Cortical Excitability after Mild Traumatic Brain Injury in Children

Abstract

Introduction: Mild traumatic brain injury is frequently complicated by post-concussive syndrome. It is unknown why these symptoms persist, but recent research suggests that cortical excitability may play a role. Objectives: To determine if cortical excitability is different in pediatric mTBI, and if it correlates with symptom persistence. Methods:This was a cross-sectional controlled cohort study. Cortical excitability was measured using a variety of TMS paradigms in children with (symptomatic) and without (asymptomatic) persistent symptoms at one month post injury. The primary outcome measure was the corticalsilent period (cSP) (thought to represent GABAergic inhibition). Results: 57 children with mTBI (44% male; age 14.23 (SD:2.49)) and 28 controls were compared. cSP was similar between groups (F(2, 70)=0.53, p=0.591). There were no other significant group differences in cortical excitability. Conclusions: TMS was well tolerated in children with mTBI. Cortical excitability is similar to normal children at one-month following the injury.