Do lesion site and severity predict deficits in attentional control after preschool traumatic brain injury (TBI)?

Abstract

Primary objective: To determine the predictive value of structural neuroimaging in the clinical setting following TBI.

Research design: Prospective between-group design, comparing groups with regard to: (i) the presence or absence of cerebral pathology and (ii) the location of cerebral pathology. The predictive value of injury variables was investigated using hierarchical regressions.

Methods and procedures: Thirty-six children, between 6 and 14 years, who sustained a moderate to severe TBI 5 years previously participated in this study. Children's performances on five measures of attentional control were examined in relation to the presence, location and severity of their lesions, as coded by the Coffey classification system .

Main outcomes and results: Frontal lesion severity was not predictive of performance on any of the measures. However, generalized (frontal and extrafrontal) and extrafrontal lesion severity was predictive of poor performance.

Conclusions: These findings support the argument that functional organization in children may differ from that in adults, suggesting that multiple cerebral regions, or a diffuse cerebral network, may mediate children's executive functions (EF). Results are also consistent with the hypothesis that the amount of damaged brain tissue, rather than its location, may be more predictive of neurobehavioural outcome following early TBI.

• Child
• traumatic brain injury
• MRI
• lesion location
• severity
• executive function
• attention