Childhood traumatic brain injury (TBI) affects over 600 000 children per year in the United States. Following TBI, children are vulnerable to deficits in psychosocial adjustment and neurocognition, including social cognition, which persist long-term. They are also susceptible to direct and secondary damage to related brain networks. In this study, we examine whether brain morphometry of the mentalizing network (MN) and theory of mind (ToM; one component of social cognition) mediates the effects of TBI on adjustment. Children with severe TBI (n = 15, Mage = 10.32), complicated mild/moderate TBI (n = 30, Mage = 10.81) and orthopedic injury (OI; n = 42, Mage = 10.65) completed measures of ToM and executive function and underwent MRI; parents rated children's psychosocial adjustment. Children with severe TBI demonstrated reduced right-hemisphere MN volume, and poorer ToM, vs children with OI. Ordinary least-squares path analysis indicated that right-hemisphere MN volume and ToM mediated the association between severe TBI and adjustment. Parallel analyses substituting the central executive network and executive function were not significant, suggesting some model specificity. Children at greatest risk of poor adjustment after TBI could be identified based in part on neuroimaging of social brain networks and assessment of social cognition and thereby more effectively allocate limited intervention resources.

中文翻译：

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儿童时期脑外伤后的心理网络和心理理论介导调节。

在美国，儿童创伤性脑损伤（TBI）每年影响超过60万儿童。进行TBI后，儿童很容易遭受心理社会适应和神经认知（包括社会认知）缺陷的困扰，这种缺陷会长期持续存在。它们还容易受到相关脑网络的直接和继发性损害。在这项研究中，我们研究了心理网络（MN）和心理理论（ToM；社会认知的一个组成部分）的大脑形态是否介导了TBI对调节的影响。患有严重TBI（n = 15，法师= 10.32），复杂的轻度/中度TBI（n = 30，Mage = 10.81）和骨科损伤（OI； n = 42，Mage = 10.65）的儿童完成了ToM和执行功能的测量进行MRI; 父母对孩子的心理适应能力进行了评估。与OI儿童相比，重度TBI儿童表现出右半球MN容量减少，ToM较差。普通最小二乘路径分析表明，右半球的MN体积和ToM介导了严重TBI与调节之间的联系。代替中央执行网络和执行功能的并行分析并不重要，表明存在某些模型特异性。可以部分基于社交脑网络的神经成像和社交认知评估来确定TBI后适应不良风险最大的儿童，从而更有效地分配有限的干预资源。代替中央执行网络和执行功能的并行分析并不重要，表明存在某些模型特异性。可以部分基于社交脑网络的神经成像和社交认知评估来确定TBI后适应不良风险最大的儿童，从而更有效地分配有限的干预资源。替代中央执行网络和执行功能的并行分析并不显着，表明某些模型具有特殊性。可以部分基于社交脑网络的神经成像和社交认知评估来确定TBI后适应不良风险最大的儿童，从而更有效地分配有限的干预资源。