Head Injury in Children Linked to Reduction in Brain Size and Learning Difficulties - Neuroscience News

Summary: In children, traumatic brain injury can lead to reduced brain size and cognitive impairment that affects learning, researchers report.

Source: Imperial College London

Traumatic brain injury can lead to reduced brain size in some children and teens, which could be linked to cognitive problems, a new study suggests.

People who are hit hard to the head can suffer brain injuries that result in long-term cognitive problems such as difficulty with memory, concentration, and problem solving.

Researchers have been able to study this problem in adults, using brain scans to accurately measure the impact of each injury. However, this is more difficult for children and adolescents to do because their brains grow and change so quickly.

In a new study, published in the journal BrainResearchers at Imperial College London and Great Ormond Street Hospital have collected detailed measurements of the brains of normally developing children and used them as a guide to help spot differences between children with moderate or severe brain injury.

They have found that injury can result in the brain volume of some children being smaller than expected and found that this could be linked to learning and behavior problems.

Study author Dr. Célia Demarchi, from Imperial College London’s Department of Brain Sciences and Great Ormond Street Hospital, said: “When children or adolescents suffer a serious blow to the head, they usually undergo a scan to look for brain injury. Using the results of this study could allow us to start looking at scans for abnormalities in terms of the growth of different areas of the brain. ”

First author Dr. Niall Bourke, formerly of Imperial College London’s Division of Brain Sciences and now based at King’s College London, said, “We know that some children and adolescents who have suffered traumatic brain injuries may continue to have learning or emotional difficulties, but at this time we cannot predict who. who will have problems and who will not. This often means that children and youth who are experiencing difficulties will be delayed in getting the initial support they need.

“To help understand more about this issue, we studied a large group of children and adolescents to see what normally happens to their brain volume as they grow older. This allowed us to find differences in children with brain injury.”

Decreased brain volume after injury

Researchers used MRI scans to make detailed measurements of the brains of more than 1,200 healthy children and young people ages 8 to 22, enabling them to understand normal growth and development of various brain areas.

They compared it to brain scans taken from a group of 39 teenagers, aged between 12 and 16, who had suffered moderate or severe brain injury in the previous month or year. Injuries are usually caused by traffic accidents, falls or sports injuries. The researchers also conducted a series of assessments to test for any cognitive difficulties.

Researchers have been able to study this problem in adults, using brain scans to accurately measure the impact of each injury. Image is in public domain

The researchers found that among 39 teens with brain injuries, 11 had reduced volume in at least one white matter area of ​​their brain and seven had reduced volume in at least one gray matter area of ​​their brain. White matter is made up of “wires” that connect different parts of the brain. Gray matter consists of cell bodies where information is processed and thought takes place.

They also found that adolescents with relatively smaller brain volumes also had problems such as slower mental processing speed, learning difficulties, higher rates of depression, apathy, and anger compared to the healthy group of children.

Among some children without low brain volume, they or their parents reported difficulties in daily functioning, highlighting challenges in meeting the needs of children after injury.

Professor David Sharp, study author from Imperial’s Department of Brain Sciences, added, “The effects of head injuries are complex and vary from person to person. If we can get to the point where precise scanning analysis helps in routine clinical management, it could help us identify why some children and youth are at risk for learning or behavioral difficulties and provide them with additional support or rehabilitation.

“This is very important because the hardships experienced by young people can have a long-lasting impact on their education and subsequent opportunities in adult life.”

About this TBI research and neurodevelopmental news

Author: Emily’s head
Source: Imperial College London
Contact: Emily Head – Imperial College London
Picture: Image is in public domain

Original Research: Open access.
“Brain volume abnormalities and clinical outcome after pediatric traumatic brain injury” by Niall J Bourke et al. Brain

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Abstract

Brain volume abnormalities and clinical outcome after pediatric traumatic brain injury

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Long-term outcomes are difficult to predict after a pediatric traumatic brain injury. The presence or absence of focal brain injury often does not explain the common and disabling cognitive, emotional and behavioral defects.

In adults, traumatic brain injury produces progressive brain atrophy that can be accurately measured and is associated with cognitive decline. However, the effect of pediatric traumatic brain injury on brain volume is more challenging to measure because of its interaction with normal brain development.

Here we report a robust approach for individual estimation of brain volume after pediatric traumatic brain injury and investigate its relationship to clinical outcome.

We first used a large healthy control dataset (n>1200, ages 8–22) to describe the healthy development of the white and gray matter areas through adolescence. Individual estimates of regional gray and white matter volumes were then generated for a group of moderate/severe traumatic brain injury patients who were injured in childhood (n= 39, mean age 13.53 ± 1.76, mean time since injury = 14 months, range 4–168 months) by comparing brain volume in patients with age-matched controls.

Patients were individually classified as having a low or normal brain volume. Neuropsychological and neuropsychiatric outcomes were assessed using standardized testing and parent/guardian assessments.

With respect to head size, gray matter areas decrease in volume during normal juvenile development whereas white matter tracts increase in volume.

Traumatic brain injury interferes with healthy brain development, resulting in a reduction in gray and white matter brain volume after correcting for age. Of the 39 patients investigated, 11 (28%) had at least one reduced volume white matter tract and seven (18%) at least one reduced volume gray matter area.

Those classified as having low brain volume had slower processing speeds compared to healthy controls, emotional disturbances, higher rates of apathy, increased anger and learning difficulties. In contrast, the presence of focal brain injury and microbleeding was not associated with an increased risk of this clinical disorder.

In summary, we show how brain volume abnormalities following pediatric traumatic brain injury can be robustly quantified from T. individual₁ MRI uses a large normative data set that allows the effects of healthy brain development to be controlled.

Using this approach, we demonstrated that volumetric abnormalities were common after moderate/severe traumatic brain injury in the gray and white matter regions, and were associated with higher rates of cognitive, emotional, and behavioral abnormalities common after pediatric traumatic brain injury. .

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