{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:43:09Z","timestamp":1777927389634,"version":"3.51.4"},"reference-count":58,"publisher":"SAGE Publications","issue":"5-6","license":[{"start":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T00:00:00Z","timestamp":1708992000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:p>\n                    Emerging evidence suggests that advanced neuroimaging modalities such as arterial spin labelling (ASL) might have prognostic utility for pediatric concussion. This study aimed to: 1) examine group differences in global and regional brain perfusion in youth with concussion or orthopedic injury (OI) at 72\u2009h and 4 weeks post-injury; 2) examine patterns of abnormal brain perfusion within both groups and their recovery; 3) investigate the association between perfusion and symptom burden within concussed and OI youths at both time-points; and 4) explore perfusion between symptomatic and asymptomatic concussed and OI youths. Youths ages 10.00-17.99 years presenting to the emergency department with an acute concussion or OI were enrolled. ASL-magnetic resonance imaging scans were conducted at 72\u2009h and 4 weeks post-injury to measure brain perfusion, along with completion of the Health Behavior Inventory (HBI) to measure symptoms. Abnormal perfusion clusters were identified using voxel-based z-score analysis at each visit. First, mixed analyses of covariance (ANCOVAs) investigated the Group*Time interaction on global and regional perfusion.\n                    <jats:italic toggle=\"yes\">Post hoc<\/jats:italic>\n                    region of interest (ROI) analyses were performed on significant regions. Second, within-group generalized estimating equations investigated the recovery of abnormal perfusion at an individual level. Third, multiple regressions at each time-point examined the association between HBI and regional perfusion, and between HBI and abnormal perfusion volumes within the concussion group. Fourth, whole\u2013brain one-way ANCOVAs explored differences in regional and abnormal perfusion based on symptomatic status (symptomatic vs. asymptomatic) and OIs at each time-point. A total of 70 youths with a concussion [median age (interquartile range; IQR)\u2009=\u200912.70 (11.67-14.35), 47.1% female] and 29 with an OI [median age (IQR)\u2009\n                    <jats:sub>=<\/jats:sub>\n                    \u200912.05 (11.18-13.89), 41.4% female] were included. Although no Group effect was found in global perfusion, the concussion group showed greater adjusted perfusion within the anterior cingulate cortex\/middle frontal gyrus (MFG) and right MFG compared with the OI group across time-points (\n                    <jats:italic toggle=\"yes\">ps<\/jats:italic>\n                    \u2264 0.004). The concussion group showed lower perfusion within the right superior temporal gyrus at both time-points and bilateral occipital gyrus at 4 weeks, (\n                    <jats:italic toggle=\"yes\">ps<\/jats:italic>\n                    \u2264 0.006). The number of hypoperfused clusters was increased at 72\u2009h compared with 4 weeks in the concussion youths (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001), but not in the OIs. Moreover, Group moderated the HBI-perfusion association within the left precuneus and superior frontal gyrus at both time-points, (\n                    <jats:italic toggle=\"yes\">ps<\/jats:italic>\n                    \u2264 0.001). No association was found between HBI and abnormal perfusion volume within the concussion group at any visits. At 4 weeks, the symptomatic sub-group (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200910) showed lower adjusted perfusion within the right cerebellum and lingual gyrus, while the asymptomatic sub-group (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200959) showed lower adjusted perfusion within the left calcarine, but greater perfusion within the left medial orbitofrontal cortex, right middle frontal gyrus, and bilateral caudate compared with OIs. Yet, no group differences were observed in the number of abnormal perfusion clusters or volumes at any visit. The present study suggests that symptoms may be associated with changes in regional perfusion, but not abnormal perfusion levels.\n                  <\/jats:p>","DOI":"10.1089\/neu.2023.0071","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T01:58:53Z","timestamp":1704938333000},"page":"552-570","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Longitudinal Brain Perfusion and Symptom Presentation Following Pediatric Concussion: A Pediatric Concussion Assessment of Rest and Exertion\n                    <sup>+MRI<\/sup>\n                    (PedCARE\n                    <sup>+MRI<\/sup>\n                    ) Substudy"],"prefix":"10.1177","volume":"41","author":[{"given":"Veronik","family":"Sicard","sequence":"first","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuo","family":"Fang","sequence":"additional","affiliation":[{"name":"School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Kardish","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada."},{"name":"Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Healey","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada."},{"name":"School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andra M","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Reid","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada."},{"name":"Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg O.","family":"Cron","sequence":"additional","affiliation":[{"name":"Department of Neurology, Stanford University, Stanford, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerd","family":"Melkus","sequence":"additional","affiliation":[{"name":"The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada."},{"name":"Department of Radiology, Radiation Oncology, and Medical Physics, University of Ottawa, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nishard","family":"Abdeen","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith Owen","family":"Yeates","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Calgary, Calgary, Alberta, Canada."},{"name":"Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada."},{"name":"Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary","family":"Goldfield","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nick","family":"Reed","sequence":"additional","affiliation":[{"name":"Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Zemek","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada."},{"name":"Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9e-Anne","family":"Ledoux","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada."},{"name":"School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada."},{"name":"Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada."},{"name":"Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,2,27]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2022.03.039"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2018.3820"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.2900"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.25197"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2020.7100"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11065-020-09451-7"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0000000000000505"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2016.01.003"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-011-1476-z"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1997.87.1.0009"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/02699052.2018.1540798"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-2083"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11682-018-9946-5"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0149109"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2014.4778"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2018.6024"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40798-022-00435-w"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2020.7566"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.3171\/2023.3.PEDS2339"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2017.07.019"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2016.4634"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2017.02.015"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0118061"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2017.5237"},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2020.7553"},{"key":"e_1_3_6_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0000000000000943"},{"key":"e_1_3_6_28_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2019.6805"},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.1089\/neur.2021.0028"},{"key":"e_1_3_6_30_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097981"},{"key":"e_1_3_6_31_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2021-105030"},{"key":"e_1_3_6_32_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097699"},{"key":"e_1_3_6_33_2","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev-2019-043517"},{"key":"e_1_3_6_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2007.12.025"},{"key":"e_1_3_6_35_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617708090188"},{"key":"e_1_3_6_36_2","unstructured":"Janusz J A Sady MD Gioia GA. Postconcussion symptom assessment. In: Mild Traumatic Brain Injury in Children and Adolescents: From Basic Science to Clinical Management (Kirkwood MW Yeates KO eds). The Guilford Place: New York NY; 2012; pp. 241\u2013263."},{"key":"e_1_3_6_37_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2018.5643"},{"key":"e_1_3_6_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2011.09.015"},{"key":"e_1_3_6_39_2","unstructured":"Ashburner J Barnes G Chen CC et al. SPM12 Manual. Available from: https:\/\/www.fil.ion.ucl.ac.uk\/spm [Last accessed January16 2024]."},{"key":"e_1_3_6_40_2","unstructured":"R Core Team. R: A language and environment for statistical computing [Internet]. Vienna Austria: R Foundation for Statistical Computing; 2022. Available from: https:\/\/www.R-project.org [Last accessed January16 2024]."},{"key":"e_1_3_6_41_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2016.00558"},{"key":"e_1_3_6_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2005.05.058"},{"key":"e_1_3_6_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2011.10.018"},{"key":"e_1_3_6_44_2","article-title":"Introduction to perfusion quantification using arterial spin labelling","author":"Chappell M","year":"2017","unstructured":"Chappell M, , MacIntosh B, , Okell T. Introduction to perfusion quantification using arterial spin labelling. Oxford Academic, 2017; https:\/\/doi.org\/10.1093\/oso\/9780198793816.003.0001","journal-title":"Oxford Academic"},{"key":"e_1_3_6_45_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11682-018-9836-x"},{"key":"e_1_3_6_46_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11682-017-9702-2"},{"key":"e_1_3_6_47_2","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.22563"},{"key":"e_1_3_6_48_2","unstructured":"Cohen J. Statistical power analysis for behavioral sciences. Hillsdale NJ; 1988."},{"key":"e_1_3_6_49_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.545174"},{"key":"e_1_3_6_50_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-097X.2010.00990.x"},{"key":"e_1_3_6_51_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2016.00061"},{"key":"e_1_3_6_52_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2014-093901"},{"key":"e_1_3_6_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nic.2023.01.008"},{"key":"e_1_3_6_54_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2018.00023"},{"key":"e_1_3_6_55_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2018.00023"},{"key":"e_1_3_6_56_2","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X19896883"},{"key":"e_1_3_6_57_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2017.5513"},{"key":"e_1_3_6_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneumeth.2015.02.017"},{"key":"e_1_3_6_59_2","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0000000000000810"}],"container-title":["Journal of Neurotrauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/neu.2023.0071","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/neu.2023.0071","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/neu.2023.0071","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:43:11Z","timestamp":1777675391000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/neu.2023.0071"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,27]]},"references-count":58,"journal-issue":{"issue":"5-6","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1089\/neu.2023.0071"],"URL":"https:\/\/doi.org\/10.1089\/neu.2023.0071","relation":{},"ISSN":["0897-7151","1557-9042"],"issn-type":[{"value":"0897-7151","type":"print"},{"value":"1557-9042","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,27]]}}}