Ten-year outcome of early childhood traumatic brain injury: Diffusion tensor imaging of the ventral striatum in relation to executive functioning.
OBJECTIVE
The long-term effects of TBI on verbal fluency and related structures, as well as the relation between cognition and structural integrity, were evaluated. It was hypothesized that the group with TBI would evidence poorer performance on cognitive measures and a decrease in structural integrity.


METHODS
Between a paediatric group with TBI and a group of typically-developing children, the long-term effects of traumatic brain injury were investigated in relation to both structural integrity and cognition. Common metrics for diffusion tensor imaging (DTI) were used as indicators of white matter integrity.


METHODS
Using DTI, this study examined ventral striatum (VS) integrity in 21 patients aged 10-18 years sustaining moderate-to-severe traumatic brain injury (TBI) 5-15 years earlier and 16 demographically comparable subjects. All participants completed Delis-Kaplan Executive Functioning System (D-KEFS) sub-tests.


RESULTS
The group with TBI exhibited lower fractional anisotropy (FA) and executive functioning performance and higher apparent diffusion coefficient (ADC). DTI metrics correlated with D-KEFS performance (right VS FA with Inhibition errors, right VS ADC with Letter Fluency, left VS FA and ADC with Category Switching).


CONCLUSIONS
TBI affects VS integrity, even in a chronic phase, and may contribute to executive functioning deficits.
a Rice University , Houston , TX , USA.|b Department of Physical Medicine and Rehabilitation.
J
J
Faber
b Department of Physical Medicine and Rehabilitation.|c Department of Neurology.|d Department of Radiology , Baylor College of Medicine , Houston , TX , USA.|e Michael E. DeBakey Veterans Affairs Medical Center , Houston , TX , USA.
E A
EA
Wilde
b Department of Physical Medicine and Rehabilitation.
G
G
Hanten
f Children's Learning Institute and Department of Pediatrics , University of Texas Health Science Center at Houston , Houston , TX , USA.
L
L
Ewing-Cobbs
g Department of Pediatrics , University of Arkansas for Medical Sciences , Little Rock , AR , USA.
M E
ME
Aitken
b Department of Physical Medicine and Rehabilitation.|e Michael E. DeBakey Veterans Affairs Medical Center , Houston , TX , USA.
R
R
Yallampalli
b Department of Physical Medicine and Rehabilitation.
M C
MC
MacLeod
g Department of Pediatrics , University of Arkansas for Medical Sciences , Little Rock , AR , USA.
S H
SH
Mullins
d Department of Radiology , Baylor College of Medicine , Houston , TX , USA.|h Department of Pediatric Radiology , Texas Children's Hospital , Houston , TX , USA.
Z D
ZD
Chu
b Department of Physical Medicine and Rehabilitation.
X
X
Li
b Department of Physical Medicine and Rehabilitation.|d Department of Radiology , Baylor College of Medicine , Houston , TX , USA.|h Department of Pediatric Radiology , Texas Children's Hospital , Houston , TX , USA.
J V
JV
Hunter
i Departments of Neurosurgical Surgery and Physical Therapy and Rehabilitation Science , University of California , San Francisco , CA , USA.
L
L
Noble-Haeusslein
b Department of Physical Medicine and Rehabilitation.|c Department of Neurology.|e Michael E. DeBakey Veterans Affairs Medical Center , Houston , TX , USA.
H S
HS
Levin
D000293:Adolescent; D016880:Anisotropy; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000000981:diagnostic imaging*; D002648:Child; D003072:Cognition Disorders / Q000209:etiology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D013223:Statistics as Topic; D015599:Trauma Severity Indices; D066328:Ventral Striatum / Q000000981:diagnostic imaging* / Q000473:pathology; D014705:Verbal Behavior / Q000502:physiology; D066127:White Matter / Q000000981:diagnostic imaging
MRI; Neuroimaging; paediatric