Examining the neural impact of pediatric concussion:  a scoping review of multimodal and integrative approaches using functional and structural MRI techniques.
OBJECTIVE
This study presents the findings from a scoping review of recent, original research investigating changes in brain structure and/or function following pediatric concussion or mild traumatic brain injury (mTBI) using MRI and functional MRI techniques.


RESULTS
Our scoping review identified only five studies, two of which were focused specifically on sports-related concussion. A common finding across studies was that traditional structural methods such as anatomical T1, T2, and even susceptibility-weighted MRI failed to reveal abnormalities in brain structure following pediatric concussion/mTBI. Although data suggest alterations in brain function associated with concussion, correlation with changes in performance is inconsistently found, possibly because of the use of compensatory cerebral mechanisms or alternate pathways while the brain is still dysfunctional.


CONCLUSIONS
In conclusion, the literature describing neuroimaging investigations of pediatric concussion is too scarce to allow the formulation of definitive conclusions regarding the impact of concussion on the developing brain. There is a dire need for longitudinal, multisite investigations focused on a wider age range and recovery period.
Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada. mkeightley@hollandbloorview.ca
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Keightley
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Chen
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Ptito
D000293:Adolescent; D001265:Athletic Injuries / Q000175:diagnosis; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D001924:Brain Concussion / Q000175:diagnosis* / Q000503:physiopathology; D001930:Brain Injuries / Q000175:diagnosis / Q000503:physiopathology; D002648:Child; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*