Childhood Traumatic Brain Injuries Linked to Executive Function Problems: Study

Children who suffer a brain injury may experience structural changes to the brain that impact executive functions, such as multitasking, working memory, inhibition, self-control and other critical skills, according to the findings of a new study.

In a report published this month in the medical journal JAMA Network Open, researchers warn that children may suffer changes to their brain structure even six months after suffering a traumatic brain injury (TBI), even after they were considered largely recovered.

An international team of researchers from the United States, Australia, Iran, the Netherlands, Norway, and other countries conducted a longitudinal cohort study of 600 children and adolescents. They combined 12 datasets from nine sites in the Enhancing Neuroimaging Genetics Through Meta-Analysis Consortium Pediatric TBI working group.

Researchers conducted MRIs on participants to examine structural changes to the brain and used parent-reported scores to determine effects to executive function.

Childhood TBIs Linked to Lower Brain Volume

The findings indicate patients who suffered TBI experienced widespread decreases in cerebellum volume in the brain, confirmed by MRIs. This was especially the case in the posterior lobe.

The cerebellum area of the brain initiates movement, regulates temperature, and enables speech and thinking. The posterior lobe is primarily linked to executive function, judgment, and reasoning.

Changes to the cerebellum can lead to poor executive function, leading to poor judgment and decision-making, difficulty solving problems and expressing emotions.

The study indicated the changes in brain structure volume were prominent in younger participants. The changes to the structure of the brain were primarily seen in patients at the six-month mark after surgery.

Researchers also noticed a decline in white matter organization in the brain. Those were linked with cerebellar disruption, leading to brain injuries.

Participants who experienced a decline in white matter organization in the first few months post-injury also experienced decreases in cerebellum size over time. The white matter decline was an early indicator the patient would later suffer from alterations to the brain structure that could lead to serious changes in executive function.

Childhood Brain Trauma Recovery

Prior research linked TBI in children to long-term effects such as migraines and attention deficit hyperactivity disorder (ADHD) risk later.

Other studies indicated the recovery time for traumatic brain injury may take longer than two weeks, contrary to what was previously believed. The new study reinforces this finding, indicating some significant changes to brain size and function can appear months after the concussion or brain injury first occurred.

The researchers concluded that injuries to the brain, even minor TBIs that are classified as typical concussions, can evolve over time to affect the brain and change the structure of the brain in areas that affect major life functioning.

They indicated early intervention with rest and treatment, as well as not keeping children out of school too long, can help improve recovery and decrease the risk of significant side effects to the brain.