% 0期刊文章%安德鲁·R·梅耶% b盖。迈耶% b安德鲁。多德% Cidney R . Robertson-Benta大卫·D·斯蒂芬森% %一个约瑟夫·m·凌% Sharvani Pabbathi Reddy %一个基肖尔Vakamudi瓦迪姆Zotev % %一个罗伯特·e·理查德·A·坎贝尔% % b埃里克。Erhardt %智慧约翰·p·菲利普斯%安德烈·A·Vakhtin % T前瞻性研究小儿轻度创伤性脑损伤后的灰质萎缩2023% % D / WNL 10.1212 R。0000000000201470 % J首页神经病学% P e516-e527 % V 100% N 5% X背景和目标的临床过程和生理时间复苏后小儿轻度创伤性脑损伤(pmTBI)仍然积极讨论。当前研究的主要目标是前瞻性研究(皮质厚度和皮层下卷)大脑的结构变化和age-at-injury效果。先天的研究假说预测皮质厚度和海马体积减少到4个月受伤后这将是反向与年龄相关的伤害。方法前瞻性群组研究设计与连续招聘。康复医学的研究包括改编自美国国会(上阈值)和苏黎世脑震荡运动组(最小阈值),紧急部门和紧急护理临床医生诊断。主要的神经、精神或发育障碍被排除。临床(通用数据元素)和结构(3 T MRI)评估在11天内(亚急性访问(SA))和4个月postinjury(早期慢性访问(EC))。年龄和sex-matched健康对照组(HC)控制重复测试/神经发育。临床结果基于自我报告和认知测试。结构性图像量化FreeSurfer(安装7.1.1版本)。结果共有208名患者pmTBI(= 14.4±2.9岁; 40.4% female) and 176 HC (age = 14.2 ± 2.9; 42.0% female) were included in the final analyses (>80% retention). Reduced cortical thickness (right rostral middle frontal gyrus; d = −0.49) and hippocampal volumes (d = −0.24) observed for pmTBI, but not associated with age at injury. Hippocampal volume recovery was mediated by loss of consciousness/posttraumatic amnesia. Significantly greater postconcussive symptoms and cognitive deficits were observed at SA and EC visits, but were not associated with the structural abnormalities. Structural abnormalities slightly improved balanced classification accuracy above and beyond clinical gold standards (∆+3.9%), with a greater increase in specificity (∆+7.5%) relative to sensitivity (∆+0.3%).Discussion Current findings indicate that structural brain abnormalities may persist up to 4 months post-pmTBI and are partially mediated by initial markers of injury severity. These results contribute to a growing body of evidence suggesting prolonged physiologic recovery post-pmTBI. In contrast, there was no evidence for age-at-injury effects or physiologic correlates of persistent symptoms in our sample.AFNI=Analysis of Functional NeuroImages; EC=early chronic; GEE=generalized estimating equation; GM=gray matter; HC=healthy controls; LOC=loss of consciousness; PCS=postconcussive symptoms; PCSI=Post-Concussion Symptom Inventory; pmTBI=pediatric mild traumatic brain injury; PPCS=persistent PCS; PTA=posttraumatic amnesia; ROI=region of interest; SA=subacute %U //www.ez-admanager.com/content/neurology/100/5/e516.full.pdf