AccScience Publishing / AN / Volume 3 / Issue 4 / DOI: 10.36922/an.3886
REVIEW

Long-term neurocognitive follow-up in children with traumatic brain injury: A literature review and monocentric cohort study

Ilaria Liguoro1,2†* Tiziana Zilli3†* Eva Passone2 Maria Cristina de Colle4 Michele Patui1,2 Annalisa Lo Sasso1,2 Paola Cogo1,2
Show Less
1 Department of Medicine DAME - Division of Pediatrics, University of Udine, Udine, Italy
2 Division of Pediatrics, University Hospital of Central Friuli, Udine, Italy
3 Scientific Institute IRCCS Eugenio Medea, Pasian di Prato, Udine, Italy
4 Department of Neuroradiology, University Hospital of Udine, Udine, Italy
Advanced Neurology 2024, 3(4), 3886 https://doi.org/10.36922/an.3886
Submitted: 6 June 2024 | Accepted: 19 August 2024 | Published: 29 October 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Children with mild traumatic brain injury (mTBI) may experience long-term cognitive sequelae. However, previous study results have been controversial. It remains unclear whether clinical follow-up is useful, how long patients should be followed-up, and which psychological dimensions should be investigated. Herein, we described neurocognitive evolution in a small sample of Italian children who were hospitalized for mTBI and systematically reviewed the existing evidence in this setting. In total, 15 children aged 4 – 16 (median, 9) years who were evaluated for mTBI at our institution between March 2017 and September 2018 were retrospectively enrolled. All patients underwent computed tomography or magnetic resonance imaging for clinical reasons; moreover, they underwent neurocognitive evaluation within few days from the event (T0), after 3 – 6 months (T1), and after 18 – 24 months (T2). Neuropsychological assessment included the Child Behavior Checklist, Developmental Neuropsychology Assessment II Edition, and Wechsler Intelligence Scale for Children. An electronic search was conducted to identify studies published in the past 12 years. Neurocognitive assessments revealed low scores in memory, sensorimotor, and social perception tasks at T1 and T2. Univariate analysis of neuroradiological and clinical findings revealed no risk factors for cognitive deficits. Overall, 17 studies involving 1336 children were reviewed and analyzed. Following mTBI, psychiatric disorders were frequently newly diagnosed and were associated with significant deficits in adaptive functioning and other pre-injury psychosocial risk factors. Our study findings demonstrate that children with mTBI exhibit subtle persistent cognitive difficulties that may affect academic and social functioning. Thus, follow-up using extensive neuropsychological evaluation is essential.

Keywords
Traumatic brain injury
Pediatrics
Cognition
Magnetic resonance imaging
Head computed tomography
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
References
  1. Dewan MC, Mummareddy N, Wellons JC 3rd, Bonfield CM. Epidemiology of global pediatric traumatic brain injury: Qualitative review. World Neurosurg. 2016;91:497-509.e1. doi: 10.1016/j.wneu.2016.03.045

 

  1. Sarnaik A, Ferguson NM, O’Meara AMI, et al. Age and mortality in pediatric severe traumatic brain injury: Results from an international study. Neurocrit Care. 2018;28:302-313. doi: 10.1007/s12028-017-0480-x

 

  1. Maas AIR, Menon DK, Adelson PD, et al. Traumatic brain injury: Integrated approaches to improve prevention, clinical care, and research. Lancet Neurol. 2017;16:987-1048. doi: 10.1016/S1474-4422(17)30371-X

 

  1. GBD 2016 Traumatic Brain Injury and Spinal Cord Injury Collaborators. Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18:56-87. doi: 10.1016/S1474-4422(18)30415-0

 

  1. Babikian T, Asarnow R. Neurocognitive outcomes and recovery after pediatric TBI: Meta-analytic review of the literature. Neuropsychology. 2009;23:283-296. doi: 10.1037/a0015268

 

  1. Anderson V, Brown S, Newitt H, Hoile H. Educational, vocational, psychosocial, and quality-of-life outcomes for adult survivors of childhood traumatic brain injury. J Head Trauma Rehabil. 2009;24:303-312. doi: 10.1097/HTR.0b013e3181ada830

 

  1. Bigler ED. Neuropsychology and clinical neuroscience of persistent post-concussive syndrome. J Int Neuropsychol Soc. 2008;14:1-22. doi: 10.1017/S135561770808017X

 

  1. Moran LM, Taylor HG, Rusin J, et al. Quality of life in pediatric mild traumatic brain injury and its relationship to postconcussive symptoms. J Pediatr Psychol. 2012;37: 736-744. doi: 10.1093/jpepsy/jsr087

 

  1. Yeates KO, Taylor HG, Rusin J, et al. Premorbid child and family functioning as predictors of post-concussive symptoms in children with mild traumatic brain injuries. Int J Dev Neurosci. 2012;30:231-237. doi: 10.1016/j.ijdevneu.2011.05.008

 

  1. Yeates KO. Mild traumatic brain injury and postconcussive symptoms in children and adolescents. J Int Neuropsychol Soc. 2010;16:953-960. doi: 10.1017/S1355617710000986

 

  1. Kochanek PM, Tasker RC, Bell MJ, et al. Management of pediatric severe traumatic brain injury: 2019 consensus and guidelines-based algorithm for first and second tier therapies. Pediatr Crit Care Med. 2019;20:269-279. doi: 10.1097/PCC.0000000000001737

 

  1. Araki T, Yokota H, Morita A. Pediatric traumatic brain injury: Characteristic features, diagnosis, and management. Neurol Med Chir (Tokyo). 2017;57:82-93. doi: 10.2176/nmc.ra.2016-0191

 

  1. Teng SS, Chong SL. Pediatric traumatic brain injury--a review of management strategies. J Emerg Crit Care Med. 2018;2:18. doi: 10.21037/jeccm.2018.01.11

 

  1. CDC Pediatric mTBI Guideline. Concussion. Traumatic Brain Injury. CDC Injury Center. Available from: https://www. cdc.gov/traumaticbraininjury/pediatricmtbiguideline.html [Last accessed On 2020 Oct 10].

 

  1. Babikian T, Satz P, Zaucha K, Light R, Lewis RS, Asarnow RF. The UCLA longitudinal study of neurocognitive outcomes following mild pediatric traumatic brain injury. J Int Neuropsychol Soc. 2011;17:886-895. doi: 10.1017/S1355617711000907

 

  1. Bardoni A, Galbiati S, Recla M, Pastore V, Formica F, Strazzer S. Evolution of the cognitive profile in school-aged patients with severe TBI during the first 2 years of neurorehabilitation. Brain Injury. 2013;27:1395-1401. doi: 10.3109/02699052.2013.823652

 

  1. Pivonka-Jones J, Johnson V, Freier Randall K, Ashwal S. Pediatric traumatic brain injury: Longitudinal neurocognitive outcomes. Arch Clin Neuropsychol. 2014;29:586-587. doi: 10.1093/arclin/acu038.217

 

  1. Anderson V, Godfrey C, Rosenfeld JV, Catroppa C. Predictors of cognitive function and recovery 10 years after traumatic brain injury in young children. Pediatrics. 2012;129:e254-e261. doi: 10.1542/peds.2011-0311

 

  1. Beauchamp MH, Anderson V. Cognitive and psychopathological sequelae of pediatric traumatic brain injury. Handb Clin Neurol. 2013;112:913-920. doi: 10.1016/B978-0-444-52910-7.00013-1

 

  1. Ewing-Cobbs L, Fletcher JM, Levin HS, Francis DJ, Davidson K, Miner ME. Longitudinal neuropsychological outcome in infants and preschoolers with traumatic brain injury. J Int Neuropsychol Soc. 1997;3:581-591.

 

  1. Ryan NP, Catroppa C, Beare R, et al. Predictors of longitudinal outcome and recovery of pragmatic language and its relation to externalizing behaviour after pediatric traumatic brain injury. Brain Lang. 2015;142:86-95. doi: 10.1016/j.bandl.2015.01.007

 

  1. Krasny-Pacini A, Chevignard M, Lancien S, et al. Executive function after severe childhood traumatic brain injury - Age-at-injury vulnerability periods: The TGE prospective longitudinal study. Ann Phys Rehabil Med. 2017;60:74-82. doi: 10.1016/j.rehab.2016.06.001

 

  1. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med. 2009;6(7):e1000097. doi: 10.1371/journal.pmed.1000097

 

  1. Munn Z, Moola S, Riitano D, Lisy K. The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence. Int J Health Policy Manag. 2014;3:123-128. doi: 10.15171/ijhpm.2014.71

 

  1. Korkman, M, Kirk, U, Kemp, S. NEPSY-II: A Developmental Neuropsychological Assessment. 2nd ed. San Antonio, TX: Harcourt Assessment; 2007.

 

  1. Urgesi C, Campanella F, Fabbro F. NEPSY II: Contributo Alla Taratura Italiana. Italian Version. Firenze: Giunti O.S.; 2011.

 

  1. Wechsler D. The Wechsler Intelligence Scale for Children. 4th ed. London, UK: Pearson Assessment; 2004

 

  1. Wechsler D. Wechsler Preschool and Primary Scale of Intelligence III. London: Pearson Assessment; 2002

 

  1. Achenbach T, Rescorla L. Questionario Sul Comportamento del Bambino. Italy: IRCCS, Eugenio Medea; 2002.

 

  1. Max JE, Pardo D, Hanten G, et al. Psychiatric disorders in children and adolescents six-to-twelve months after mild traumatic brain injury. J Neuropsychiatry Clin Neurosci. 2013;25:272-282. doi: 10.1176/appi.neuropsych.12040078

 

  1. McNally KA, Bangert B, Dietrich A, et al. Injury versus noninjury factors as predictors of postconcussive symptoms following mild traumatic brain injury in children. Neuropsychology. 2013;27:1-12. doi: 10.1037/a0031370

 

  1. Olsson KA, Lloyd OT, Lebrocque RM, McKinlay L, Anderson VA, Kenardy JA. Predictors of child post-concussion symptoms at 6 and 18 months following mild traumatic brain injury. Brain Inj. 2013;27:145-157. doi: 10.3109/02699052.2012.729286

 

  1. Loher S, Fatzer ST, Roebers CM. Executive functions after pediatric mild traumatic brain injury: A prospective short-term longitudinal study. Appl Neuropsychol Child. 2014;3:103-114. doi: 10.1080/21622965.2012.716752

 

  1. Taylor HG, Orchinik LJ, Minich N, et al. Symptoms of persistent behavior problems in children with mild traumatic brain injury. J Head Trauma Rehabil. 2015;30:302-310. doi: 10.1097/HTR.0000000000000106

 

  1. Bernard CO, Ponsford JA, McKinlay A, McKenzie D, Krieser D. Predictors of Post-concussive symptoms in young children: Injury versus non-injury related factors. J Int Neuropsychol Soc. 2016;22:793-803. doi: 10.1017/S1355617716000709

 

  1. Connery AK, Peterson RL, Baker DA, Kirkwood MW. The impact of pediatric neuropsychological consultation in mild traumatic brain injury: A model for providing feedback after invalid performance. Clin Neuropsychol. 2016;30:579-598. doi: 10.1080/13854046.2016.1177596

 

  1. Segev S, Shorer M, Peleg TP, Apter A, Fennig S, Rassovsky Y. Gender differences in neurocognitive performance among children with posttraumatic stress disorder and mild traumatic brain injury. J Trauma Stress. 2018;31:64-70. doi: 10.1002/jts.22250

 

  1. Plourde V, Daya H, Low TA, Barlow KM, Brooks BL. Evaluating anxiety and depression symptoms in children and adolescents with prior mild traumatic brain injury: Agreement between methods and respondents. Child Neuropsychology. 2019;25:44-59. doi: 10.1080/09297049.2018.1432585

 

  1. Renaud MI, Lambregts SAM, van de Port IGL, Catsman- Berrevoets CE, van Heugten CM. Predictors of activities and participation six months after mild traumatic brain injury in children and adolescents. Eur J Paediatr Neurol. 2020;25:145-156. doi: 10.1016/j.ejpn.2019.11.008

 

  1. Bosworth C, Dodd JN. Noncredible effort on the Nonverbal- Medical Symptom Validity Test (NV-MSVT): Impact on cognitive performance in pediatric mild traumatic brain injury. Appl Neuropsychol Child. 2020;9:367-374. doi: 10.1080/21622965.2020.1742717

 

  1. Shorer M, Segev S, Rassovsky Y, Fennig S, Apter A, Peleg TP. Efficacy of psychological intervention for children with concurrent posttraumatic stress disorder and mild traumatic brain injury. J Trauma Stress. 2020;33:330-337. doi: 10.1002/jts.22512

 

  1. Murphy SA, Dodd JN. The role of family burden on informant discrepancies between parents and youths with protracted recovery from mild traumatic brain injury. Child Neuropsychol. 2021;27:151-164. doi: 10.1080/09297049.2020.1817354

 

  1. Studer M, Mischler L, Romano F, Lidzba K, Bigi S. Different trajectories of post-concussive symptom subscales after pediatric mild traumatic brain injury: Data from a prospective longitudinal study. Eur J Paediatr Neurol. 2024;51:9-16. doi: 10.1016/j.ejpn.2024.05.003

 

  1. Keightley ML, Côté P, Rumney P, et al. Psychosocial consequences of mild traumatic brain injury in children: Results of a systematic review by the international collaboration on mild traumatic brain injury prognosis. Arch Phys Med Rehabil. 2014;95:S192-S200. doi: 10.1016/j.apmr.2013.12.018

 

  1. Emery CA, Barlow KM, Brooks BL, et al. A systematic review of psychiatric, psychological, and behavioural outcomes following mild traumatic brain injury in children and adolescents. Can J Psychiatry. 2016;61:259-269. doi: 10.1177/0706743716643741

 

  1. Yumul JN, Crowe L, Catroppa C, Anderson V, McKinlay A. Post-concussive Signs and symptoms in preschool children: A systematic review. Neuropsychol Rev. 2022;32(3):631-650. doi: 10.1007/s11065-021-09518-z

 

  1. AbdelMalik P, Husted J, Chow EWC, Bassett AS. Childhood head injury and expression of schizophrenia in multiply affected families. Arch Gen Psychiatry. 2003;60:231-236. doi: 10.1001/archpsyc.60.3.231

 

  1. Barlow KM, Crawford S, Brooks BL, Turley B, Mikrogianakis A. The incidence of postconcussion syndrome remains stable following mild traumatic brain injury in children. Pediatr Neurol. 2015;53:491-497. doi: 10.1016/j.pediatrneurol.2015.04.011

 

  1. Max JE, Lansing AE, Koele SL, et al. Attention deficit hyperactivity disorder in children and adolescents following traumatic brain injury. Dev Neuropsychol. 2004;25:159-177. doi: 10.1080/87565641.2004.9651926

 

  1. Tulving E. Multiple memory systems and consciousness. Hum Neurobiol. 1987;6:67-80.

 

  1. Viot S, Câmara-Costa H, Laurence W, et al. Assessment of memory functioning over two years following severe childhood traumatic brain injury: Results of the TGE cohort. Brain Injury. 2019;33:1208-1218. doi: 10.1080/02699052.2019.1631485

 

  1. Taylor HG, Alden J. Age-related differences in outcomes following childhood brain insults: An introduction and overview. J Int Neuropsychol Soc. 1997;3:555-567.

 

  1. McFarlane LH, Burles F, Yeates KO, Schneider K, Iaria G. A pilot study evaluating the effects of concussion on the ability to form cognitive maps for spatial orientation in adolescent hockey players. Brain Injury. 2020;34:1112-1117. doi: 10.1080/02699052.2020.1773537

 

  1. Burles CF. The Development of a Practical Measure of Environmental-Scale Spatial Ability: The Spatial Configuration Task. (Master’s thesis, University of Calgary, Calgary, Canada); 2014. doi: 10.11575/PRISM/28057

 

  1. Seydell-Greenwald A, Ferrara K, Chambers CE, Newport EL, Landau B. Bilateral parietal activations for complex visual-spatial functions: Evidence from a visual-spatial construction task. Neuropsychologia. 2017;106:194-206. doi: 10.1016/j.neuropsychologia.2017.10.005

 

  1. D’Hondt F, Lassonde M, Thebault-Dagher F, et al. Electrophysiological correlates of emotional face processing after mild traumatic brain injury in preschool children. Cogn Affect Behav Neurosci. 2016;17:124-142. doi: 10.3758/s13415-016-0467-7

 

  1. Schmidt AT, Hanten GR, Li X, Orsten KD, Levin HS. Emotion recognition following pediatric traumatic brain injury: Longitudinal analysis of emotional prosody and facial emotion recognition. Neuropsychologia. 2010;48:2869-2877. doi: 10.1016/j.neuropsychologia.2010.05.029

 

  1. Tonks J, Williams WH, Frampton I, Yates P, Slater A. Reading emotions after child brain injury: A comparison between children with brain injury and non-injured controls. Brain Injury. 2007;21:731-739. doi: 10.1080/02699050701426899

 

  1. Rigon A, Turkstra LS, Mutlu B, Duff MC. Facial-affect recognition deficit as a predictor of different aspects of social-communication impairment in traumatic brain injury. Neuropsychology. 2018;32:476-483. doi: 10.1037/neu0000368

 

  1. Neumann D, McDonald BC, West J, Keiski MA, Wang Y. Neurobiological mechanisms associated with facial affect recognition deficits after traumatic brain injury. Brain Imaging Behav. 2016;10:569-580. doi: 10.1007/s11682-015-9415-3

 

  1. Karver CL, Wade SL, Cassedy A, et al. Age at injury and long-term behavior problems after traumatic brain injury in young children. Rehabil Psychol. 2012;57:256-265. doi: 10.1037/a0029522

 

  1. Catroppa C, Anderson V. Recovery in memory function in the first year following TBI in children. Brain Inj. 2002;16:369-384. doi: 10.1080/02699050110104444

 

  1. Verger K, Junqué C, Jurado MA, et al. Age effects on long-term neuropsychological outcome in paediatric traumatic brain injury. Brain Inj. 2000;14:495-503. doi: 10.1080/026990500120411

 

  1. Babikian T, Merkley T, Savage RC, Giza CC, Levin H. Chronic aspects of pediatric traumatic brain injury: Review of the literature. J Neurotrauma. 2015;32:1849-1860. doi: 10.1089/neu.2015.3971

 

  1. Donders J, DeWit C. Parental ratings of daily behavior and child cognitive test performance after pediatric mild traumatic brain injury. Child Neuropsychol. 2017;23:554-570. doi: 10.1080/09297049.2016.1161015

 

  1. Suskauer SJ, Huisman TAGM. Neuroimaging in pediatric traumatic brain injury: Current and future predictors of functional outcome. Dev Disabil Res Rev. 2009;15:117-123. doi: 10.1002/ddrr.62

 

  1. Mayer AR, Kaushal M, Dodd AB, et al. Advanced biomarkers of pediatric mild traumatic brain injury: Progress and perils. Neurosci Biobehav Rev. 2018;94:149-165. doi: 10.1016/j.neubiorev.2018.08.002

 

  1. Dennis EL, Babikian T, Giza CC, Thompson PM, Asarnow RF. Neuroimaging of the injured pediatric brain: Methods and new lessons. Neuroscientist. 2018;24:652-670. doi: 10.1177/1073858418759489

 

  1. Dennis EL, Ellis MU, Marion SD, et al. Callosal function in pediatric traumatic brain injury linked to disrupted white matter integrity. J Neurosci. 2015;35:10202-10211. doi: 10.1523/JNEUROSCI.1595-15.2015

 

  1. Hernandez F, Giordano C, Goubran M, et al. Lateral impacts correlate with Falx cerebri displacement and corpus callosum trauma in sports-related concussions. Biomech Model Mechanobiol. 2019;18:631-649. doi: 10.1007/s10237-018-01106-0

 

  1. Fong A, Allen M, Waltzman D, et al. Neuroimaging in pediatric patients with mild traumatic brain injury: Relating the current 2018 centers for Disease Control guideline and the potential of advanced neuroimaging modalities for research and clinical biomarker development. J Neurotrauma. 2020;38:44-52. doi: 10.1089/neu.2020.7100

 

  1. Dennis EL, Caeyenberghs K, Asarnow RF, et al. Challenges and opportunities for neuroimaging in young patients with traumatic brain injury: A coordinated effort towards advancing discovery from the ENIGMA pediatric moderate/ severe TBI group. Brain Imaging Behav. 2020;15:555-575. doi: 10.1007/s11682-020-00363-x

 

  1. Schmidt J, Hayward KS, Brown KE, et al. Imaging in pediatric concussion: A systematic review. Pediatrics. 2018;141:e20173406. doi: 10.1542/peds.2017-3406
Share
Back to top
Advanced Neurology, Electronic ISSN: 2810-9619 Print ISSN: 3060-8589, Published by AccScience Publishing