[Informative value of instrumental methods in assessing the anatomical and functional state of the corticospinal tract in children with severe traumatic brain injury].

Authors

D S Kanshina, I A Melnikov, M V Ublinsky, S B Ivanov, T A Akhadov, V P Zykov, S S Nikitin

Published in

Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. Volume 126. Issue 7. Pages 92-99.

Abstract

To compare motor recovery in children with severe traumatic brain injury (TBI) with findings from functional and imaging diagnostic techniques based on the age-dependent theory of motor development.
The study included 43 children (26 boys and 17 girls), aged 5 to 17 years, with severe TBI who underwent rehabilitation at the Department of Rehabilitation of the Research Institute of Emergency Pediatric Surgery and Traumatology (Dr. Roshal Clinic) from 2023 to 2024. The clinical evaluation used the Muscle Strength Scale, the Modified Ashworth Scale, and a classification system for gross motor function. Instrumental assessments of the anatomical and functional state of the corticospinal tract (CST) included diagnostic single-pulse transcranial magnetic stimulation (sTMS) and magnetic resonance (MR) tractography, which analyzed corticomotor neuronal pathways originating from the primary motor cortex (PMC) and supplementary motor area.
Improvement in motor deficits during both intermediate and long-term phases post-injury was associated with a reduction in the threshold for motor evoked responses (MER) (AUCs of 0.583 and 0.548, respectively) and an increase in MER amplitude (AUCs of 0.5 and 0.508, respectively). A significant correlation was noted between the deviation of the MER threshold from reference values and the patient's age at the time of injury, with deviations of 9.27% for ages 6-12 years and 26.1% for ages 12-18 years (p<0.05). Additionally, an increase in the fractional anisotropy coefficient of CST was observed in children with various degrees of motor impairment following severe TBI within the first-year post-trauma.
The findings suggest that instrumental diagnostic methods can effectively assess the severity of motor deficits in children with severe TBI and diminished consciousness. The interpretation of these results should incorporate the age-dependent theory of locomotor behavior development.

PMID:
42565404
Bibliographic data and abstract were imported from PubMed on 07 Aug 2026.

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