Traumatic brain injury (TBI) produces microstructural damage to white matter pathways connecting neural structures in pre-frontal and striatal regions involved in self-regulation (SR). Dorsal and ventral frontostriatal pathways have been linked to cognitive (“cool”) and emotional (“hot”) SR, respectively. We evaluated the relation of frontostriatal pathway fractional anisotropy (FA) 2 months post-TBI on cool and hot SR assessed 7 months post-TBI. Participants were 8–15 years of age, including children with uncomplicated mild TBI (mTBI; n = 24), more severe TBI (complicated-mild, moderate, severe [cms]TBI; n = 60), and typically developing (TD) children (n = 55). Diffusion tensor tractography was used to map frontostriatal pathways. Cool SR included focused and sustained attention performance, and parent-reported attention, whereas hot SR included risk-taking performance and parent-reported emotional control. Multivariate general linear models showed that children with cmsTBI had greater parent-reported cool and hot SR difficulties and lower dorsal and ventral FA than TD children. Focused attention, risk taking, and emotional control correlated with FA of specific dorsal and ventral pathways; however, only the effect of TBI on focused attention was mediated by integrity of dorsal pathways. Results suggest that frontostriatal FA may serve as a biomarker of risk for SR difficulties or to assess response to interventions targeting SR in pediatric TBI and in broader neurodevelopmental populations.

中文翻译：

---

小儿创伤性脑损伤后纹状体白质完整性与“凉”“热”自律的关系

创伤性脑损伤 (TBI) 对连接前额叶和纹状体区域中涉及自我调节 (SR) 的神经结构的白质通路产生微观结构损伤。背侧和腹侧额纹状体通路分别与认知（“冷”）和情绪（“热”）SR 有关。我们评估了 TBI 后 2 个月前纹状体通路分数各向异性 (FA) 与 TBI 后 7 个月评估的冷和热 SR 的关系。参与者的年龄为 8-15 岁，包括患有无并发症的轻度 TBI (mTBI；n  = 24)、更严重的 TBI（复杂的轻度、中度、重度 [cms]TBI；n  = 60）和典型发育 (TD) 的儿童儿童 ( n = 55）。扩散张量纤维束成像用于绘制额纹状体通路。Cool SR 包括专注和持续注意力的表现，以及父母报告的注意力，而 hot SR 包括冒险表现和父母报告的情绪控制。多元一般线性模型表明，与 TD 儿童相比，cmsTBI 儿童的父母报告的冷热 SR 困难更大，背侧和腹侧 FA 更低。集中注意力、冒险和情绪控制与特定背侧和腹侧通路的 FA 相关；然而，只有 TBI 对集中注意力的影响是由背侧通路的完整性介导的。结果表明，额纹状体 FA 可作为 SR 困难风险的生物标志物，或用于评估针对小儿 TBI 和更广泛神经发育人群中针对 SR 的干预措施的反应。