Imaging in pediatric concussion: A systematic review

Julia Schmidt, Kathryn S. Hayward, Katlyn E. Brown, Jill G. Zwicker, Jennie Ponsford, Paul Van Donkelaar, Shelina Babul, Lara A. Boyd

Research output: Contribution to journalReview ArticleResearchpeer-review

Abstract

CONTEXT: Pediatric mild traumatic brain injury (mTBI) is a common and poorly understood injury. Neuroimaging indexes brain injury and outcome after pediatric mTBI, but remains largely unexplored. OBJECTIVE: To investigate the differences in neuroimaging findings in children/youth with mTBI. Measures of behavior, symptoms, time since injury, and age at injury were also considered. DATA SOURCES: A systematic review was conducted up to July 6, 2016. STUDY SELECTION: Studies were independently screened by 2 authors and included if they met predetermined eligibility criteria: (1) children/youth (5-18 years of age), (2) diagnosis of mTBI, and (3) use of neuroimaging. DATA EXTRACTION: Two authors independently appraised study quality and extracted demographic and outcome data. RESULTS: Twenty-two studies met the eligibility criteria, involving 448 participants with mTBI (mean age = 12.7 years ± 2.8). Time postinjury ranged from 1 day to 5 years. Seven different neuroimaging methods were investigated in included studies. The most frequently used method, diffusion tensor imaging (41%), had heterogeneous findings with respect to the specific regions and tracts that showed group differences. However, group differences were observed in many regions containing the corticospinal tract, portions of the corpus callosum, or frontal white-matter regions; fractional anisotropy was increased in 88% of the studies. LIMITATIONS: This review included a heterogeneous sample with regard to participant ages, time since injury, symptoms, and imaging methods which prevented statistical pooling/modelling. CONCLUSIONS: These data highlight essential priorities for future research (eg, common data elements) that are foundational to progress the understanding of pediatric concussion.

Original languageEnglish
Article numbere20173406
Number of pages16
JournalPediatrics
Volume141
Issue number5
DOIs
Publication statusPublished - 1 May 2018

Cite this

Schmidt, J., Hayward, K. S., Brown, K. E., Zwicker, J. G., Ponsford, J., Van Donkelaar, P., ... Boyd, L. A. (2018). Imaging in pediatric concussion: A systematic review. Pediatrics, 141(5), [e20173406]. https://doi.org/10.1542/peds.2017-3406
Schmidt, Julia ; Hayward, Kathryn S. ; Brown, Katlyn E. ; Zwicker, Jill G. ; Ponsford, Jennie ; Van Donkelaar, Paul ; Babul, Shelina ; Boyd, Lara A. / Imaging in pediatric concussion : A systematic review. In: Pediatrics. 2018 ; Vol. 141, No. 5.
@article{cbed8bfd72f34e2297d14cfc48836e1c,
title = "Imaging in pediatric concussion: A systematic review",
abstract = "CONTEXT: Pediatric mild traumatic brain injury (mTBI) is a common and poorly understood injury. Neuroimaging indexes brain injury and outcome after pediatric mTBI, but remains largely unexplored. OBJECTIVE: To investigate the differences in neuroimaging findings in children/youth with mTBI. Measures of behavior, symptoms, time since injury, and age at injury were also considered. DATA SOURCES: A systematic review was conducted up to July 6, 2016. STUDY SELECTION: Studies were independently screened by 2 authors and included if they met predetermined eligibility criteria: (1) children/youth (5-18 years of age), (2) diagnosis of mTBI, and (3) use of neuroimaging. DATA EXTRACTION: Two authors independently appraised study quality and extracted demographic and outcome data. RESULTS: Twenty-two studies met the eligibility criteria, involving 448 participants with mTBI (mean age = 12.7 years ± 2.8). Time postinjury ranged from 1 day to 5 years. Seven different neuroimaging methods were investigated in included studies. The most frequently used method, diffusion tensor imaging (41{\%}), had heterogeneous findings with respect to the specific regions and tracts that showed group differences. However, group differences were observed in many regions containing the corticospinal tract, portions of the corpus callosum, or frontal white-matter regions; fractional anisotropy was increased in 88{\%} of the studies. LIMITATIONS: This review included a heterogeneous sample with regard to participant ages, time since injury, symptoms, and imaging methods which prevented statistical pooling/modelling. CONCLUSIONS: These data highlight essential priorities for future research (eg, common data elements) that are foundational to progress the understanding of pediatric concussion.",
author = "Julia Schmidt and Hayward, {Kathryn S.} and Brown, {Katlyn E.} and Zwicker, {Jill G.} and Jennie Ponsford and {Van Donkelaar}, Paul and Shelina Babul and Boyd, {Lara A.}",
year = "2018",
month = "5",
day = "1",
doi = "10.1542/peds.2017-3406",
language = "English",
volume = "141",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "5",

}

Schmidt, J, Hayward, KS, Brown, KE, Zwicker, JG, Ponsford, J, Van Donkelaar, P, Babul, S & Boyd, LA 2018, 'Imaging in pediatric concussion: A systematic review' Pediatrics, vol. 141, no. 5, e20173406. https://doi.org/10.1542/peds.2017-3406

Imaging in pediatric concussion : A systematic review. / Schmidt, Julia; Hayward, Kathryn S.; Brown, Katlyn E.; Zwicker, Jill G.; Ponsford, Jennie; Van Donkelaar, Paul; Babul, Shelina; Boyd, Lara A.

In: Pediatrics, Vol. 141, No. 5, e20173406, 01.05.2018.

Research output: Contribution to journalReview ArticleResearchpeer-review

TY - JOUR

T1 - Imaging in pediatric concussion

T2 - A systematic review

AU - Schmidt, Julia

AU - Hayward, Kathryn S.

AU - Brown, Katlyn E.

AU - Zwicker, Jill G.

AU - Ponsford, Jennie

AU - Van Donkelaar, Paul

AU - Babul, Shelina

AU - Boyd, Lara A.

PY - 2018/5/1

Y1 - 2018/5/1

N2 - CONTEXT: Pediatric mild traumatic brain injury (mTBI) is a common and poorly understood injury. Neuroimaging indexes brain injury and outcome after pediatric mTBI, but remains largely unexplored. OBJECTIVE: To investigate the differences in neuroimaging findings in children/youth with mTBI. Measures of behavior, symptoms, time since injury, and age at injury were also considered. DATA SOURCES: A systematic review was conducted up to July 6, 2016. STUDY SELECTION: Studies were independently screened by 2 authors and included if they met predetermined eligibility criteria: (1) children/youth (5-18 years of age), (2) diagnosis of mTBI, and (3) use of neuroimaging. DATA EXTRACTION: Two authors independently appraised study quality and extracted demographic and outcome data. RESULTS: Twenty-two studies met the eligibility criteria, involving 448 participants with mTBI (mean age = 12.7 years ± 2.8). Time postinjury ranged from 1 day to 5 years. Seven different neuroimaging methods were investigated in included studies. The most frequently used method, diffusion tensor imaging (41%), had heterogeneous findings with respect to the specific regions and tracts that showed group differences. However, group differences were observed in many regions containing the corticospinal tract, portions of the corpus callosum, or frontal white-matter regions; fractional anisotropy was increased in 88% of the studies. LIMITATIONS: This review included a heterogeneous sample with regard to participant ages, time since injury, symptoms, and imaging methods which prevented statistical pooling/modelling. CONCLUSIONS: These data highlight essential priorities for future research (eg, common data elements) that are foundational to progress the understanding of pediatric concussion.

AB - CONTEXT: Pediatric mild traumatic brain injury (mTBI) is a common and poorly understood injury. Neuroimaging indexes brain injury and outcome after pediatric mTBI, but remains largely unexplored. OBJECTIVE: To investigate the differences in neuroimaging findings in children/youth with mTBI. Measures of behavior, symptoms, time since injury, and age at injury were also considered. DATA SOURCES: A systematic review was conducted up to July 6, 2016. STUDY SELECTION: Studies were independently screened by 2 authors and included if they met predetermined eligibility criteria: (1) children/youth (5-18 years of age), (2) diagnosis of mTBI, and (3) use of neuroimaging. DATA EXTRACTION: Two authors independently appraised study quality and extracted demographic and outcome data. RESULTS: Twenty-two studies met the eligibility criteria, involving 448 participants with mTBI (mean age = 12.7 years ± 2.8). Time postinjury ranged from 1 day to 5 years. Seven different neuroimaging methods were investigated in included studies. The most frequently used method, diffusion tensor imaging (41%), had heterogeneous findings with respect to the specific regions and tracts that showed group differences. However, group differences were observed in many regions containing the corticospinal tract, portions of the corpus callosum, or frontal white-matter regions; fractional anisotropy was increased in 88% of the studies. LIMITATIONS: This review included a heterogeneous sample with regard to participant ages, time since injury, symptoms, and imaging methods which prevented statistical pooling/modelling. CONCLUSIONS: These data highlight essential priorities for future research (eg, common data elements) that are foundational to progress the understanding of pediatric concussion.

UR - http://www.scopus.com/inward/record.url?scp=85046463986&partnerID=8YFLogxK

U2 - 10.1542/peds.2017-3406

DO - 10.1542/peds.2017-3406

M3 - Review Article

VL - 141

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 5

M1 - e20173406

ER -

Schmidt J, Hayward KS, Brown KE, Zwicker JG, Ponsford J, Van Donkelaar P et al. Imaging in pediatric concussion: A systematic review. Pediatrics. 2018 May 1;141(5). e20173406. https://doi.org/10.1542/peds.2017-3406