Neuroimaging in Pediatric Patients with Mild Traumatic Brain Injury: Relating the Current 2018 Centers for Disease Control Guideline and the Potential of Advanced Neuroimaging Modalities for Research and Clinical Biomarker Development.
Neuroimaging in Pediatric Patients with Mild Traumatic Brain Injury: Relating the Current 2018 Centers for Disease Control Guideline and the Potential of Advanced Neuroimaging Modalities for Research and Clinical Biomarker Development.
复制标题
DOI：
10.1089/neu.2020.7100
复制
发表时间：
2021-01-01
影响因子：
4.2
通讯作者：
Loewen JL
中科院分区：
文献类型：
--
作者：
Fong AK;Allen MD;Waltzman D;Sarmiento K;Yeates KO;Suskauer S;Wintermark M;Lindberg DM;Tate DF;Wilde EA;Loewen JL
CDC的2018年儿科轻度创伤性脑损伤（mTBI;本文中也称为脑震荡）现行实践指南系统地确定了基于当前证据的最佳最新实践，特别是确定了有关CT，MRI和颅骨X光片成像的推荐实践。在这篇评论中，我们讨论了指南中没有讨论的神经影像学类型，包括它们对儿科人群的安全性，它们的潜在应用，以及研究未来使用某些模式来帮助诊断和治疗儿童mTBI的研究。神经影像学在儿童mTBI病例中的作用，除了直接的临床价值外，还应考虑对儿童神经和社会发育的潜在贡献在研究中选择性使用特定的神经成像模式已经显示出检测弥漫性脑损伤、脑血流中断的方面，并将生理因素与持续症状相关联，如疲劳、认知能力下降、头痛和情绪变化。然而，这些先进的神经成像模式目前仅限于研究竞技场，并且先进成像模式在儿科mTBI中的任何未来临床应用将需要强有力的证据来证明每种模式能够提供对大脑发育、疾病、损伤或退化的微妙状况的测量，同时考虑非损伤和损伤后时间段的变量。研究人员和医疗保健提供者之间的持续合作和沟通对于研究，开发和验证儿科mTBI诊断和管理中先进成像模式的潜力至关重要。
CDC’s 2018 Guideline for current practices in pediatric mild traumatic brain injury (mTBI; also referred to as concussion herein) systematically identified the best up-to-date practices based on current evidence and, specifically, identified recommended practices regarding CT, MRI, and skull radiograph imaging. In this commentary, we discuss types of neuroimaging not discussed in the guideline in terms of their safety for pediatric populations, their potential application, and the research investigating the future use of certain modalities to aid in the diagnosis and treatment of mTBI in children. The role of neuroimaging in pediatric mTBI cases should be considered for the potential contribution to children’s neural and social development, in addition to the immediate clinical value (as in the case of acute structural findings).Selective use of specific neuroimaging modalities in research has already been shown to detect aspects of diffuse brain injury, disrupted cerebral blood flow, and correlate physiological factors with persistent symptoms, such as fatigue, cognitive decline, headache, and mood changes, following mTBI. However, these advanced neuroimaging modalities are currently limited to the research arena, and any future clinical application of advanced imaging modalities in pediatric mTBI will require robust evidence for each modality’s ability to provide measurement of the subtle conditions of brain development, disease, damage, or degeneration while accounting for variables at both non-injury and time-post-injury epochs. Continued collaboration and communication between researchers and health care providers is essential to investigate, develop, and validate the potential of advanced imaging modalities in pediatric mTBI diagnostics and management.
登录
查看更多内容
影响因子：
5.7
作者：
Barkovich MJ;Li Y;Desikan RS;Barkovich AJ;Xu D
通讯作者：
Xu D
影响因子：
4.2
作者：
Dennis, Emily L.;Jin, Yan;Villalon-Reina, Julio E.;Zhan, Liang;Kernan, Claudia L.;Babikian, Talin;Mink, Richard B.;Babbitt, Christopher J.;Johnson, Jeffrey L.;Giza, Christopher C.;Thompson, Paul M.;Asarnow, Robert F.
通讯作者：
Asarnow, Robert F.
影响因子：
1.9
作者：
Ashwal S;Tong KA;Ghosh N;Bartnik-Olson B;Holshouser BA
通讯作者：
Holshouser BA
影响因子：
2.7
作者：
Chen, Jen-Kai;Johnston, Karen M.;Ptito, Alain
通讯作者：
Ptito, Alain
影响因子：
5.2
作者：
Dunning, J.;Daly, J. Patrick;Mackway-Jones, K.
通讯作者：
Mackway-Jones, K.