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Persistent alterations in cerebrovascular reactivity in response to hypercapnia following pediatric mild traumatic brain injury
Abstract
Much attention has been paid to the effects of mild traumatic brain injury (mTBI) on cerebrovascular reactivity in adult populations, yet it remains understudied in pediatric injury. In this study, 30 adolescents (12–18 years old) with pediatric mTBI (pmTBI) and 35 age- and sex-matched healthy controls (HC) underwent clinical and neuroimaging assessments during sub-acute (6.9 ± 2.2 days) and early chronic (120.4 ± 11.7 days) phases of injury. Relative to controls, pmTBI reported greater initial post-concussion symptoms, headache, pain, and anxiety, resolving by four months post-injury. Patients reported increased sleep issues and exhibited deficits in processing speed and attention across both visits. In grey-white matter interface areas throughout the brain, pmTBI displayed increased maximal fit/amplitude of a time-shifted end-tidal CO 2 regressor to blood oxygen-level dependent response relative to HC, as well as increased latency to maximal fit. The alterations persisted through the early chronic phase of injury, with maximal fit being associated with complaints of ongoing sleep disturbances during post hoc analyses but not cognitive measures of processing speed or attention. Collectively, these findings suggest that deficits in the speed and degree of cerebrovascular reactivity may persist longer than current conceptualizations about clinical recovery within 30 days.
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“(1) pmTBI displayed increased maximal fit/amplitude and increased latency to maximal fit of a time-shifted end-tidal CO2 regressor to BOLD response in grey-white matter interface areas throughout the brain, relative to HC.”
From A systematic review of brain structural and functional alterations in pediatric mild traumatic brain injury (2026) · cites this paper as Dodd et al. (2020)
In the citing paper
“(2) These cerebrovascular reactivity (CVR) alterations persisted through the early chronic phase (∼4 months) of injury, outlasting the resolution of many clinical symptoms (e.g., post-concussion symptoms, headache, pain).”
From A systematic review of brain structural and functional alterations in pediatric mild traumatic brain injury (2026) · cites this paper as Dodd et al. (2020)
In the citing paper
“(4) Increased maximal fit and latency to maximal fit together had high accuracy (90.8%) in classifying pmTBI from HC.”
From A systematic review of brain structural and functional alterations in pediatric mild traumatic brain injury (2026) · cites this paper as Dodd et al. (2020)
In the citing paper
“(5) No group differences were found in resting cerebral blood flow (CBF) in regions with altered CVR.”
From A systematic review of brain structural and functional alterations in pediatric mild traumatic brain injury (2026) · cites this paper as Dodd et al. (2020)
In the citing paper
“(3) The maximal fit was associated with complaints of ongoing sleep disturbances at the early chronic phase but not with cognitive measures of processing speed or attention.”
From A systematic review of brain structural and functional alterations in pediatric mild traumatic brain injury (2026) · cites this paper as Dodd et al. (2020)
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Dynamic mapping of human cortical development during childhood through early adulthood
Gogtay, N., Giedd, J. N., Lusk, L., Hayashi, K. M., Greenstein, D., Vaituzis, A. C., Nugent, T. F., Herman, D. H., Clasen, L. S., Toga, A. W., et al. (2004) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0402680101 · Cited by 5,604 · cited 1×
“Moreover, longitudinal studies are needed to examine how injury affects CVR trajectory during neurodevelopment, in particular in terms of cerebrovascular dilation(7) or neuronal pruning.(8) CVR contributes a unique perspective of cerebral vascular functioning.”
BackgroundWise, R. G., Ide, K., Poulin, M. J., & Tracey, I. (2004) · NeuroImage · doi:10.1016/j.neuroimage.2003.11.025 · Cited by 664
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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
- Dodd, A. B., Lu, H., Wertz, C. J., Ling, J. M., Shaff, N. A., Wasserott, B. C., Meier, T. B., Park, G., Oglesbee, S. J., Phillips, J. P., Campbell, R. A., Liu, P., & Mayer, A. R.
- Affiliations
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Pediatric Emergency Medicine, University of New Mexico, Albuquerque, NM, USA
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
- Venue
- Journal of Cerebral Blood Flow & Metabolism
- Publisher
- SAGE Publications
- Published
- 2020-01-05
- Volume
- 40
- Issue
- 12
- Pages
- 2491-2504
- ISSN
- 0271-678X
- 1559-7016
- Cited by
- 26
- References
- 3
- Language
- en
- Licence
- journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
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- Dodd, A. B., Lu, H., Wertz, C. J., Ling, J. M., Shaff, N. A., Wasserott, B. C., Meier, T. B., Park, G., Oglesbee, S. J., Phillips, J. P., Campbell, R. A., Liu, P., & Mayer, A. R. (2020). Persistent alterations in cerebrovascular reactivity in response to hypercapnia following pediatric mild traumatic brain injury. Journal of Cerebral Blood Flow & Metabolism. https://doi.org/10.1177/0271678x19896883
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