title: Predictors of personality change due to traumatic brain injury in children and adolescents six to twenty-four months after injury.
abstract: Phenomenology and predictive factors of personality change due to traumatic brain injury (TBI) 6 to 24 months after injury was investigated in children, ages 5 to 14 years, enrolled from consecutive admissions and followed prospectively for 2 years. Injury and preinjury psychosocial variables were assessed. Personality change occurred in 13% of participants between 6 and 12 months after injury and 12% in the second year after injury. Severity of injury consistently predicted personality change, and preinjury adaptive function predicted personality change only in the second year postinjury. Lesions of the superior frontal gyrus were associated with personality change between 6 and 12 months following injury, after controlling for severity of injury and the presence of other brain lesions. Only lesions in the frontal lobe white matter were significantly related to personality change in the second year after injury. After childhood TBI, neural correlates of personality change evolve between 6 and 12 months and 12 to 24 months after injury. The data implicate the dorsal prefrontal cortex and frontal lobe white matter in the emergence of personality change involving the effortful or conscious regulation of affective states.
authors.affiliation: Department of Psychiatry at the University of California, San Diego, CA 92123, USA. jmax@ucsd.edu
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Max
authors.forename: Harvey S
authors.initials: HS
authors.lastname: Levin
authors.forename: Russell J
authors.initials: RJ
authors.lastname: Schachar
authors.forename: Julie
authors.initials: J
authors.lastname: Landis
authors.forename: Ann E
authors.initials: AE
authors.lastname: Saunders
authors.forename: Linda
authors.initials: L
authors.lastname: Ewing-Cobbs
authors.forename: Sandra B
authors.initials: SB
authors.lastname: Chapman
authors.forename: Maureen
authors.initials: M
authors.lastname: Dennis
mesh_terms: D000293:Adolescent; D020208:Brain Injury, Chronic / Q000175:diagnosis* / Q000453:epidemiology / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000293:injuries; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D017063:Outcome Assessment, Health Care; D010552:Personality Assessment; D010554:Personality Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000534:rehabilitation; D017397:Prefrontal Cortex / Q000293:injuries; D011446:Prospective Studies; D012307:Risk Factors