Pediatric TBI study links mild head injuries with behavioral problems in kids
Prior research has indicated that children who experience a traumatic brain injury might later struggle with behavioral and/or mental health issues, but less is known about the impact of mild TBIs and whether these less serious blows alter structural brain metrics.
Experts with the Del Monte Institute for Neuroscience recently took a deeper look into the effects of mild TBIs by comparing the behavioral data and MRI exams of children who participated in the Adolescence Brain Cognitive Development (ABCD) Study.
“These hits to the head are hard to study because much of it depends on recall of an injury since the impacts do not all require a visit to a doctor,” said Daniel Lopez, from the Department of Neuroscience at the University of Rochester School of Medicine and Dentistry, and co-authors. "But being able to analyze longitudinal data from a large cohort and ask important questions like this gives us valuable information into how a TBI, even a mild one, impacts a developing brain."
The researchers analyzed imaging and behavioral data on more than 11,000 children, 199 of whom had mild TBI and 527 of whom had a possible mild TBI. The analysis revealed that these children were at a 15% increased risk of an emotional or behavioral problem if they had experienced a mild TBI, and 7% increased risk if they had a significant blow to the head that resulted in a possible mild TBI.
On imaging, the experts did not associate a brain region with risk of adverse mental health outcomes s/p mTBI, however, volumetric analysis indicated that 2% to 5% of the total effect of mild TBI on mental health outcomes operated through total cortical volume. Additional image intensity analyses suggested that 2% to 5% of this effect was mediated through the left-hemisphere of the dorsolateral prefrontal cortex.
The experts noted the importance of having an accurate timeframe for when these injuries occur. This study had both strengths and limitations in that respect. While the mental and behavioral health analyses took place at equally spaced intervals (a strength), which provided a longitudinal assessment, there were no baseline imaging data available for comparison from the first year following the injuries.
“The imaging findings potentially reflect a short-term consequence of mTBI rather than a lasting neurological impairment. The decision to restrict the mediation analysis to a single-time point (i.e., a cross-sectional analysis) limits claims of causal inference,” the authors explained.
These shortcomings are, however, being addressed in the long-term ABCD Study as more imaging data become available.
“Additional data is needed to identify meaningful brain mechanisms involved in the development of mental health challenges following mTBI.”
The study abstract can be viewed in the journal NeuroImage.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.