title: Is there evidence for neurodegenerative change following traumatic brain injury in children and youth? A scoping review.
abstract: While generalized cerebral atrophy and neurodegenerative change following traumatic brain injury (TBI) is well recognized in adults, it remains comparatively understudied in the pediatric population, suggesting that research should address the potential for neurodegenerative change in children and youth following TBI. This focused review examines original research findings documenting evidence for neurodegenerative change following TBI of all severities in children and youth. Our relevant inclusion and exclusion criteria identified a total of 16 articles for review. Taken together, the studies reviewed suggest there is evidence for long-term neurodegenerative change following TBI in children and youth. In particular both cross-sectional and longitudinal studies revealed volume loss in selected brain regions including the hippocampus, amygdala, globus pallidus, thalamus, periventricular white matter, cerebellum, and brain stem as well as overall decreased whole brain volume and increased CSF and ventricular space. Diffusion Tensor Imaging (DTI) studies also report evidence for decreased cellular integrity, particularly in the corpus callosum. Sensitivity of the hippocampus and deep limbic structures in pediatric populations are similar to findings in the adult literature and we consider the data supporting these changes as well as the need to investigate the possibility of neurodegenerative onset in childhood associated with mild traumatic brain injury (mTBI).
authors.affiliation: Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital Toronto, ON, Canada ; Department of Occupational Science and Occupational Therapy, University of Toronto Toronto, ON, Canada ; Graduate Department of Rehabilitation Science, University of Toronto ON, Canada ; Department of Psychology, University of Toronto ON, Canada ; Cognitive Neurorehabilitation Sciences, Toronto Rehabilitation Institute Toronto, ON, Canada.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Keightley
authors.affiliation: Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital Toronto, ON, Canada ; Department of Psychology and Division of Neurology, Sickids Hospital for Sick Children Toronto, ON, Canada.
authors.forename: Katia J
authors.initials: KJ
authors.lastname: Sinopoli
authors.affiliation: Division of Brain, Imaging and Behaviour - Systems Neuroscience, Toronto Western Research Institute, University Health Network Toronto, ON, Canada ; Department of Surgery and Institute of Medical Science, University of Toronto Toronto, ON, Canada.
authors.forename: Karen D
authors.initials: KD
authors.lastname: Davis
authors.affiliation: Division of Brain, Imaging and Behaviour - Systems Neuroscience, Toronto Western Research Institute, University Health Network Toronto, ON, Canada.
authors.forename: David J
authors.initials: DJ
authors.lastname: Mikulis
authors.affiliation: Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network and University of Toronto Toronto, ON, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Wennberg
authors.affiliation: Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network and University of Toronto Toronto, ON, Canada.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Tartaglia
authors.affiliation: Neuropsychology/Cognitive Neuroscience Unit, Montreal Neurological Institute Montreal, QC, Canada.
authors.forename: Jen-Kai
authors.initials: JK
authors.lastname: Chen
authors.affiliation: Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network and University of Toronto Toronto, ON, Canada.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Tator
keywords: magnetic resonance imaging; neurodegeneration; traumatic brain injury