| 제목 |
Diagnostic approach to traumatic axonal injury of the STT in individual patients with mild TBI |
| 소속 |
Yeungnam University Medical Center, Department of Rehabilitation Medicine1 |
| 저자 |
Sung Ho Jang1†, Han Do Lee1†, Seung Hwa Jang1*† |
Objectives: We investigated an approach to the diagnosis of traumatic axonal injury (TAI) of the spinothalamic tract (STT) that was based on diffusion tensor tractography (DTT) results and a statistical comparison of individual patients who showed central pain following mild traumatic brain injury(mTBI) with control group.
Methods: Five right-handed female patients in their forties and with central pain following mTBI and 12 age-, sex-, and handedness-matched healthy control subjects were recruited. After DTT reconstruction of the STT, we analyzed the STT in terms of three DTT parameters (fractional anisotropy[FA], mean diffusivity[MD], and fiber number[FN]) and its configuration (narrowing and tearing). To assess narrowing, we determined the area of the STT on an axial slice of the subcortical white matter.
Results: the FN values were significantly lower in at least one hemisphere of each patient compared to those of the control subjects(p<0.05). Significant decrements from the STT area in the control group were observed in at least one hemisphere of each patient(p<0.05). Regarding configurational analysis, the STT showed narrowing and/or partial tearing in at least one hemisphere of each of the five patients.
Conclusions: Herein, we demonstrate a DTT-based approach to the diagnosis of TAI of the STT. The approach involves a statistical comparison between DTT parameters of individual patients who show central pain following mTBI and those of an age-, gender-, and handedness-matched control group. We think the method described in this study can be useful in the diagnosis of TAI of the STT in individual mTBI patients.
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Results of diffusion tensor tractography (DTT) for the spinothalamic tract of five patients and a representative control group subject. Partially torn and narrowed areas are marked with red arrows while narrowed areas are marked with purple arrows.
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