Brain Development in Young Children Following Mild Traumatic Brain Injury - Pilot Study

Study Overview
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Brief Summary
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Concussions (also known as mild traumatic brain injury) are common in young children. In some children, they can lead to short- and long-term difficulties. However, our knowledge of the exact consequences of injuries on young children's brains and behavior is limited. These consequences may be different in children under 6, as their brains are fragile and undergoing significant developmental changes. The aim of this study is to determine the extent to which a concussion sustained before the age of 6 years is associated with changes in young children's brain structure, function and behaviours, using a brain imaging. In this study, the results of a group of 30 children with a concussion will be compared to those of 30 children of the same age with an orthopaedic injury to the upper or lower limbs.

Official Title
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Brain Development in Young Children Following Mild Traumatic Brain Injury - Pilot Study

Conditions
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TBI (Traumatic Brain Injury)

Intervention / Treatment
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* Other: IRM exam


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient group with mild traumatic brain injury (mTBI) : Children aged between 36 months (3 years) and 71 months and 31 days (5 years; before their 6th birthday) Presentation to the emergency department within 48 hours post-injury Documented, unintentional traumatic event (e.g. blow, fall, etc.) resulting in non-penetrating head injury Diagnosis of mTBI (World Health Organization (WHO) paediatric diagnostic criteria) Control group with orthopaedic injury: Children aged between 36 months (3 years) and 71 months and 31 days (5 years; before their 6th birthday) Presentation to the emergency department within 48 hours post-injury Documented, unintentional traumatic event (e.g. blow, fall, etc.) resulting in trauma to an upper or lower limb Diagnosis of simple fracture, sprain, contusion or unspecified trauma to a limb (mild). Exclusion Criteria: Diagnosis of previous TBI (any severity, any age) Intentional injury, Administration of sedative drugs that can alter brain function Complications following injury MRI contraindication, Parent non-fluent in French, Prematurity, Diagnosis of a severe neurological, developmental, or psychiatric disorder Children in foster care at the time of recruitment

Ages Eligible for Study
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Minimum Age: 36 Months
Maximum Age: 71 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients with a mTBI<br>Children with a mTBI aged 3 to 5 years (i.e., up to 71 months and 31 days, i.e., before the 6th birthday) recruited from the paediatric emergency department of Rennes University Hospital. | Other: IRM exam<br>* A non-sedated MRI scan will be performed to assess the structure and function of the children's brains<br>|
| Control with an orthopaedic injury<br>Children with an orthopaedic injury aged 3 to 5 years (i.e., up to 71 months and 31 days, i.e., before the 6th birthday) recruited from the paediatric emergency department of Rennes University Hospital. | Other: IRM exam<br>* A non-sedated MRI scan will be performed to assess the structure and function of the children's brains<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Persistent brain structure alterations | Quantitative assessment of the brain morphometry extracted from T1-w MRI sequence | 3 months post-injury | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Persistent brain lesions - Volume | Volume of brain lesions measured with susceptibility MRI | 3 months post-injury | 
| Persistent brain lesions - Number | Number brain lesions measured with susceptibility MRI | 3 months post-injury | 
| Cerebral blood flow alteration | Cerebral blood flow quantified by arterial spin labelling perfusion MRI (ASL) | 3 months post-injury | 
| Functional integrity of brain networks | Functional connectivity (i.e., correlation between the activation of brain regions) measured by resting-state functional MRI | 3 months post-injury | 
| Structural integrity of brain networks | White matter micro-structure measured by diffusion MRI | 3 months post-injury |