Diffuse Changes in Cortical Thickness in Pediatric Moderate-to-Severe Traumatic Brain Injury

Generalized whole brain volume loss has been well documented in moderate-to-severe traumatic brain injury (TBI), as has diffuse cerebral atrophy based on magnetic resonance imaging (MRI) volumetric methods where white matter may be more selectively affected than gray matter. However, specific regional differences in gray matter thickness of the cortical mantle have not been previously examined. As such, cortical thickness was assessed using FreeSurfer (R) software to identify regions of significant gray matter cortical thinning in MRI scans of 16 young TBI subjects (age range, 9-16 years) compared to 16 demographically matched controls. Significant cortical thinning was observed globally in the TBI group compared to the cohort of typically developing children. Reduced cortical thickness was related to reported deficits in working memory. TBI-induced cortical thickness reductions are probably due to a combination of focal and diffuse effects and have implications for the neurobehavioral sequelae of TBI.