Abstract

Traumatic brain injury (TBI) is highly prevalent in children. Attention deficits are among the most common and persistent post-TBI cognitive and behavioral sequalae that can contribute to adverse outcomes. This study investigated the topological properties of the functional brain network for sustained attention processing and their dynamics in 42 children with severe post-TBI attention deficits (TBI-A) and 47 matched healthy controls. Functional MRI data during a block-designed sustained attention task was collected for each subject, with each full task block further divided into the pre-, early, late-, and post-stimulation stages. The task-related functional brain network was constructed using the graph theoretic technique. Then, the sliding-window-based method was utilized to assess the dynamics of the topological properties in each stimulation stage. Relative to the controls, the TBI-A group had significantly reduced nodal efficiency and/or degree of left postcentral, inferior parietal, inferior temporal, and fusiform gyri and their decreased stability during the early and late-stimulation stages. The left postcentral inferior parietal network anomalies were found to be significantly associated with elevated inattentive symptoms in children with TBI-A. These results suggest that abnormal functional network characteristics and their dynamics associated with the left parietal lobe may significantly link to the onset of the severe post-TBI attention deficits in children.

Highlights

  • Published: 13 October 2021Pediatric traumatic brain injury (TBI) is a significant public health issue, which occurs in more than 3 million children each year globally [1]

  • The current study proposed to utilize the GTTand dynamic functional connectivity (FC)-based techniques to study the topological properties and their dynamics of the functional network for attention processing, and their relations with TBI-related attention deficits in a homogeneous group of children with TBI attention deficits (TBI-A) and matched controls

  • Together with the existing findings, results of the present of the present study further suggest that the suboptimal efficiency left parietal regions for functional study further suggest that the suboptimal efficiency of left parietalof regions for functional interactions with other brain areas, especially during the initiation stage of attention prointeractions with other brain areas, especially during the initiation stage of attention processing, significantly implicate the TBI-A-specific impairment of the attention network, cessing, significantly implicate the TBI-A-specific impairment of the attention network, which can contribute to severe behavioral inattentiveness and hyperactivity/impulsivity in children with TBI

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Summary

Introduction

Pediatric traumatic brain injury (TBI) is a significant public health issue, which occurs in more than 3 million children each year globally [1]. Neurocognitive impairments and behavioral abnormalities, including attention problems, depression and mood disorders, anxiety, and posttraumatic stress disorder, were frequently reported in children with chronic TBI [2,3,4,5]. Attention deficits are among the most common and persistent cognitive and behavioral consequences that can be observed in at least 35% of children within two years of their injuries [6,7]. The neural substrates associated with TBI-A in children have not yet been well investigated. Understanding the early brain mechanisms of TBI-A have considerable heuristic value for informing novel and timely strategies of prevention and intervention in affected individuals

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