Neurosurgical outcome studies of traumatic brain injury (TBI) identify strikingly high rates of mortality and morbidity in infants and young children. As few prospective longitudinal outcome studies have been completed, the objective of this proposal is to examine factors influencing the outcome of infants and young children who sustain TBI from either physical child abuse (inflicted) or accidental (noninflicted) causes. To more clearly dissociate the effects of age, external cause of injury, and severity of brain injury, we propose to study the following Specific Aims: 1) tom characterize the influence of age at injury, inflicted versus noninflicted TBI, structural damage to brain regions, and disturbance of consciousness on outcome; 2) to relate family characteristics and executive function deficits to the development of social competence, self-regulation, and academic skills; and 3) to identify relationships of regional and global cerebral volume based on quantitative MRI to outcome domains. We propose 3 interrelated prospective, longitudinal neurobehavioral follow-up studies of young children sustaining inflicted or noninflicted TBI. Study 1 will follow the cohort of children enrolled in the initial funding period to assess the long-term effects of inflicted and noninflicted TBI sustained from 0-71 months of age on the expanded outcome domains. Study 2 will enroll a new cohort of children ages 0-35 months with either inflicted or noninflicted TBI to address the influence of age, injury characteristics, and quantitative neuroimaging findings on the developmental trajectory of cognitive and social outcomes. Study 3 will examine the relationship between quantitative neuroimaging findings, executive functions, and the development of academic skills in children sustaining noninflicted TBI between 36-59 months. Studies 2 and 3 will follow children at baseline, 3, 12, and 24 months after injury; quantitative MRIs will be obtained at 3 and 24 months. Noninjured comparison children from sociodemographic backgrounds comparable to the injured children will be recruited for each study and followed on the same schedule. Current knowledge will be extended by assessment of 1) a multifactorial index characterizing severity of TBI, 2) dissociation of effects of age at injury and cause of injury, 3) relationships between regional cerebral volume and outcome domains, 4) the impact of early TBI on the developmental trajectory of executive functions, and 5) relationships between family and injury variables that moderate cognitive, behavioral, and affective development.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
5R01NS029462-09
Application #
6786624
Study Section
Special Emphasis Panel (ZRG1-BBBP-6 (01))
Program Officer
Babcock, Debra J
Project Start
1994-08-01
Project End
2007-08-31
Budget Start
2004-09-01
Budget End
2007-08-31
Support Year
9
Fiscal Year
2004
Total Cost
$488,157
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
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
Ewing-Cobbs, Linda; Prasad, Mary R; Mendez, Donna et al. (2013) Social interaction in young children with inflicted and accidental traumatic brain injury: relations with family resources and social outcomes. J Int Neuropsychol Soc 19:497-507
Ewing-Cobbs, Linda; Prasad, Mary R; Swank, Paul et al. (2012) Social communication in young children with traumatic brain injury: relations with corpus callosum morphometry. Int J Dev Neurosci 30:247-54
Ewing-Cobbs, Linda; Prasad, Mary R; Kramer, Larry et al. (2006) Late intellectual and academic outcomes following traumatic brain injury sustained during early childhood. J Neurosurg 105:287-96
Ewing-Cobbs, L; Hasan, K M; Prasad, M R et al. (2006) Corpus callosum diffusion anisotropy correlates with neuropsychological outcomes in twins disconcordant for traumatic brain injury. AJNR Am J Neuroradiol 27:879-81
Prasad, M R; Kramer, L A; Ewing-Cobbs, L (2005) Cognitive and neuroimaging findings in physically abused preschoolers. Arch Dis Child 90:82-5
Ewing-Cobbs, Linda; Prasad, Mary R; Landry, Susan H et al. (2004) Executive functions following traumatic brain injury in young children: a preliminary analysis. Dev Neuropsychol 26:487-512
Ewing-Cobbs, Linda; Barnes, Marcia; Fletcher, Jack M et al. (2004) Modeling of longitudinal academic achievement scores after pediatric traumatic brain injury. Dev Neuropsychol 25:107-33
Landry, Susan H; Swank, Paul; Stuebing, Karla et al. (2004) Social competence in young children with inflicted traumatic brain injury. Dev Neuropsychol 26:707-33
Ewing-Cobbs, Linda; Barnes, Marcia A; Fletcher, Jack M (2003) Early brain injury in children: development and reorganization of cognitive function. Dev Neuropsychol 24:669-704

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