Seo Jeong Pyo, Jang Sung Ho
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University , Taegu , Republic of Korea.
Brain Inj. 2015;29(1):110-4. doi: 10.3109/02699052.2014.973447. Epub 2014 Oct 30.
Little is known about injury of the corticospinal tract (CST) in patients with mild traumatic brain injury (TBI). This study reports on patients with mild TBI who showed traumatic axonal injury of the CST in the sub-cortical white matter, as demonstrated by diffusion tensor tractography (DTT).
Four patients with mild TBI who complained of motor weakness and had DTT parameters within the normal range, including fractional anisotropy, apparent diffusion coefficient and fibre number of the CST, and 10 normal control subjects were recruited for this study.
All four patients showed partial tearing of the CSTs in a portion of the sub-cortical white matter in both hemispheres on DTT. However, three patients showed low amplitude on motor evoked potential obtained from both hand muscles by transcranial magnetic stimulation and two patients revealed abnormality of hand motor function in terms of grip strength or Purdue Pegboard score.
This study demonstrated traumatic axonal injury of the CST using configurational evaluation of DTT in patients with mild TBI. It is believed that configurational evaluation using DTT would be a useful technique for detection of localized traumatic axonal injury in patients with mild TBI.
对于轻度创伤性脑损伤（TBI）患者的皮质脊髓束（CST）损伤了解甚少。本研究报告了经扩散张量纤维束成像（DTT）证实，患有轻度TBI且在皮质下白质出现CST创伤性轴索损伤的患者情况。
本研究招募了4例主诉运动无力且DTT参数（包括CST的各向异性分数、表观扩散系数和纤维数量）在正常范围内的轻度TBI患者以及10名正常对照者。
所有4例患者在DTT上均显示双侧半球部分皮质下白质中的CST出现部分撕裂。然而，3例患者经颅磁刺激从双侧手部肌肉获得的运动诱发电位显示波幅较低，2例患者在握力或普渡钉板试验评分方面手部运动功能存在异常。
本研究通过对轻度TBI患者进行DTT构型评估，证实了CST的创伤性轴索损伤。据信，使用DTT进行构型评估将是检测轻度TBI患者局部创伤性轴索损伤的一项有用技术。
