Journal of the International Neuropsychological Society



Long-term neural processing of attention following early childhood traumatic brain injury: fMRI and neurobehavioral outcomes


MEGAN E.  KRAMER  a1 c1 , C.-Y. PETER  CHIU  a1 a2 , NICOLAY CHERTKOFF  WALZ  a3 a4 , SCOTT K.  HOLLAND  a3 a4 a5 , WEIHONG  YUAN  a5 , PRASANNA  KARUNANAYAKA  a5 and SHARI L.  WADE  a3 a4
a1 Department of Psychology, University of Cincinnati, Cincinnati, Ohio
a2 Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, Ohio
a3 Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
a4 College of Medicine, University of Cincinnati, Cincinnati, Ohio
a5 Children's Hospital Research Foundation, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

Article author query
kramer me   [PubMed][Google Scholar] 
chiu c-   [PubMed][Google Scholar] 
walz nc   [PubMed][Google Scholar] 
holland sk   [PubMed][Google Scholar] 
yuan w   [PubMed][Google Scholar] 
karunanayaka p   [PubMed][Google Scholar] 
wade sl   [PubMed][Google Scholar] 

Abstract

Attentional deficits are common and significant sequelae of pediatric traumatic brain injury (TBI). However, little is known about how the underlying neural processes that support different components of attention are affected. The present study examined brain activation patterns using fMRI in a group of young children who sustained a TBI in early childhood (n = 5; mean age = 9.4), and a group of age-matched control children with orthopedic injuries (OI) (n = 8) during a continuous performance task (CPT). Four children in the TBI group had moderate injuries, and one had a severe injury. Performance on the CPT task did not differ between groups. Both TBI and OI children activated similar networks of brain regions relevant to sustained attention processing, but the TBI group demonstrated several areas of significantly greater activation relative to controls, including frontal and parietal regions. These findings of over-activation of the relevant attention network in the TBI group contrast with those obtained in imaging studies of Attention-Deficit/Hyperactivity Disorder where under-activation of the attention network has been documented. This study provides evidence that young children's brains function differently following a traumatic brain injury, and that these differences persist for years after the injury. (JINS, 2008, 14, 424–435.)

(Received June 11 2007)
(Revised December 21 2007)
(Accepted December 24 2007)


Key Words: Childhood brain disorder; Continuous performance test; Brain imaging; Children; Head injury; Neuropsychology.

Correspondence:
c1 Correspondence and reprint requests to: Megan E. Kramer, M.A., Department of Psychology, University of Cincinnati, 101A Dyer Hall, ML 0376, Cincinnati, OH 45221-0376. E-mail: kramerm2@email.uc.edu