Jang Sung Ho, Lee Han Do
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
Department of Physical Medicine and Rehabilitation, College of Natural Science, Ulsan College University, Ulsan, Republic of Korea.
Neural Regen Res. 2020 Nov;15(11):2063-2066. doi: 10.4103/1673-5374.282259.
Post-traumatic movement disorder is one of the sequelae of traumatic brain injury. The dentatorubrothalamic tract (DRTT) is reported to be involved in the control of movement. Therefore, injury of the DRTT can be accompanied by abnormal movements, including ataxia, tremor, or dystonia. We investigated DRTT injuries in 27 patients who showed post-traumatic tremor in at least one of four extremities following mild traumatic brain injury. We classified DRTT injuries based on diffusion tensor tractography parameters and configuration: type A: the DRTT showed narrowing, type B: the DRTT showed partial tearing, and type C: the DRTT showed discontinuation. Fractional anisotropy and fiber number of the DRTT were significantly decreased in patients compared with the healthy controls. Based on our DRTT injury classification, among the 54 hemispheres of the 27 patients, type A injury occurred in 22 hemispheres (40.7%) of 17 patients, type B injury was present in 15 hemispheres (27.7%) of 10 patients, and type C injury was observed in 8 hemispheres (14.8%) of 6 patients. Our results suggest that diffusion tensor tractography-based evaluation of the DRTT would be useful when determining cause of post-traumatic tremor in patients with mild traumatic brain injury. The study protocol was approved by the Institutional Review Board of Yeungnam University Hospital (YUMC-2018-09-007) on September 5, 2018.
创伤后运动障碍是创伤性脑损伤的后遗症之一。据报道，齿状红核丘脑束（DRTT）参与运动控制。因此，DRTT损伤可能伴有异常运动，包括共济失调、震颤或肌张力障碍。我们调查了27例轻度创伤性脑损伤后至少一侧四肢出现创伤后震颤的患者的DRTT损伤情况。我们根据扩散张量纤维束成像参数和形态对DRTT损伤进行分类：A型：DRTT变窄；B型：DRTT部分撕裂；C型：DRTT中断。与健康对照组相比，患者DRTT的分数各向异性和纤维数量显著降低。根据我们对DRTT损伤的分类，在27例患者的54个半球中，17例患者的22个半球（40.7%）出现A型损伤，10例患者的15个半球（27.7%）出现B型损伤，6例患者的8个半球（14.8%）出现C型损伤。我们的结果表明，基于扩散张量纤维束成像对DRTT进行评估，对于确定轻度创伤性脑损伤患者创伤后震颤的原因可能是有用的。该研究方案于2018年9月5日获得庆南大学医院机构审查委员会（YUMC-2018-09-007）的批准。
