This study investigated the effects of lesion presence within larger brain networks (e.g., default mode network (DMN), salience network (SN), and mentalizing network (MN)) in the chronic phase of a pediatric traumatic brain injury (TBI) and the effect on social function. We compared children with a TBI to children with an orthopedic injury (OI) with three different aims. The first aim was to determine whether network volume differed by group (e.g., TBI vs. OI). Second, investigate if lesion presence in a sub component region of the network resulted in total network volume loss for that network. Finally, learn whether network volume would predict outcome on the Behavior Assessment System for Children, Second Edition (BASC-2). Approximately 184 participants (65% male; 70% Caucasian) between the ages of 6-17 years completed testing and a structural MRI scan in the chronic stage (at least one-year post-injury) of the injury. Injury severity included complicated mild, moderate, and severe TBI. Radiological findings were analyzed using recommendations from the Common Data Elements' core (presence or absence of a lesion) and supplementary (lesion type and location) recommendations. Volumetrics for all participants were obtained with FreeSurfer to quantify total network volumes for the DMN, SN, and MN. The parent of each participant completed a behavioral measure for externalizing and internalizing behaviors. Three sets of statistical analyses were completed, including multivariate analysis of covariance, analysis of covariance, and multiple regression, for each of the three aims of the study, respectively. There were significant differences in total DMN volume between the two groups and participants with lesions solely in the MN had lower total MN volume. Moreover, lower total MN volume was associated with worse functioning on measures of externalizing and internalizing behaviors. The larger implications, including developmental and social implications, of these findings are discussed.



College and Department

Family, Home, and Social Sciences; Psychology



Date Submitted


Document Type





pediatric, traumatic brain injury, TBI, volume, social function, externalizing behaviors, internalizing behaviors, default mode network, salience network, mentalizing network



Included in

Psychology Commons