Ten-year outcome of early childhood traumatic brain injury: Diffusion tensor imaging of the ventral striatum in relation to executive functioning

Abstract

Primary objective: The long-term effects of TBI on verbal fluency and related structures, as well as the relation between cognition and structural integrity, were evaluated. It was hypothesized that the group with TBI would evidence poorer performance on cognitive measures and a decrease in structural integrity.

Research design: Between a paediatric group with TBI and a group of typically-developing children, the long-term effects of traumatic brain injury were investigated in relation to both structural integrity and cognition. Common metrics for diffusion tensor imaging (DTI) were used as indicators of white matter integrity.

Methods and procedures: Using DTI, this study examined ventral striatum (VS) integrity in 21 patients aged 10–18 years sustaining moderate-to-severe traumatic brain injury (TBI) 5–15 years earlier and 16 demographically comparable subjects. All participants completed Delis-Kaplan Executive Functioning System (D-KEFS) sub-tests.

Main outcomes and results: The group with TBI exhibited lower fractional anisotropy (FA) and executive functioning performance and higher apparent diffusion coefficient (ADC). DTI metrics correlated with D-KEFS performance (right VS FA with Inhibition errors, right VS ADC with Letter Fluency, left VS FA and ADC with Category Switching).

Conclusions: TBI affects VS integrity, even in a chronic phase, and may contribute to executive functioning deficits.

Keywords:

• Neuroimaging
• MRI
• paediatric

Declaration of interest

This study was supported by the National Institute of Health grant R21 NS065937 (‘Trauma to Developing Brain: Model Refinement and Therapeutic Intervention’; Levin, PI and Noble, PI). We thank the participants and their families for their participation in this research. The authors report no conflicts of interest. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.