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Identifying which children are at greatest risk for negative outcomes can be difficult due to the heterogeneity of TBI. To address this barrier, the current study applied a novel method of characterizing brain connectivity networks, Bayesian multi\u2010subject vector autoregressive modelling (BVAR\u2010connect), which used white matter integrity as priors to evaluate effective connectivity\u2014the time\u2010dependent relationship in functional magnetic resonance imaging (fMRI) activity between two brain regions\u2014within the default mode network (DMN). In a prospective longitudinal study, children ages 8\u201315\u2009years with mild to severe TBI underwent diffusion tensor imaging and resting state fMRI 7\u00a0weeks after injury; post\u2010concussion and anxiety symptoms were assessed 7\u00a0months after injury. The goals of this study were to (1) characterize differences in positive effective connectivity of resting\u2010state DMN circuitry between healthy controls and children with TBI, (2) determine if severity of TBI was associated with differences in DMN connectivity and (3) evaluate whether patterns of DMN effective connectivity predicted persistent post\u2010concussion symptoms and anxiety. Healthy controls had unique positive connectivity that mostly emerged from the inferior temporal lobes. In contrast, children with TBI had unique effective connectivity among orbitofrontal and parietal regions. These positive orbitofrontal\u2010parietal DMN effective connectivity patterns also differed by TBI severity and were associated with persisting behavioural outcomes. Effective connectivity may be a sensitive neuroimaging marker of TBI severity as well as a predictor of chronic post\u2010concussion symptoms and anxiety.<\/jats:p>","DOI":"10.1111\/ejn.15546","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T03:19:53Z","timestamp":1638155993000},"page":"318-336","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Effective connectivity in the default mode network after paediatric traumatic brain injury"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4122-740X","authenticated-orcid":false,"given":"Kelly A.","family":"Vaughn","sequence":"first","affiliation":[{"name":"Children's Learning Institute, Department of Pediatrics, McGovern Medical School University of Texas Health Science Center at Houston  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"DeMaster","sequence":"additional","affiliation":[{"name":"Children's Learning Institute, Department of Pediatrics, McGovern Medical School University of Texas Health Science Center at Houston  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Hwan","family":"Kook","sequence":"additional","affiliation":[{"name":"Merck &amp; Co.  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