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A Review of Family Environment and Neurobehavioral Outcomes Following Pediatric Traumatic Brain Injury: Implications of Early Adverse Experiences, Family Stress, and Limbic Development
Biological Psychiatry ( IF 10.6 ) Pub Date : 2021-08-24 , DOI: 10.1016/j.biopsych.2021.08.012
Jesse T Fischer 1 , Kevin C Bickart 2 , Christopher Giza 3 , Talin Babikian 1
Affiliation  

Pediatric traumatic brain injury (TBI) is a public health crisis, with neurobehavioral morbidity observed years after an injury associated with changes in related brain structures. A substantial literature base has established family environment as a significant predictor of neurobehavioral outcomes following pediatric TBI. The neural mechanisms linking family environment to neurobehavioral outcomes have, however, received less empiric study in this population. In contrast, limbic structural differences as well as challenges with emotional adjustment and behavioral regulation in non-TBI populations have been linked to a multitude of family environmental factors, including family stress, parenting style, and adverse childhood experiences. In this article, we systematically review the more comprehensive literature on family environment and neurobehavioral outcomes in pediatric TBI and leverage the work in both TBI and non-TBI populations to expand our understanding of the underlying neural mechanisms. Thus, we summarize the extant literature on the family environment’s role in neurobehavioral sequelae in children with TBI and explore potential neural correlates by synthesizing the wealth of literature on family environment and limbic development, specifically related to the amygdala. This review underscores the critical role of environmental factors, especially those predating the injury, in modeling recovery outcomes post-TBI in childhood, and discusses clinical and research implications across pediatric populations. Given the public health crisis of pediatric TBI, along with the context of sparse available medical interventions, a broader understanding of factors contributing to outcomes is warranted to expand the range of intervention targets.



中文翻译:

小儿创伤性脑损伤后家庭环境和神经行为结果的回顾:早期不良经历、家庭压力和边缘发育的影响

小儿创伤性脑损伤 (TBI) 是一种公共卫生危机,在与相关脑结构变化相关的损伤后数年观察到神经行为发病率。大量的文献资料表明,家庭环境是儿科 TBI 后神经行为结果的重要预测因素。然而,将家庭环境与神经行为结果联系起来的神经机制在这一人群中得到的经验研究较少。相比之下,非 TBI 人群的边缘结构差异以及情绪调整和行为调节方面的挑战与多种家庭环境因素有关,包括家庭压力、养育方式和不良童年经历。在本文中,我们系统地回顾了关于儿童 TBI 的家庭环境和神经行为结果的更全面的文献,并利用 TBI 和非 TBI 人群的工作来扩大我们对潜在神经机制的理解。因此,我们总结了关于家庭环境在 TBI 儿童神经行为后遗症中的作用的现有文献,并通过综合有关家庭环境和边缘发育的大量文献,特别是与杏仁核相关,探索潜在的神经相关性。本综述强调了环境因素,尤其是损伤前的环境因素在模拟儿童 TBI 后恢复结果中的关键作用,并讨论了对儿科人群的临床和研究影响。鉴于小儿 TBI 的公共卫生危机,

更新日期:2021-08-24
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