Recent longitudinal studies of long-term functional outcomes following pediatric traumatic brain injury (TBI) have suggested differential trajectories of recovery. While almost all children show some impairments in functional outcomes early after moderate/severe TBI, many exhibit significant recovery during the first 1-2 years after injury, with a subset showing ongoing deficits. In mild injuries, early sub-acute functional deficits and imaging correlates can be common, but transient, though there is a minority subset who exhibits chronic functional outcomes. Neuroimaging methods have allowed us to examine the brain’s evolving structural, metabolic, and functional changes following injury that correlate with long-term functional outcomes. Integrating these modalities provides a window into the biological underpinnings of recovery observed in some children and neurodegeneration observed in others. This symposium will present longitudinal studies in children across the range of injury severity (mild to severe). Studies using measures of brain structure (DTI/DWI) and function (metabolic status - MR spectroscopy; functional connectivity - fMRI; and event related potentials - measuring interhemispheric transfer time) will be used to predict cognitive and adaptive outcomes. These studies begin to elucidate the biological mechanisms underlying impairment, recovery/regeneration, and ongoing degeneration. Neuroinflammatory processes contributing to neurodegeneration will be specifically addressed. Pathobiology following pediatric TBI will be discussed in the context of ongoing development, which makes young patients particularly vulnerable to injury. The ultimate goal of this symposium is to summarize what we know about the repair and degenerative processes following an injury to the young brain in order to inform targeted and timely treatments for functional outcomes.
At the conclusion of this session, attendees will be able to: