Neural Correlates of Response Control in Children with Traumatic Brain Injury (TBI)

Children with traumatic brain injury often have difficulty with regulating their responses to the environment.  For example, many children will have slowed response times as well as difficulty inhibiting unwanted responses or behaviors.  We have two studies evaluating response control in children with mild complicated to severe TBI in association with parent report on the child’s “real-world” function and imaging studies.  One study is designed for children 8 years and older who are already at least one year post-injury.  The second study follows children 10 years and older beginning 2 months after their injury with multiple study visits until 18 months post-injury.  The goals of these studies are to better understand the brain-basis of difficulties with response control, factors contributing to real-world difficulties in response control, and how to identify early after injury which children will have lasting problems in these areas.  Ultimately this information can be used to better tailor treatment for children with TBI.  Typically developing children without TBI are also needed for these studies, as a control sample.

Somatosensory Information Processing in Children with Concussion

Currently the “gold standard” for evaluating recovery from concussion is to ensure that a child is symptom-free and performing at his/her typical level of pre-injury function prior to return to activities which put the child at risk for another injury to the head.  Research suggests, however, that the brain may be functioning differently to support return to typical function after a concussion.  We have two studies evaluating a new test to understand if it may help us better understand recovery in brain function after a concussion.  This new test involves careful evaluation of how a child senses vibrations applied to the fingertips.  In the first study we will evaluate teenagers within the first week after concussion and again about one month after concussion; in addition to the sensory testing, children will receive MRI brain imaging and cognitive testing.  In the second study we will test children receiving clinical care in Kennedy Krieger Institute’s Concussion Clinic each time they are seen for clinical care over the course of their recovery.  Children without any history of concussion or with concussion more than 6 months prior to study participation are needed to serve as controls for these studies.

Body Fluid Markers of Pediatric Traumatic Brain Injury (TBI)

The ability to identify early after a TBI what kind of assistance a child will need in the months after injury would be very helpful for planning for the child’s care and identifying which children may most benefit from early treatments to optimize outcome after injury.  Research suggests that measuring the amounts of certain proteins in the blood, urine, and/or cerebrospinal fluid after a TBI may be useful for this purpose.  For this study we will collect blood and urine samples from children admitted to the Pediatric Intensive Care Unit at Johns Hopkins Hospital with TBI; for children who require an external ventricular drain we will also collect cerebrospinal fluid.  We will seek to identify proteins from these body fluids which predict a child’s level of functioning one month post-injury.