Studies of brain morphometry may illuminate the effects of pediatric mild traumatic brain injury (TBI; e.g., concussion). However, no published studies have examined cortical thickness in the early injury phases of pediatric mild TBI using an appropriate comparison group. The current study used an automated approach (i.e., FreeSurfer) to determine whether cortical thickness differed in children following a mild TBI or a mild orthopedic injury (OI), and to examine whether post-acute cortical thickness predicted post-acute and chronic post-concussive symptoms (PCS). Children ages 8.00-16.99 years with mild TBI (n = 136) or OI (n = 70) were recruited at emergency department visits to two children's hospitals, during which parents rated children's pre-injury symptoms retrospectively. Children completed a post-acute (3–24 days post-injury) assessment, which included a 3 Tesla MRI, and 3- and 6-month post-injury assessments. Parents and children rated PCS at each assessment. Cortical thickness was estimated using FreeSurfer. Linear mixed effects and multi-variable negative binomial regression models were used to test study aims, with false discovery rate (FDR) correction for multiple comparisons. Groups differed significantly on left parietal cortical thickness (TBI > OI) after FDR correction. Cortical thickness also varied by brain subregion and age, but not sex. Groups differed significantly on PCS post-acutely (TBI > OI), but not at 3 or 6 months. Right frontal thickness was positively related to post-acute PCS in both groups. Right cingulum thickness predicted chronic PCS in the OI group only. Results highlight the complexity of predicting outcomes of pediatric mild TBI from post-acute neuroimaging biomarkers.

中文翻译：

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轻度创伤性脑损伤与骨科损伤儿童的急性后皮质厚度。

脑形态测量学的研究可以阐明小儿轻度创伤性脑损伤（TBI；例如，脑震荡）的影响。然而，没有已发表的研究使用适当的对照组检查小儿轻度 TBI 早期损伤阶段的皮质厚度。目前的研究使用自动化方法（即 FreeSurfer）来确定轻度 TBI 或轻度骨科损伤 (OI) 后儿童的皮质厚度是否不同，并检查急性后皮质厚度是否预测急性和慢性后脑震荡症状 (PCS)。8.00-16.99 岁患有轻度 TBI ( n  = 136) 或 OI ( n = 70) 被招募到两家儿童医院的急诊科就诊，在此期间，父母对儿童的伤前症状进行回顾性评估。儿童完成了急性后（受伤后 3-24 天）评估，其中包括 3 特斯拉 MRI，以及 3 个月和 6 个月的受伤后评估。家长和孩子在每次评估中都对 PCS 进行评分。使用 FreeSurfer 估计皮质厚度。线性混合效应和多变量负二项式回归模型用于测试研究目标，并使用错误发现率 (FDR) 校正进行多重比较。FDR 矫正后，各组的左顶叶皮质厚度（TBI > OI）存在显着差异。皮质厚度也因大脑亚区和年龄而异，但与性别无关。急性后（TBI > OI）的 PCS 组差异显着，但在 3 或 6 个月时没有显着差异。右额叶厚度与两组的急性 PCS 呈正相关。右扣带厚度仅预测 OI 组的慢性 PCS。结果突出了从急性后神经影像学生物标志物预测儿科轻度 TBI 预后的复杂性。