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<p><b>Objective.</b> To compare clinical recovery of locomotor function with results from assessments of the functional and structural integrity of the corticospinal and thalamocortical projections in the pediatric population in the intermediate and late periods of severe traumatic brain injury (TBI). <b>Materials and methods.</b> The study included 11 children (seven in the intermediate and four in the late periods of severe TBI). Clinical status was assessed using results of testing muscle strength and tone in the distal parts of the arms (on the muscle strength scale and the modified Ashworth spasticity scale) and application of the gross motor function classification system. Electrophysiological methods consisted of somatosensory evoked potentials on stimulation of the median nerves; diagnostic single-pulse transcranial magnetic stimulation (Sp-TMS) and routine electroencephalography with functional tests. Neuroimaging included magnetic resonance (MR) tractography of the primary motor cortex and supplementary motor area. <b>Results.</b> Preliminary data indicated the difficulty of assessing the relationship between motor deficit (the K-coefficient) and preservation of corticospinal projections from the primary motor cortex and supplementary motor area and the amplitudes of motor evoked potentials in the intermediate period, though they provided an initial indication that these parameters may correlate with each other in the late period of severe TBI in children. <b>Conclusions.</b> Preservation of corticospinal projections as indicated by neuroimaging data, as well as motor evoked potentials on Sp-TMS, is not, based on the cases presented here, a sufficient predictor of recovery of lost locomotor function. The study data are probably most reliable in terms of prognosticating possible recovery of locomotor function in the late period of TBI, i.e., when the processes of structural and functional reorganization are complete.</p>

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Reorganization of the Corticospinal Tract and Thalamocortical Projections in Children with Sequelae of Severe Traumatic Brain Injury

  • 期刊论文

  • 发表日期：

    2025年10月1日

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  • D. S. Kanshina,
  • M. V. Ublinsky,
  • I. A. Melnikov,
  • O. V. Bozhko,
  • T. A. Akhadov,
  • S. A. Valliulina,
  • V. P. Zykov

摘要

Objective. To compare clinical recovery of locomotor function with results from assessments of the functional and structural integrity of the corticospinal and thalamocortical projections in the pediatric population in the intermediate and late periods of severe traumatic brain injury (TBI). Materials and methods. The study included 11 children (seven in the intermediate and four in the late periods of severe TBI). Clinical status was assessed using results of testing muscle strength and tone in the distal parts of the arms (on the muscle strength scale and the modified Ashworth spasticity scale) and application of the gross motor function classification system. Electrophysiological methods consisted of somatosensory evoked potentials on stimulation of the median nerves; diagnostic single-pulse transcranial magnetic stimulation (Sp-TMS) and routine electroencephalography with functional tests. Neuroimaging included magnetic resonance (MR) tractography of the primary motor cortex and supplementary motor area. Results. Preliminary data indicated the difficulty of assessing the relationship between motor deficit (the K-coefficient) and preservation of corticospinal projections from the primary motor cortex and supplementary motor area and the amplitudes of motor evoked potentials in the intermediate period, though they provided an initial indication that these parameters may correlate with each other in the late period of severe TBI in children. Conclusions. Preservation of corticospinal projections as indicated by neuroimaging data, as well as motor evoked potentials on Sp-TMS, is not, based on the cases presented here, a sufficient predictor of recovery of lost locomotor function. The study data are probably most reliable in terms of prognosticating possible recovery of locomotor function in the late period of TBI, i.e., when the processes of structural and functional reorganization are complete.