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Outcome of moderate to severe traumatic brain injury (TBI) includes impaired emotion regulation. Emotion regulation has been associated with amygdala and rostral anterior cingulate (rACC). However, functional connectivity between the two structures after injury has not been reported. A preliminary examination of functional connectivity of rACC and right amygdala was conducted in adolescents 2 to 3 years after moderate to severe TBI and in typically developing (TD) control adolescents, with the hypothesis that the TBI adolescents would demonstrate altered functional connectivity in the two regions. Functional connectivity was determined by correlating fluctuations in the blood oxygen level dependent (BOLD) signal of the rACC and right amygdala with that of other brain regions. In the TBI adolescents, the rACC was found to be significantly less functionally connected to medial prefrontal cortices and to right temporal regions near the amygdala (height threshold T = 2.5, cluster level p < .05, FDR corrected), while the right amygdala showed a trend in reduced functional connectivity with the rACC (height threshold T = 2.5, cluster level p = .06, FDR corrected). Data suggest disrupted functional connectivity in emotion regulation regions. Limitations include small sample sizes. Studies with larger sample sizes are necessary to characterize the persistent neural damage resulting from moderate to severe TBI during development. (JINS, 2013, 19, 1–14)
To evaluate effects of unilateral frontal lesions on psychosocial and
global outcome of traumatic brain injury (TBI) in children, Study 1
compared matched groups of 22 school aged children who had sustained
TBI either with or without unilateral frontal lesions. Study 2
evaluated effects of unilateral extrafrontal lesions in 18 TBI patients
as compared with 18 nonlesional TBI patients. Communication, Daily
Living, and Socialization domains and the Maladaptive Behavior Scale of
the Vineland Adaptive Behavior Scales (VABS) were used to assess
psychosocial outcome, and the Glasgow Outcome Scale (GOS) measured
global outcome. All patients underwent magnetic resonance imaging at
least 3 months post injury. Children with frontal lesions had worse
scores on the Daily Living and Socialization domains and a higher
frequency of maladaptive behavior than those without frontal lesions,
but there was no difference in cognitive function. Disability was twice
as common in the frontal lesion group relative to children without
frontal lesions. Volume of frontal lesion was related to the
Socialization domain. Side of lesion had no effect, nor did presence of
an extrafrontal lesion (Study 2). Unilateral frontal lesions adversely
affect late psychosocial outcome of TBI in children. (JINS,
2004, 10, 305–316.)