Introduction Pediatric mild traumatic brain injury (pmTBI) constitutes 70–90% of childhood traumatic brain injury cases. While magnetic resonance imaging (MRI) reveals subtle brain alterations, fragmented evidence across modalities limits understanding of long-term neurobiological consequences. Methods This systematic review synthesized 42 studies from MEDLINE/PubMed, Web of Science, Cochrane Library, and Scopus (inception to December 2025) employing structural MRI and functional MRI (fMRI). Methodological quality was assessed using a modified GRADE framework. Results White matter investigations (n = 18) suggested widespread microstructural alterations in limbic and commissural pathways-alongside reduced global network efficiency and disrupted hub connectivity in executive and salience networks. Gray matter studies (n = 9) identified regional cortical thinning in prefrontal and parietal regions, hippocampal atrophy persisting up to 1 year. Resting-state fMRI studies (n = 5) revealed diminished default mode network (DMN) integrity and elevated striatal spontaneous activity. Task-based fMRI studies (n = 10) demonstrated compensatory hyperactivation during working memory and inhibitory tasks-manifesting as enhanced preparatory activation but resource depletion during execution-alongside lower DMN deactivation and persistent cerebrovascular reactivity abnormalities extending to chronic phases. Discussion In sum, multimodal MRI provides evidence suggesting systematic structural and functional alterations in pmTBI encompassing white matter disruption, gray matter vulnerability, and network reorganization.
Hui Xu, Si-Qi Wu, Hao-Cheng Zhan et al.· Frontiers in Neuroscience· 0 citations
Background Adolescent obesity has emerged as a global public health crisis, with accumulating evidence suggesting that it involves not only peripheral metabolic dysfunction but also significant central nervous system remodeling. Given that childhood and adolescence represent a critical window for neurodevelopment, understanding these alterations is vital for effective intervention. This review aimed to systematically synthesize multimodal magnetic resonance imaging (MRI) findings regarding brain structural and functional changes in children and adolescents with obesity, and its underlying neurobiological mechanisms. Methods Following PRISMA guidelines, there were in total 41 high-quality studies encompassing functional MRI, structural MRI, and diffusion tensor imaging modalities involved in this review. Results Synthesis of the literature reveals a consistent “reward-control” imbalance. Functionally, adolescents with obesity exhibited hyper-responsivity in reward-related regions (e.g., striatum, insula) to food cues, coupled with diminished recruitment of executive control areas (e.g., prefrontal cortex). Structurally, obesity was associated with gray matter atrophy in the prefrontal and cingulate cortices, and lower white matter integrity in tracts connecting these regions (e.g., corpus callosum, uncinate fasciculus). These changes may be associated with a synergy of chronic neuroinflammation, insulin resistance, and dopamine pathway dysregulation, although the cross-sectional nature of most evidence precludes definitive causal inferences. Conclusion Obesity-related brain remodeling constitutes a pathological basis that reinforces maladaptive eating behaviors. Future research should prioritize longitudinal designs and targeted neuro-interventions to mitigate long-term cognitive and metabolic consequences in children and adolescent with obesity.
Hui Xu, Jun-Shen Zhang, Yang Wang et al.· Frontiers in Human Neuroscie...· 1 citation
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