The overarching aim of the application is to model multivariate relations between neuroimaging, cognitive, and psychosocial predictors of academic outcomes after traumatic brain injury (TBI). Academic deficits are among the most significant and pervasive areas of deficit after TBI in school-aged children and adolescents. Moderate to severe TBI is associated with deficits in executive processes that influence outcomes in many domains, including academic skill development, academic performance, and child adjustment. Traditional achievement measures grossly underestimate the functional academic deficits of children with TBI as they infrequently examine related components of executive processing. To address these limitations, we developed integrative academic tasks that incorporate more real-world demands for speed and automaticity of symbol manipulation, inferencing, cohesion, strategy use, resistance to distraction, and comprehension monitoring. We will administer a battery of 1) executive processing tasks assessing processing speed, working memory, and inhibitory control, 2) core achievement tasks, 3) integrative academic tasks and 4) measures of child adjustment to characterize post-traumatic deficits impacting academic outcomes. We propose to use multiple quantitative structural neuroimaging methods, including DT-MRI and volumetric analyses of white and gray matter, to characterize microstructural and macrostructural damage to neural systems and to examine brain-behavior relations after TBI. Study 1 prospectively examines academic outcomes 2, 6, 12, and 24 months after moderate to severe TBI in youth ages 6-15 at the time of injury and an orthopedic comparison group. MRI studies will be obtained at 2 and 24 months after injury for both groups. Study 2 will examine extended follow-up 3 to 8 years after moderate to severe TBI in a cohort of children who sustained TBI at 0-14 years of age in relation to healthy controls. Study 2 allows characterization of the impact of indices of diffuse and focal injury on the late consequences of brain injury. Quantitative MRI will examine late changes in diffusion anisotropy as well as global and regional atrophy as they relate to academic outcomes. Our approach to prediction of outcomes is unique as it emphasizes 1) more precise behavioral measures related to executive processes and integrative academic skills, 2) measures of factors affecting child adjustment; and 3) quantitative indices of macrostructural and microstructural brain injury that are linked through a developmental model. ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
5R01NS046308-04
Application #
7243357
Study Section
Child Psychopathology and Developmental Disabilities Study Section (CPDD)
Program Officer
Hicks, Ramona R
Project Start
2004-05-01
Project End
2009-04-30
Budget Start
2007-05-01
Budget End
2008-04-30
Support Year
4
Fiscal Year
2007
Total Cost
$615,668
Indirect Cost
Name
University of Texas Health Science Center Houston
Department
Pediatrics
Type
Schools of Medicine
DUNS #
800771594
City
Houston
State
TX
Country
United States
Zip Code
77225
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Ewing-Cobbs, Linda; Prasad, Mary R; Cox Jr, Charles S et al. (2017) Altered stress system reactivity after pediatric injury: Relation with post-traumatic stress symptoms. Psychoneuroendocrinology 84:66-75
Prasad, Mary R; Swank, Paul R; Ewing-Cobbs, Linda (2017) Long-Term School Outcomes of Children and Adolescents With Traumatic Brain Injury. J Head Trauma Rehabil 32:E24-E32
Gorman, Stephanie; Barnes, Marcia A; Swank, Paul R et al. (2016) Does processing speed mediate the effect of pediatric traumatic brain injury on working memory? Neuropsychology 30:263-73
Ewing-Cobbs, Linda; Johnson, Chad Parker; Juranek, Jenifer et al. (2016) Longitudinal diffusion tensor imaging after pediatric traumatic brain injury: Impact of age at injury and time since injury on pathway integrity. Hum Brain Mapp 37:3929-3945
Johnson, Chad Parker; Juranek, Jenifer; Swank, Paul R et al. (2015) White matter and reading deficits after pediatric traumatic brain injury: A diffusion tensor imaging study. Neuroimage Clin 9:668-77
Ewing-Cobbs, Linda; Bloom, Douglas R; Prasad, Mary R et al. (2014) Assessing recovery and disability after physical trauma: the Pediatric Injury Functional Outcome Scale. J Pediatr Psychol 39:653-65
Treble, Amery; Hasan, Khader M; Iftikhar, Amal et al. (2013) Working memory and corpus callosum microstructural integrity after pediatric traumatic brain injury: a diffusion tensor tractography study. J Neurotrauma 30:1609-19
Raghubar, Kimberly P; Barnes, Marcia A; Prasad, Mary et al. (2013) Mathematical outcomes and working memory in children with TBI and orthopedic injury. J Int Neuropsychol Soc 19:254-63

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