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White matter microstructure predicts longitudinal social cognitive outcomes after paediatric traumatic brain injury: a diffusion tensor imaging study

Published online by Cambridge University Press:  07 August 2017

N. P. Ryan ,
S. Genc ,
M. H. Beauchamp ,
K. O. Yeates ,
S. Hearps ,
C. Catroppa ,
V. A. Anderson  and
T. J. Silk
N. P. Ryan*
Affiliation:
Australian Centre for Child Neuropsychological Studies, Murdoch Children's Research Institute, Melbourne, Australia Department of Psychology, Royal Children's Hospital, Melbourne, Australia Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
S. Genc
Affiliation:
Developmental Imaging, Murdoch Childrens Research Institute, Melbourne, Australia Department of Paediatrics, University of Melbourne, Melbourne, Australia
M. H. Beauchamp
Affiliation:
Department of Psychology, University of Montreal, Montreal, Canada Ste-Justine Research Center, Montreal, Quebec, Canada
K. O. Yeates
Affiliation:
Department of Psychology, Hotchkiss Brain Institute, Calgary, Alberta, Canada Alberta Children's Hospital Research Institute, The University of Calgary, Calgary, Alberta, Canada
S. Hearps
Affiliation:
Australian Centre for Child Neuropsychological Studies, Murdoch Children's Research Institute, Melbourne, Australia
C. Catroppa
Affiliation:
Australian Centre for Child Neuropsychological Studies, Murdoch Children's Research Institute, Melbourne, Australia Department of Psychology, Royal Children's Hospital, Melbourne, Australia Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
V. A. Anderson
Affiliation:
Australian Centre for Child Neuropsychological Studies, Murdoch Children's Research Institute, Melbourne, Australia Department of Psychology, Royal Children's Hospital, Melbourne, Australia Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia Department of Paediatrics, University of Melbourne, Melbourne, Australia
T. J. Silk
Affiliation:
Developmental Imaging, Murdoch Childrens Research Institute, Melbourne, Australia Department of Paediatrics, University of Melbourne, Melbourne, Australia
*
*Address for correspondence: N. P. Ryan, BA (Hons.) MPsych (Neuro), Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Parkville 3052, Australia. (Email: nicholas.ryan@unimelb.edu.au)
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Abstract

Background

Deficits in social cognition may be among the most profound and disabling sequelae of paediatric traumatic brain injury (TBI); however, the neuroanatomical correlates of longitudinal outcomes in this domain remain unexplored. This study aimed to characterize social cognitive outcomes longitudinally after paediatric TBI, and to evaluate the use of sub-acute diffusion tensor imaging (DTI) to predict these outcomes.

Methods

The sample included 52 children with mild complex-severe TBI who were assessed on cognitive theory of mind (ToM), pragmatic language and affective ToM at 6- and 24-months post-injury. For comparison, 43 typically developing controls (TDCs) of similar age and sex were recruited. DTI data were acquired sub-acutely (mean = 5.5 weeks post-injury) in a subset of 65 children (TBI = 35; TDC = 30) to evaluate longitudinal prospective relationships between white matter microstructure assessed using Tract-Based Spatial Statistics and social cognitive outcomes.

Results

Whole brain voxel-wise analysis revealed significantly higher mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) in the sub-acute TBI group compared with TDC, with differences observed predominantly in the splenium of the corpus callosum (sCC), sagittal stratum (SS), dorsal cingulum (DC), uncinate fasciculus (UF) and middle and superior cerebellar peduncles (MCP & SCP, respectively). Relative to TDCs, children with TBI showed poorer cognitive ToM, affective ToM and pragmatic language at 6-months post-insult, and those deficits were related to abnormal diffusivity of the sCC, SS, DC, UF, MCP and SCP. Moreover, children with TBI showed poorer affective ToM and pragmatic language at 24-months post-injury, and those outcomes were predicted by sub-acute alterations in diffusivity of the DC and MCP.

Conclusions

Abnormal microstructure within frontal-temporal, limbic and cerebro-cerebellar white matter may be a risk factor for long-term social difficulties observed in children with TBI. DTI may have potential to unlock early prognostic markers of long-term social outcomes.

Keywords

Brain injurieschildhooddiffusion tensor imagingsocial cognitiontheory of mind
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 4 , March 2018 , pp. 679 - 691
Copyright
Copyright © Cambridge University Press 2017 

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