Predictors of personality change due to traumatic brain injury in children and adolescents six to twenty-four months after injury
Predictors of personality change due to traumatic brain injury in children and adolescents six to twenty-four months after injury
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DOI：
10.1176/appi.neuropsych.18.1.21
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发表时间：
2006-12-01
影响因子：
2.9
通讯作者：
Dennis, M
中科院分区：
文献类型：
--
作者：
Max, JE;Levin, HS;Dennis, M
研究对象为5 ~ 14岁的儿童，从连续入院的患者中招募，并前瞻性随访2年，研究创伤性脑损伤（TBI）后6 ~ 24个月人格改变的现象学和预测因素。评估了损伤和损伤前的心理社会变量。13%的参与者在受伤后6至12个月内发生了性格变化，12%在受伤后第二年发生。损伤的严重程度始终预测人格的变化，和伤前适应功能预测人格的变化，只有在第二年伤后。在控制了损伤的严重程度和其他脑损伤的存在后，额上级回的损伤与损伤后6至12个月的人格改变有关。只有额叶白色物质的损伤与受伤后第二年的人格改变显著相关。儿童TBI后，人格改变的神经相关性在受伤后6至12个月和12至24个月之间发展。这些数据表明，背侧前额叶皮层和额叶白色物质参与了涉及情感状态的努力或有意识调节的人格改变的出现。
Phenomenology and predictive factors of personality change due to traumatic brain injury (TBI) 6 to 24 months after injury was investigated in children, ages 5 to 14 years, enrolled from consecutive admissions and followed prospectively for 2 years. Injury and preinjury psychosocial variables were assessed. Personality change occurred in 13% of participants between 6 and 12 months after injury and 12% in the second year after injury. Severity of injury consistently predicted personality change, and preinjury adaptive function predicted personality change only in the second year postinjury. Lesions of the superior frontal gyrus were associated with personality change between 6 and 12 months following injury, after controlling for severity of injury and the presence of other brain lesions. Only lesions in the frontal lobe white matter were significantly related to personality change in the second year after injury. After childhood TBI, neural correlates of personality change evolve between 6 and 12 months and 12 to 24 months after injury. The data implicate the dorsal prefrontal cortex and frontal lobe white matter in the emergence of personality change involving the effortful or conscious regulation of affective states.