Relevance of neuroimaging for neurocognitive and behavioral outcome after pediatric traumatic brain injury

Marsh Konigs*, Petra J. W. Pouwels, L. W. Ernest van Heurn, Roel Bakx, R. Jeroen Vermeulen, J. Carel Goslings, Bwee Tien Poll-The, Marleen van der Wees, Coriene E. Catsman-Berrevoets, Jaap Oosterlaan

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


This study aims to (1) investigate the neuropathology of mild to severe pediatric TBI and (2) elucidate the predictive value of conventional and innovative neuroimaging for functional outcome. Children aged 8-14 years with trauma control (TC) injury (n = 27) were compared to children with mild TBI and risk factors for complicated TBI (mild(RF+), n = 20) or moderate/severe TBI (n = 17) at 2.8 years post-injury. Neuroimaging measures included: acute computed tomography (CT), volumetric analysis on post-acute conventional T1-weighted magnetic resonance imaging (MRI) and post-acute diffusion tensor imaging (DTI, analyzed using tract-based spatial statistics and voxel-wise regression). Functional outcome was measured using Common Data Elements for neurocognitive and behavioral functioning. The results show that intracranial pathology on acute CT-scans was more prevalent after moderate/severe TBI (65%) than after mild(RF+) TBI (35%; p = .035), while both groups had decreased white matter volume on conventional MRI (ps ae<currency> .029, ds ae<yen> -0.74). The moderate/severe TBI group further showed decreased fractional anisotropy (FA) in a widespread cluster affecting all white matter tracts, in which regional associations with neurocognitive functioning were observed (FSIQ, Digit Span and RAVLT Encoding) that consistently involved the corpus callosum. FA had superior predictive value for functional outcome (i.e. intelligence, attention and working memory, encoding in verbal memory and internalizing problems) relative to acute CT-scanning (i.e. internalizing problems) and conventional MRI (no predictive value). We conclude that children with mild(RF+) TBI and moderate/severe TBI are at risk of persistent white matter abnormality. Furthermore, DTI has superior predictive value for neurocognitive out-come relative to conventional neuroimaging.
Original languageEnglish
Pages (from-to)29-43
Number of pages15
JournalBrain Imaging and Behavior
Issue number1
Publication statusPublished - 1 Feb 2018


  • Diffusion tensor imaging
  • Tract-based spatial statistics
  • Pediatrics
  • Traumatic brain injury
  • Neurocognitive functioning
  • Behavior problems
  • TBI


Dive into the research topics of 'Relevance of neuroimaging for neurocognitive and behavioral outcome after pediatric traumatic brain injury'. Together they form a unique fingerprint.

Cite this