FT groups were not related to ToM performance. These results highlight altered developmental changes in brain regions underlying mentalizing functions in EPT adolescents relative to FT controls.
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Affiliation(s)
- Xiaoxue Fu
- Correspondence should be addressed to Xiaoxue Fu, Department of Psychology, University of South Carolina, 129 Institute for Mind and Brain, 1800 Gervais Street, Columbia, SC 29201, USA. E-mail:
| | - Andy Hung
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43205, USA
| | - Aryanne D de Silva
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43205, USA
| | - Tyler Busch
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43205, USA
| | - Whitney I Mattson
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43205, USA
| | - Kristen R Hoskinson
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43205, USA,Department of Pediatrics, Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Hudson Gerry Taylor
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43205, USA,Department of Pediatrics, Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Eric E Nelson
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43205, USA,Department of Pediatrics, Ohio State University College of Medicine, Columbus, OH 43210, USA
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Chai WJ, Abd Hamid AI, Omar H, Abdul Rahman MR, Fitzrol DN, Idris Z, Ghani ARI, Wan Mohamad WNA, Mustafar F, Hanafi MH, Kandasamy R, Abdullah MZ, Amaruchkul K, Valdes-Sosa PA, Bringas-Vega ML, Biswal B, Songsiri J, Yaacob H, Ibrahim H, Sumari P, Noh NA, Musa KI, Ahmad AH, Azman A, Jamir Singh PS, Othman A, Abdullah JM. Neural alterations in working memory of mild-moderate TBI: An fMRI study in Malaysia. J Neurosci Res 2022; 100:915-932. [PMID: 35194817 DOI: 10.1002/jnr.25023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 10/10/2021] [Accepted: 12/31/2021] [Indexed: 02/05/2023]
Abstract
Working memory (WM) encompasses crucial cognitive processes or abilities to retain and manipulate temporary information for immediate execution of complex cognitive tasks in daily functioning such as reasoning and decision-making. The WM of individuals sustaining traumatic brain injury (TBI) was commonly compromised, especially in the domain of WM. The current study investigated the brain responses of WM in a group of participants with mild-moderate TBI compared to their healthy counterparts employing functional magnetic resonance imaging. All consented participants (healthy: n = 26 and TBI: n = 15) performed two variations of the n-back WM task with four load conditions (0-, 1-, 2-, and 3-back). The respective within-group effects showed a right hemisphere-dominance activation and slower reaction in performance for the TBI group. Random-effects analysis revealed activation difference between the two groups in the right occipital lobe in the guided n-back with cues, and in the bilateral occipital lobe, superior parietal region, and cingulate cortices in the n-back without cues. The left middle frontal gyrus was implicated in the load-dependent processing of WM in both groups. Further group analysis identified that the notable activation changes in the frontal gyri and anterior cingulate cortex are according to low and high loads. Though relatively smaller in scale, this study was eminent as it clarified the neural alterations in WM in the mild-moderate TBI group compared to healthy controls. It confirmed the robustness of the phenomenon in TBI with the reproducibility of the results in a heterogeneous non-Western sample.
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Affiliation(s)
- Wen Jia Chai
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Aini Ismafairus Abd Hamid
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Hazim Omar
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Muhammad Riddha Abdul Rahman
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,School of Medical Imaging, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Nerus, Malaysia
| | - Diana Noma Fitzrol
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Zamzuri Idris
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Abdul Rahman Izaini Ghani
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Wan Nor Azlen Wan Mohamad
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Faiz Mustafar
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Muhammad Hafiz Hanafi
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | | | - Mohd Zaid Abdullah
- School of Electrical and Electronic Engineering, Universiti Sains Malaysia, Nibong Tebal, Malaysia
| | - Kannapha Amaruchkul
- Graduate School of Applied Statistics, National Institute of Development Administration (NIDA), Bangkok, Thailand
| | - Pedro A Valdes-Sosa
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.,The Cuban Neurosciences Center, La Habana, Cuba
| | - Maria L Bringas-Vega
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.,The Cuban Neurosciences Center, La Habana, Cuba
| | - Bharat Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA
| | - Jitkomut Songsiri
- EE410 Control Systems Laboratory, Department of Electrical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
| | - Hamwira Yaacob
- Department of Computer Science, Kulliyyah of Information and Communication Technology, Kuala Lumpur, International Islamic University Malaysia, Kuala Lumpur, Malaysia
| | - Haidi Ibrahim
- Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,School of Electrical and Electronic Engineering, Universiti Sains Malaysia, Nibong Tebal, Malaysia
| | - Putra Sumari
- School of Computer Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Nor Azila Noh
- Department of Medical Science 1, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Asma Hayati Ahmad
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Azlinda Azman
- School of Medical Imaging, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Nerus, Malaysia.,School of Social Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | | | - Azizah Othman
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Jafri Malin Abdullah
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kota Bharu, Malaysia
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Ryan NP, Catroppa C, Hughes N, Painter FL, Hearps S, Beauchamp MH, Anderson VA. Executive function mediates the prospective association between neurostructural differences within the central executive network and anti-social behavior after childhood traumatic brain injury. J Child Psychol Psychiatry 2021; 62:1150-1161. [PMID: 33624844 DOI: 10.1111/jcpp.13385] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Despite increasing evidence of a link between early life brain injury and anti-social behavior, very few studies have assessed factors that explain this association in children with traumatic brain injury (TBI). One hypothesis suggests that childhood TBI elevates risk for anti-social behavior via disruption to anatomically distributed neural networks implicated in executive functioning (EF). In this longitudinal prospective study, we employed high-resolution structural neuroimaging to (a) evaluate the impact of childhood TBI on regional morphometry of the central executive network (CEN) and (b) evaluate the prediction that lower EF mediates the prospective relationship between structural differences within the CEN and postinjury anti-social behaviors. METHODS This study involved 155 children, including 112 consecutively recruited, hospital-confirmed cases of mild-severe TBI and 43 typically developing control (TDC) children. T1-weighted brain magnetic resonance imaging (MRI) sequences were acquired sub-acutely in a subset of 137 children [TBI: n = 103; TDC: n = 34]. All participants were evaluated using direct assessment of EF 6 months postinjury, and parents provided ratings of anti-social behavior 12 months postinjury. RESULTS Severe TBI was associated with postinjury volumetric differences within the CEN and its putative hub regions. When compared with TD controls, the TBI group had significantly worse EF, which was associated with more frequent anti-social behaviors and abnormal CEN morphometry. Mediation analysis indicated that reduced EF mediated the prospective association between postinjury volumetric differences within the CEN and more frequent anti-social behavior. CONCLUSIONS Our longitudinal prospective findings suggest that detection of neurostructural abnormalities within the CEN may aid in the early identification of children at elevated risk for postinjury executive dysfunction, which may in turn contribute to chronic anti-social behaviors after early life brain injury. Findings underscore the potential value of early surveillance and preventive measures for children presenting with neurostructural and/or neurocognitive risk factors.
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Affiliation(s)
- Nicholas P Ryan
- School of Psychology, Deakin University, Geelong, Vic., Australia.,Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - Cathy Catroppa
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - Nathan Hughes
- Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | | | - Stephen Hearps
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal, Montreal, QC, Canada.,Research Centre, Ste-Justine Hospital, Montreal, QC, Canada
| | - Vicki A Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
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Bigler ED, Allder S. Improved neuropathological identification of traumatic brain injury through quantitative neuroimaging and neural network analyses: Some practical approaches for the neurorehabilitation clinician. NeuroRehabilitation 2021; 49:235-253. [PMID: 34397432 DOI: 10.3233/nre-218023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Quantitative neuroimaging analyses have the potential to provide additional information about the neuropathology of traumatic brain injury (TBI) that more thoroughly informs the neurorehabilitation clinician. OBJECTIVE Quantitative neuroimaging is typically not covered in the standard radiological report, but often can be extracted via post-processing of clinical neuroimaging studies, provided that the proper volume acquisition sequences were originally obtained. METHODS Research and commercially available quantitative neuroimaging methods provide region of interest (ROI) quantification metrics, lesion burden volumetrics and cortical thickness measures, degree of focal encephalomalacia, white matter (WM) abnormalities and residual hemorrhagic pathology. If present, diffusion tensor imaging (DTI) provides a variety of techniques that aid in evaluating WM integrity. Using quantitatively identified structural and ROI neuropathological changes are most informative when done from a neural network approach. RESULTS Viewing quantitatively identifiable damage from a neural network perspective provides the neurorehabilitation clinician with an additional tool for linking brain pathology to understand symptoms, problems and deficits as well as aid neuropsychological test interpretation. All of these analyses can be displayed in graphic form, including3-D image analysis. A case study approach is used to demonstrate the utility of quantitative neuroimaging and network analyses in TBI. CONCLUSIONS Quantitative neuroimaging may provide additional useful information for the neurorehabilitation clinician.
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Affiliation(s)
- Erin D Bigler
- Department of Neurology and Psychiatry, University of Utah, Salt Lake City, UT, USA.,Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT, USA.,Department of Neurology, University of California-Davis, Sacramento, CA, USA
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Ryan NP, Anderson VA, Bigler ED, Dennis M, Taylor HG, Rubin KH, Vannatta K, Gerhardt CA, Stancin T, Beauchamp MH, Hearps S, Catroppa C, Yeates KO. Delineating the Nature and Correlates of Social Dysfunction after Childhood Traumatic Brain Injury Using Common Data Elements: Evidence from an International Multi-Cohort Study. J Neurotrauma 2020; 38:252-260. [PMID: 32883163 DOI: 10.1089/neu.2020.7057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Although childhood traumatic brain injury (TBI) has been linked to heightened risk of impaired social skills and behavior, current evidence is weakened by small studies of variable methodological quality. To address these weaknesses, this international multi-cohort study involved synthesis of data from two large observational cohort studies of complicated mild-severe child TBI in Australia and North America. Both studies adopted a unified approach to data collection and coding procedures, providing the opportunity to merge datasets from multiple, well-characterized cohorts for which gold standard measures of social outcomes were collected during the chronic recovery phase. The study involved 218 children, including 33 children with severe TBI, 83 children with complicated mild-moderate TBI, 59 children with orthopedic injury, and 43 age- and sex-matched typically developing control children. All injured children were recruited from academic children's hospitals and underwent direct cognitive assessments including measures of theory of mind (ToM) at least 1-year post- injury. Parents rated their child's social adjustment using standardized measures of social skills, communication and behavior. Results showed a brain-injury specific effect on ToM abilities, such that children with both complicated mild to moderate and severe TBI displayed significantly poorer ToM than children without TBI. In mediator models, poorer ToM predicted poorer parent-rated self-direction and social skills, as well as more frequent behavioral symptoms. The ToM mediated the effect of severe TBI on parent ratings of communication and social skills, as well as on overall behavior symptoms. The findings suggest that deficits in ToM are evident across the spectrum of TBI severity and represent one mechanism linking severe child TBI to long-term social adjustment difficulties. The findings underscore the value of large-scale data harmonization projects to increase the quality of evidence regarding the outcomes of TBI. Clinical and scientific implications are discussed.
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Affiliation(s)
- Nicholas P Ryan
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Cognitive Neuroscience Unit, Deakin University, Geelong, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Victoria, Australia
| | - Vicki A Anderson
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Victoria, Australia
- Psychology, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Erin D Bigler
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Maureen Dennis
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - H Gerry Taylor
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics and Psychology, The Ohio State University, Columbus, Ohio, USA
- Rainbow Babies and Children's Hospital, University Hospitals Cleveland Medical Centre, Cleveland, Ohio, USA
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA
| | - Kenneth H Rubin
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, USA
| | - Kathryn Vannatta
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics and Psychology, The Ohio State University, Columbus, Ohio, USA
| | - Cynthia A Gerhardt
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics and Psychology, The Ohio State University, Columbus, Ohio, USA
| | - Terry Stancin
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Pediatrics, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
- Research Centre, Ste-Justine Hospital, Montreal, Quebec, Canada
| | - Stephen Hearps
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Cathy Catroppa
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Victoria, Australia
| | - Keith Owen Yeates
- Department of Psychology, Alberta Children's Hospital Research Institute, and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
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