{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:20:59Z","timestamp":1787671259556,"version":"build-2736575974"},"reference-count":73,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T00:00:00Z","timestamp":1685491200000},"content-version":"vor","delay-in-days":150,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institute of Health Research","doi-asserted-by":"publisher","award":["FDN143304"],"award-info":[{"award-number":["FDN143304"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ronald and Irene Ward Chair in Pediatric Brain Injury"},{"DOI":"10.13039\/501100003206","name":"Alberta Children\u2019s Hospital Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003206","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009003","name":"Hotchkiss Brain Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009003","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012856","name":"Alberta Children\u2019s Hospital Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012856","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Killam Postdoctoral Fellowship"},{"DOI":"10.13039\/100008459","name":"University of Calgary","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008459","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Child Health and Wellness"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Advanced diffusion-weighted imaging techniques have increased understanding of the neuropathology of paediatric mild traumatic brain injury (i.e. concussion). Most studies have examined discrete white-matter pathways, which may not capture the characteristically subtle, diffuse and heterogenous effects of paediatric concussion on brain microstructure. This study compared the structural connectome of children with concussion to those with mild orthopaedic injury to determine whether network metrics and their trajectories across time post-injury differentiate paediatric concussion from mild traumatic injury more generally. Data were drawn from of a large study of outcomes in paediatric concussion. Children aged 8\u201316.99 years were recruited from five paediatric emergency departments within 48\u2005h of sustaining a concussion (n = 360; 56% male) or mild orthopaedic injury (n = 196; 62% male). A reliable change score was used to classify children with concussion into two groups: concussion with or without persistent symptoms. Children completed 3\u2005T MRI at post-acute (2\u201333 days) and\/or chronic (3 or 6 months, via random assignment) post-injury follow-ups. Diffusion-weighted images were used to calculate the diffusion tensor, conduct deterministic whole-brain fibre tractography and compute connectivity matrices in native (diffusion) space for 90 supratentorial regions. Weighted adjacency matrices were constructed using average fractional anisotropy and used to calculate global and local (regional) graph theory metrics. Linear mixed effects modelling was performed to compare groups, correcting for multiple comparisons. Groups did not differ in global network metrics. However, the clustering coefficient, betweenness centrality and efficiency of the insula, cingulate, parietal, occipital and subcortical regions differed among groups, with differences moderated by time (days) post-injury, biological sex and age at time of injury. Post-acute differences were minimal, whereas more robust alterations emerged at 3 and especially 6 months in children with concussion with persistent symptoms, albeit differently by sex and age. In the largest neuroimaging study to date, post-acute regional network metrics distinguished concussion from mild orthopaedic injury and predicted symptom recovery 1-month post-injury. Regional network parameters alterations were more robust and widespread at chronic timepoints than post-acutely after concussion. Results suggest that increased regional and local subnetwork segregation (modularity) and inefficiency occurs across time after concussion, emerging after post-concussive symptom resolve in most children. These differences persist up to 6 months after concussion, especially in children who showed persistent symptoms. While prognostic, the small to modest effect size of group differences and the moderating effects of sex likely would preclude effective clinical application in individual patients.<\/jats:p>","DOI":"10.1093\/braincomms\/fcad173","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T13:52:28Z","timestamp":1685541148000},"source":"Crossref","is-referenced-by-count":13,"title":["Altered longitudinal structural connectome in paediatric mild traumatic brain injury: an Advancing Concussion Assessment in Paediatrics study"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8390-4915","authenticated-orcid":false,"given":"Ashley L","family":"Ware","sequence":"first","affiliation":[{"name":"Department of Psychology, Georgia State University , Atlanta, GA 30303 , USA"},{"name":"Department of Psychology , University of Calgary, Calgary, AB T2N 0V2 , Canada"},{"name":"Alberta Children's Hospital Research Institute and Hotchkiss Brain Institute , University of Calgary, AB T2N 0V2 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian I","family":"Onicas","sequence":"additional","affiliation":[{"name":"Department of Psychology , University of Calgary, Calgary, AB T2N 0V2 , Canada"},{"name":"Computer Vision Group, Sano Centre for Computational Medicine , Krak\u00f3w 30-054 , Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishard","family":"Abdeen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Children\u2019s Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada K1H 8L1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam H","family":"Beauchamp","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Montreal and CHU Sainte-Justine Hospital Research Center , Montr\u00e9al, QC, Canada H3C 3J7"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Beaulieu","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, 1098 Research Transition Facility, University of Alberta , Edmonton, AB, Canada T6G 2V2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce H","family":"Bjornson","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Pediatrics, University of British Columbia , Vancouver, BC, Canada V6H 3V4"},{"name":"BC Children\u2019s Hospital Research Institute , Vancouver, BC, Canada V6H 3V4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Craig","sequence":"additional","affiliation":[{"name":"University of Alberta and Stollery Children\u2019s Hospital , Edmonton, AB, Canada T6G 1C9"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Dehaes","sequence":"additional","affiliation":[{"name":"Department of Radiology, Radio-oncology and Nuclear Medicine, Institute of Biomedical Engineering, University of Montreal , Montr\u00e9al, QC, Canada H3T1J4"},{"name":"CHU Sainte-Justine Research Center , Montr\u00e9al, QC, Canada H3T1C5"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Deschenes","sequence":"additional","affiliation":[{"name":"CHU Sainte-Justine Research Center , Montr\u00e9al, QC, Canada H3T1C5"},{"name":"Department of Radiology, Radio-oncology and Nuclear Medicine, University of Montreal , Montr\u00e9al, QC, CHU Sainte-Justine Research Center, Montr\u00e9al, QC, Canada H3T1C5"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quynh","family":"Doan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of British Columbia, BC Children\u2019s Hospital Research Institute , Vancouver, BC, Canada V5Z 4H4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2319-6192","authenticated-orcid":false,"given":"Stephen B","family":"Freedman","sequence":"additional","affiliation":[{"name":"Departments of Pediatric and Emergency Medicine, Cumming School of Medicine, University of Calgary , Calgary, AB, Canada T3B 6A8"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7289-7126","authenticated-orcid":false,"given":"Bradley G","family":"Goodyear","sequence":"additional","affiliation":[{"name":"Alberta Children's Hospital Research Institute and Hotchkiss Brain Institute , University of Calgary, AB T2N 0V2 , Canada"},{"name":"Department of Radiology, University of Calgary , Calgary, AB T2N 0V2 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyn","family":"Gravel","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Department, CHU Sainte-Justine, Montr\u00e9al , QC H3T1C5 , Canada"},{"name":"Department of Pediatric, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al , QC H3T 1C5 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9e-Anne","family":"Ledoux","sequence":"additional","affiliation":[{"name":"Department of Cellular Molecular Medicine, University of Ottawa, Children\u2019s Hospital of Eastern Ontario Research Institute , Ottawa, ON, Canada K1H8L1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Zemek","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Emergency Medicine, University of Ottawa, Children\u2019s Hospital of Eastern Ontario Research Institute , Ottawa, ON, Canada K1H8L1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith Owen","family":"Yeates","sequence":"additional","affiliation":[{"name":"Department of Psychology , University of Calgary, Calgary, AB T2N 0V2 , Canada"},{"name":"Alberta Children's Hospital Research 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