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Journal of Child Neurology
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Morphometric MRI Findings in the Thalamus and Brainstem in Children After Moderate to Severe Traumatic Brain Injury

Michael A. Fearing, PhD

Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

Erin D. Bigler, PhD

Department of Psychology, Brigham Young University, Department of Neuroscience, Brigham Young University, Provo, UT, Departments of Radiology and Psychiatry, University of Utah, Salt Lake City, UT

Elisabeth A. Wilde, PhD

Departments of Physical Medicine and Rehabilitation, Baylor College of Medicine, ewilde{at}bcm.tmc.edu

Jamie L. Johnson, BS

Department of Psychology, Brigham Young University

Jill V. Hunter, MD

Department of Diagnostic Imaging, Texas Children's Hospital, Houston, TX

Xiaoqi Li, MS

Departments of Physical Medicine and Rehabilitation, Baylor College of Medicine

Gerri Hanten, PhD

Departments of Physical Medicine and Rehabilitation, Baylor College of Medicine

Harvey S. Levin, PhD

Departments of Physical Medicine and Rehabilitation, Baylor College of Medicine, Department of Neurosurgery, Baylor College of Medicine, Department of Psychiatry, Baylor College of Medicine, Houston, TX

Generalized whole brain volume loss is well documented in moderate to severe traumatic brain injury. Whether this atrophy occurs in the thalamus and brainstem has not been systematically studied in children. Magnetic resonance imaging (MRI) quantitative analysis was used to investigate brain volume loss in the thalamus and brainstem in 16 traumatic brain injury subjects (age range 9-16 years) compared with 16 age and demo-graphically matched controls. Based on multiple analysis of covariance, controlling for age and head size, reduced volume in the thalamus and the midbrain region of the brainstem were found. General linear model analyses revealed a relation between processing speed on a working memory task and midbrain and brain stem volumes. Reduced volume in thalamic and brainstem structures were associated with traumatic brain injury. Reduction in midbrain and thalamic volume is probably a reflection of the secondary effects of diffuse axonal injury and reduction in cortical volume from brain injury.

Key Words: brainstem • morphometry • thalamus • traumatic brain injury

Journal of Child Neurology, Vol. 23, No. 7, 729-737 (2008)
DOI: 10.1177/0883073808314159
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