Neural substrates of inhibitory and emotional processing in adolescents with traumatic brain injury

Issue title: Emerging Data in Pediatric Traumatic Brain Injury

Guest editors: Stacy Suskauer

Article type: Research Article

Authors: Tlustos, Sarah J.^a | Peter Chiu, C.Y.^{b; c; *} | Walz, Nicolay C.^{d; e} | Wade, Shari L.^{e; f}

Affiliations: [a] Department of Physical Medicine and Rehabilitation, Children's Hospital Colorado, Aurora, CO, USA | [b] Department of Psychology, University of Cincinnati, Cincinnati, OH, USA | [c] Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, USA | [d] Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA | [e] University of Cincinnati College of Medicine, Cincinnati, OH, USA | [f] Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA

Correspondence: [*] Corresponding author: C.Y. Peter Chiu, Department of Psychology, University of Cincinnati, Edwards One Room 4150F, ML 0376, Cincinnati, OH 45221-0376, USA. Tel.: +1 513 556 6451; Fax: +1 513 556 1904; E-mail:peter.chiu@uc.edu

Abstract: PURPOSE: Disturbances of emotional regulation and social difficulties are common in children and adolescents with traumatic brain injury (TBI). Recent research suggests that developments within ``socio-emotional'' brain systems during early adolescence and more protracted development of ``cognitive control'' systems have implications for emotional and behavioral regulation during adolescence. However, few functional neuroimaging studies have directly examined the interaction of these neuropsychological processes in adolescents with TBI. The current study examined how affective processing might modulate inhibitory processing in an Emotional Go/NoGo paradigm. METHOD: The study uses a cross-sectional, age, gender, and maternal education matched design. A response inhibition paradigm (i.e., the Go/NoGo task with emotional faces) was used to examine emotional-cognition interaction in 11 adolescents with complicated mild to moderate TBI, at least 12 months post injury, and 14 typically-developing (TD) adolescents using functional magnetic resonance imaging (fMRI). Participants saw adult facial expressions of emotions (happy, sad, fearful, and angry) and were instructed to respond (``go'') on all expressions other than angry (``no-go''). RESULTS: Preliminary results (p= 0.001 uncorrected, cluster size = 50) showed higher levels of inhibition-related activation in TD adolescents than in adolescents with TBI in several brain regions including anterior cingulate and motor/premotor regions. CONCLUSION: These results suggest that TBI in adolescence might alter brain activation patterns and interrupt the development of brain networks governing emotion-cognition interactions.

Keywords: Childhood brain disorder, brain imaging, executive functions, head injury, emotion, adolescence

DOI: 10.3233/PRM-150350

Journal: Journal of Pediatric Rehabilitation Medicine, vol. 8, no. 4, pp. 321-333, 2015