% 0期刊文章%阿什利·l .器皿%一个凯瑟琳•勒贝尔% Adrian Onicas % Nishard Abdeen %米里亚姆波%基督徒比尤利%一个布鲁斯·h·Bjornson %威廉·克雷格%马修Dehaes %一个Sylvain Deschenes琼Doan % %史蒂芬•弗里德曼%布拉德利G固特异%一个利多克斯Andree-Anne乔斯林砾石% %罗杰Zemek %的基思·欧文Yeates %儿科紧急研究加拿大上限研究小组% T纵向灰质轨迹在小儿轻度创伤性脑损伤% D R 10.1212 / WNL 2023%。0000000000207508 % J半岛投注体育官网神经病学% P 10.1212 / WNL。0000000000207508 % X目的:这个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;男性59%;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。灰质macrostructural指标组急性没有差异。 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. %U //www.ebmtp.com/content/neurology/early/2023/06/23/WNL.0000000000207508.full.pdf