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Behavioral-play familiarization for non-sedated magnetic resonance imaging in young children with mild traumatic brain injury

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Abstract

Background

Mild traumatic brain injury (mTBI) sustained in early childhood affects the brain at a peak developmental period and may disrupt sensitive stages of skill acquisition, thereby compromising child functioning. However, due to the challenges of collecting non-sedated neuroimaging data in young children, the consequences of mTBI on young children’s brains have not been systematically studied. In typically developing preschool children (of age 3–5years), a brief behavioral-play familiarization provides an effective alternative to sedation for acquiring awake magnetic resonance imaging (MRI) in a time- and resource-efficient manner. To date, no study has applied such an approach for acquiring non-sedated MRI in preschool children with mTBI who may present with additional MRI acquisition challenges such as agitation or anxiety.

Objective

The present study aimed to compare the effectiveness of a brief behavioral-play familiarization for acquiring non-sedated MRI for research purposes between young children with and without mTBI, and to identify factors associated with successful MRI acquisition.

Materials and methods

Preschool children with mTBI (n=13) and typically developing children (n=24) underwent a 15-minutes behavioral-play MRI familiarization followed by a 35-minutes non-sedated MRI protocol. Success rate was compared between groups, MRI quality was assessed quantitatively, and factors predicting success were documented.

Results

Among the 37 participants, 15 typically developing children (63%) and 10 mTBI (77%) reached the MRI acquisition success criteria (i.e., completing the two first sequences). The success rate was not significantly different between groups (p=.48; 95% CI [-0.36 14.08]; Cramer’s V=.15). The images acquired were of high-quality in 100% (for both groups) of the structural images, and 60% (for both groups) of the diffusion images. Factors associated with success included older child age (Β=0.73, p=.007, exp(B)=3.11, 95% CI [1.36 7.08]) and fewer parental concerns (Β=-1.56, p=.02, exp(Β)=0.21, 95% CI [0.05 0.82]) about the MRI procedure.

Conclusion

Using brief behavioral-play familiarization allows acquisition of high-quality non-sedated MRI in young children with mTBI with success rates comparable to those of non-injured peers.

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Data Availability

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly; therefore, supporting data are not available.

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Acknowledgements

We would like to thank the Ste-Justine Hospital radiology team and MRI technologists, in particular Robert Trusilo, for their advice and support throughout the project. We also thank Hongfu Sun (University of Queensland) for her help processing the QSM data.

Funding

This project was funded by grants from the Ste-Justine Hospital Foundation (Défi Trauma) and the Canadian Institutes of Health Research to MHB. CT received a doctoral scholarship (261327) from the Fonds de recherche du Québec—Nature et technologies (FRQNT). FD received a postdoctoral scholarship (35982) from the Fonds de recherche du Québec—Santé (FRQS). MD and TML received salary awards from the FRQS.

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Authors and Affiliations

  1. Department of Psychology, University of Montreal, C.P. 6128 Succursale Centre-Ville, Montreal, QC, H3C 3J7, Canada

    Fanny Dégeilh, Jessica Lacombe-Barrios, Carola Tuerk, Véronique Daneault & Miriam H. Beauchamp

  2. CHU Sainte-Justine Research Center, Montreal, QC, Canada

    Fanny Dégeilh, Jessica Lacombe-Barrios, Mathieu Dehaes, Thuy Mai Luu & Miriam H. Beauchamp

  3. Univ Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, EMPENN – ERL U 1228, Rennes, France

    Fanny Dégeilh

  4. Department of Radiology, University of Calgary, Calgary, Canada

    Catherine Lebel

  5. Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Canada

    Catherine Lebel

  6. Hotchkiss Brain Institute, University of Calgary, Calgary, Canada

    Catherine Lebel

  7. Functional Neuroimaging Unit, Montreal Geriatric University Institute, Montreal, QC, Canada

    Véronique Daneault

  8. Center for Advanced Research in Sleep Medicine, Montreal Sacré-Coeur Hospital, Montreal, QC, Canada

    Véronique Daneault

  9. Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montreal, QC, Canada

    Ramy El-Jalbout, Sylvain Deschênes, Josée Dubois, Chantale Lapierre & Mathieu Dehaes

  10. Department of Pediatric Emergency Medicine, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada

    Jocelyn Gravel

  11. Montreal Children’s Hospital, McGill University Health Center, McGill University, Montreal, QC, Canada

    Isabelle Gagnon

  12. School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada

    Isabelle Gagnon

  13. Department of Pediatrics, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada

    Thuy Mai Luu

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  1. Fanny Dégeilh
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Dégeilh, F., Lacombe-Barrios, J., Tuerk, C. et al. Behavioral-play familiarization for non-sedated magnetic resonance imaging in young children with mild traumatic brain injury. Pediatr Radiol 53, 1153–1162 (2023). https://doi.org/10.1007/s00247-023-05592-y

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