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Post-Acute Cortical Thickness in Children with Mild Traumatic Brain Injury versus Orthopedic Injury
Abstract
Studies of brain morphometry may illuminate the effects of pediatric mild traumatic brain injury (TBI; e.g., concussion). However, no published studies have examined cortical thickness in the early injury phases of pediatric mild TBI using an appropriate comparison group. The current study used an automated approach (i.e., FreeSurfer) to determine whether cortical thickness differed in children following a mild TBI or a mild orthopedic injury (OI), and to examine whether post-acute cortical thickness predicted post-acute and chronic post-concussive symptoms (PCS). Children ages 8.00-16.99 years with mild TBI ( n = 136) or OI ( n = 70) were recruited at emergency department visits to two children's hospitals, during which parents rated children's pre-injury symptoms retrospectively. Children completed a post-acute (3–24 days post-injury) assessment, which included a 3 Tesla MRI, and 3- and 6-month post-injury assessments. Parents and children rated PCS at each assessment. Cortical thickness was estimated using FreeSurfer. Linear mixed effects and multi-variable negative binomial regression models were used to test study aims, with false discovery rate (FDR) correction for multiple comparisons. Groups differed significantly on left parietal cortical thickness (TBI > OI) after FDR correction. Cortical thickness also varied by brain subregion and age, but not sex. Groups differed significantly on PCS post-acutely (TBI > OI), but not at 3 or 6 months. Right frontal thickness was positively related to post-acute PCS in both groups. Right cingulum thickness predicted chronic PCS in the OI group only. Results highlight the complexity of predicting outcomes of pediatric mild TBI from post-acute neuroimaging biomarkers.
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“(3) Greater right frontal cortical thickness was associated with higher parent-reported post-acute somatic post-concussive symptoms (PCS) across both groups.”
From A systematic review of brain structural and functional alterations in pediatric mild traumatic brain injury (2026) · cites this paper as Ware et al. (2020)
In the citing paper
“Right frontal cortical thickness was found to correlate with acute somatic PCS, whereas right temporal and inferior frontal thickness was associated with PCS (Ware et al., 2020).”
From A systematic review of brain structural and functional alterations in pediatric mild traumatic brain injury (2026) · cites this paper as Ware et al., 2020
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“(5) The association between right cingulate thickness and chronic cognitive symptoms was significant only in the orthopedic injury group, suggesting a differential relationship based on injury type.”
From A systematic review of brain structural and functional alterations in pediatric mild traumatic brain injury (2026) · cites this paper as Ware et al. (2020)
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“(2) Age was negatively associated with cortical thickness in bilateral frontal, cingulate, parietal, and occipital cortices, indicating typical age-related thinning across both injury groups.”
From A systematic review of brain structural and functional alterations in pediatric mild traumatic brain injury (2026) · cites this paper as Ware et al. (2020)
In the citing paper
“(1) mTBI group exhibited significantly greater cortical thickness in the left parietal region compared to the orthopedic injury group during the post-acute phase.”
From A systematic review of brain structural and functional alterations in pediatric mild traumatic brain injury (2026) · cites this paper as Ware et al. (2020)
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Cited by
Xu, H., Wu, S., Zhan, H., Xu, G., Zhao, J., & Yin, B. (2026) · Frontiers in Neuroscience · doi:10.3389/fnins.2026.1879109
Metadata
- Authors
- Ware, A. L., Goodrich-Hunsaker, N. J., Lebel, C., Shukla, A., Wilde, E. A., Abildskov, T. J., Bigler, E. D., Cohen, D. M., Mihalov, L. K., Bacevice, A., Bangert, B. A., Taylor, H. G., & Yeates, K. O.
- Affiliations
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA.
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
- Abigail Wexner Research Institute at Nationwide Children's Hospital, and Department of Pediatrics, Ohio State University, Columbus, Ohio, USA.
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA.
- Venue
- Journal of Neurotrauma
- Publisher
- SAGE Publications
- Published
- 2020-08-14
- Volume
- 37
- Issue
- 17
- Pages
- 1892-1901
- ISSN
- 0897-7151
- 1557-9042
- Cited by
- 24
- References
- 4
- Language
- en
- Licence
- journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
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- Ware, A. L., Goodrich-Hunsaker, N. J., Lebel, C., Shukla, A., Wilde, E. A., Abildskov, T. J., Bigler, E. D., Cohen, D. M., Mihalov, L. K., Bacevice, A., Bangert, B. A., Taylor, H. G., & Yeates, K. O. (2020). Post-Acute Cortical Thickness in Children with Mild Traumatic Brain Injury versus Orthopedic Injury. Journal of Neurotrauma. https://doi.org/10.1089/neu.2019.6850
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