Cortical excitability after pediatric mild traumatic brain injury.
| Autor: | Seeger TA; Cumming School of Medicine, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, Alberta Children's Hospital, Calgary, Canada., Kirton A; Cumming School of Medicine, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, Alberta Children's Hospital, Calgary, Canada., Esser MJ; Cumming School of Medicine, University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, Alberta Children's Hospital, Calgary, Canada., Gallagher C; Cumming School of Medicine, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, Alberta Children's Hospital, Calgary, Canada., Dunn J; Cumming School of Medicine, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, Alberta Children's Hospital, Calgary, Canada., Zewdie E; Cumming School of Medicine, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, Alberta Children's Hospital, Calgary, Canada., Damji O; Cumming School of Medicine, University of Calgary, Calgary, Canada., Ciechanski P; Cumming School of Medicine, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, Alberta Children's Hospital, Calgary, Canada., Barlow KM; Cumming School of Medicine, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, Alberta Children's Hospital, Calgary, Canada. Electronic address: karen.barlow@albertahealthservices.ca. |
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| Jazyk: | angličtina |
| Zdroj: | Brain stimulation [Brain Stimul] 2017 Mar - Apr; Vol. 10 (2), pp. 305-314. Date of Electronic Publication: 2016 Nov 19. |
| DOI: | 10.1016/j.brs.2016.11.011 |
| Abstrakt: | Introduction: Mild traumatic brain injury (mTBI) outcomes are variable, and 10-15% may suffer from prolonged symptoms beyond 3 months that impair the child's return to normal activities. Neurophysiological mechanisms of mTBI are incompletely understood, particularly in children, but alterations in cortical excitability have been proposed to underlie post-concussion syndrome. Improved understanding is required to advance interventions and improve outcomes. Objective/hypothesis: To determine if cortical excitability is altered in children with mTBI, and its association with clinical symptoms. Methods: This was a cross-sectional controlled cohort study. School-aged children (8-18 years) with mTBI were compared to healthy controls. Cortical excitability was measured using multiple TMS paradigms in children with (symptomatic) and without (recovered) persistent symptoms one-month post-injury. Primary outcome was the cortical silent period (cSP), a potential neurophysiological biomarker of GABAergic inhibition. Secondary outcomes included additional TMS neurophysiology, safety and tolerability. Associations between neurophysiology parameters and clinical symptoms were evaluated. Results: Fifty-three children with mTBI (55% male; mean age 14.1 SD: 2.4 years; 35 symptomatic and 27 asymptomatic participants) and 28 controls (46% male; mean age 14.3 SD: 3.1 years) were enrolled. cSP duration was similar between groups (F (2, 73) = 0.55, p = 0.582). Log Conclusions: TMS measures of cortical excitability are altered at one month in children with mTBI. Long interval cortical inhibition is decreased in children who remain symptomatic at one month post-injury. (Copyright © 2016 Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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