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J Neurotrauma. 2016 May 1;33(9):840-52. doi: 10.1089/neu.2015.4012. Epub 2015 Sep 22.

Tensor-Based Morphometry Reveals Volumetric Deficits in Moderate=Severe Pediatric Traumatic Brain Injury.

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1 Imaging Genetics Center, Keck School of Medicine , USC, Marina del Rey, California.
2 Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior , UCLA, Los Angeles, California.
3 Harbor-UCLA Medical Center and Los Angeles BioMedical Research Institute , Department of Pediatrics, Torrance, California.
4 Miller Children's Hospital , Long Beach, California.
5 LAC+USC Medical Center , Department of Pediatrics, Los Angeles, California.
6 UCLA Brain Injury Research Center, Dept of Neurosurgery and Division of Pediatric Neurology, Mattel Children's Hospital , Los Angeles, California.
7 Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology, USC, Marina del Rey, California.
8 Department of Psychology, UCLA, Los Angeles, California.


Traumatic brain injury (TBI) can cause widespread and prolonged brain degeneration. TBI can affect cognitive function and brain integrity for many years after injury, often with lasting effects in children, whose brains are still immature. Although TBI varies in how it affects different individuals, image analysis methods such as tensor-based morphometry (TBM) can reveal common areas of brain atrophy on magnetic resonance imaging (MRI), secondary effects of the initial injury, which will differ between subjects. Here we studied 36 pediatric moderate to severe TBI (msTBI) participants in the post-acute phase (1-6 months post-injury) and 18 msTBI participants who returned for their chronic assessment, along with well-matched controls at both time-points. Participants completed a battery of cognitive tests that we used to create a global cognitive performance score. Using TBM, we created three-dimensional (3D) maps of individual and group differences in regional brain volumes. At both the post-acute and chronic time-points, the greatest group differences were expansion of the lateral ventricles and reduction of the lingual gyrus in the TBI group. We found a number of smaller clusters of volume reduction in the cingulate gyrus, thalamus, and fusiform gyrus, and throughout the frontal, temporal, and parietal cortices. Additionally, we found extensive associations between our cognitive performance measure and regional brain volume. Our results indicate a pattern of atrophy still detectable 1-year post-injury, which may partially underlie the cognitive deficits frequently found in TBI.


MRI; pediatric; tensor based morphometry; traumatic brain injury

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