@article {Ware10.1212 / WNL。0000000000207508,作者={阿什利·l .器皿和凯瑟琳•勒贝尔和Adrian Onicas Nishard Abdeen和米里亚姆波和基督教比尤利和布鲁斯·h·Bjornson和威廉克雷格·马蒂厄Dehaes和琼Doan Sylvain Deschenes和斯蒂芬·弗里德曼和布拉德利G固特异乔斯林砾石和Andr {\ ' e} e-Anne勒杜和罗杰Zemek和基思·欧文耶茨和加拿大儿科紧急研究上限研究小组},title ={纵向灰质轨迹在小儿轻度创伤性脑损伤},elocation-id = {10.1212 / WNL。={2023}0000000000207508},年,doi = {10.1212 / WNL。出版商0000000000207508}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={目的:这种前瞻性,纵向队列研究检查了轨迹的大脑灰质宏观结构后小儿轻度创伤性脑损半岛投注体育官网伤(mTBI)。方法:8 - 16.99岁儿童与mTBI或轻度骨科损伤(OI)招募从5儿科急诊。可靠的变化具有抑制受损症状评分延伸伤前和月之间被用来分类mTBI有或没有持续的症状。儿童急性(2-33天)完成和/或慢性具有抑制受损t1加权磁共振成像,延伸(3或6个月),macrostructural指标导出使用自动分割。线性混合效应模型,与多个比较修正。结果:组(N = 623;407 mTBI / 216 OI;59 \ %的男性;年龄意味着= 12.03,SD = 2.38年)在大脑总没有差别,白色的,或灰色卷,或区域皮层下灰质卷。然而,具有抑制受损,延伸时间受伤,年龄和生理性别差异放缓症状组皮质厚度的角形脑回,基底前脑,距状皮层,回腹直肌,中间和后轨道回,胼肢体区域,所有纠正p \ < . 05。 Gray matter macrostructural metrics did not differ between groups post-acutely. However, cortical thinning emerged chronically following mTBI relative to OI in the angular gyrus in older children [d (95\% confidence interval) = -0.61 (-1.15, -0.08)]; and in the basal forebrain [-0.47 (-0.94, -0.01)], subcallosal area [-0.55 (-1.01, -0.08)], and the posterior orbital gyrus [-0.55 (-1.02, -0.08)] in females. Cortical thinning was demonstrated for frontal and occipital regions 3 months post-injury in males with mTBI with persistent symptoms versus without persistent symptoms [-0.80 (-1.55, -0.05) to -0.83 (-1.56, -0.10)], and 6 months post-injury in females and younger children with mTBI with persistent symptoms relative to mTBI without persistent symptoms and OI [-1.42 (-2.29, -0.45) to -0.91 (-1.81, -0.01)].Conclusions: These findings signal little diagnostic and prognostic utility of post-acute gray matter macrostructure in pediatric mTBI. However, mTBI altered the typical course of cortical gray matter thinning up to 6 months post-injury, even after symptoms typically abate in most children. Collapsing across symptom status obscured the neurobiological heterogeneity of discrete clinical outcomes after pediatric mTBI. Results illustrate the need to examine neurobiology in relation to clinical outcomes and within a neurodevelopmental framework.}, issn = {0028-3878}, URL = {//www.ebmtp.com/content/early/2023/06/23/WNL.0000000000207508}, eprint = {//www.ebmtp.com/content/early/2023/06/23/WNL.0000000000207508.full.pdf}, journal = {Neurology} }