Network analysis of structural MRI predicts executive function in paediatric traumatic brain injury.

Paediatric traumatic brain injury (pTBI) is likely to result in cognitive impairment, specifically executive dysfunction. Evidence of the neuroanatomical correlates of this executive function (EF) impairment is derived from studies that treat morphometry of brain regions as distinct, independent features, rather than as a complex network of interrelationships. Morphometric similarity captures the meso-scale organisation of the cortex as the interrelatedness of multiple macro-architectural features and presents a novel tool with which to investigate the brain post pTBI. In a retrospective sample (83 pTBI patients, 33 controls), we estimate morphometric similarity from structural MRI by correlating morphometric features between cortical regions. We compared the meso-scale organisation of the cortex between groups then, using partial least squares regression, assessed the predictive validity of morphometric similarity in understanding later executive functioning, two years post-injury. We found that patients and controls did not differ in terms of the overall magnitude of morphometric similarity. However, a pattern of ROI-level morphometric similarity was predictive of day-to-day EF difficulties reported by parents two years post-injury. This prediction was validated using a leave-one-out, and 20-fold cross-validation approach. Prediction was driven by regions of the prefrontal cortex, typically important for healthy maturation of EF skills in childhood. The meso-scale organisation of the cortex also produced more accurate predictions than any one morphometric feature (i.e. cortical thickness or folding index) alone. We conclude that these methodologies show utility in predicting later executive functioning in this population.

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