Jeong Pyo Seo1, Sung Ho Jang. 1. Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University , Taegu , Republic of Korea.
Abstract
BACKGROUND: This study reports on a patient with traumatic brain injury (TBI) with a thalamic lesion in the ventroposterolateral nucleus which was demonstrated by diffusion tensor tractography (DTT) for the spinothalamic tract and its thalamocortical pathway (STP). METHODS: One patient with TBI and eight normal control subjects were recruited. A 64-year-old woman who had suffered a motor vehicle accident presented with a persisting tingling sensation and pain in her right upper and lower extremities at 3 weeks after onset. The patient showed impaired touch sensation, but normal proprioception. Diffusion tensor imaging was performed at 1 month after onset. Fractional anisotropy (FA) and mean diffusivity were measured using a region of interest method along the STP. RESULTS: DTT showed normal STP integrities as compared with normal controls. However, the FA values of the left STP at the thalamus were more than 2 SD decreased. The diminished FA value of the left STP in the left thalamus seems to indicate injury of the left ventrolateroposterior nucleus. Central pain and impaired touch sensation of right extremities supports the presence of left STP injury at the ventroposterolateral nucleus in this patient. CONCLUSION: It is believed that DTT for the STP provides a useful means of detecting thalamic injury in TBI.
BACKGROUND: This study reports on a patient with traumatic brain injury (TBI) with a thalamic lesion in the ventroposterolateral nucleus which was demonstrated by diffusion tensor tractography (DTT) for the spinothalamic tract and its thalamocortical pathway (STP). METHODS: One patient with TBI and eight normal control subjects were recruited. A 64-year-old woman who had suffered a motor vehicle accident presented with a persisting tingling sensation and pain in her right upper and lower extremities at 3 weeks after onset. The patient showed impaired touch sensation, but normal proprioception. Diffusion tensor imaging was performed at 1 month after onset. Fractional anisotropy (FA) and mean diffusivity were measured using a region of interest method along the STP. RESULTS:DTT showed normal STP integrities as compared with normal controls. However, the FA values of the left STP at the thalamus were more than 2 SD decreased. The diminished FA value of the left STP in the left thalamus seems to indicate injury of the left ventrolateroposterior nucleus. Central pain and impaired touch sensation of right extremities supports the presence of left STP injury at the ventroposterolateral nucleus in this patient. CONCLUSION: It is believed that DTT for the STP provides a useful means of detecting thalamic injury in TBI.
Authors: John R Keltner; Alan Tong; Eelke Visser; Mark Jenkinson; Colm G Connolly; Alyssa Dasca; Aleks Sheringov; Zachary Calvo; Earl Umbao; Rohit Mande; Mary Beth Bilder; Gagandeep Sahota; Donald R Franklin; Stephanie Corkran; Igor Grant; Sarah Archibald; Florin Vaida; Gregory G Brown; J Hampton Atkinson; Alan N Simmons; Ronald J Ellis Journal: J Neurovirol Date: 2020-06-10 Impact factor: 3.739