Relationship between depression and dorsolateral prefronto-thalamic tract injury in patients with mild traumatic brain injury

AbstractThe prefrontal lobe has been considered to be closely related to depression. This study examined the relationship between depression and three prefronto-thalamic tract (PF-TT) regions (the dorsolateral prefronto-thalamic tract [DLPF-TT], ventrolateral prefronto-thalamic tract [VLPF-TT], and the orbitofronto-thalamic tract [OF-TT]) in patients with mild traumatic brain injury (TBI), using diffusion tensor tractography (DTT). Thirty-seven patients with depression following mild TBI were recruited based on Beck Depression Inventory-II (BDI-II) scores. Thirty-one normal control subjects were also recruited. The three regions of the PF-TTs were reconstructed using probabilistic tractography and DTT parameters for each of the three PF-TT regions were determined. The tract volume of the DLPF-TT and OF-TT in the patient group showed a significant decrease compared to that of the control group (p < 0.05). The BDI-II score of the patient group showed a moderate negative correlation with the tract volume value of the right (r = − 0.33) and left (r = − 0.41) DLPF-TT (p < 0.05). On the other hand, no significant correlations were detected between the BDI-II score of the patient group and the values of the other DTT parameters values for the three PF-TT regions (p > 0.05). Using DTT, depression was found to be closely related to a DLPF-TT injury in patients with mild TBI. We believe that evaluation of the DLPF-TT using DTT would be helpful when assessing patients with depression following mild TBI. These results can provide useful information regarding the proper application of neuromodulation in the management of depression.

Download Full-text

Relationship between Dizziness and the Core Vestibular Projection Injury in Patients with Mild Traumatic Brain Injury

Diagnostics ◽

10.3390/diagnostics11112070 ◽

2021 ◽

Vol 11 (11) ◽

pp. 2070

Author(s):

Sung-Ho Jang ◽

Chang-Hoon Bae ◽

Jae-Woon Kim ◽

Hyeok-Gyu Kwon

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Injury Severity ◽

Diffusion Tensor ◽

Control Group ◽

Item Score ◽

Mild Tbi ◽

Group A ◽

Group B

Some studies have reported that a core vestibular projection (CVP) injury is associated with dizziness following a brain injury using diffusion tensor tractography (DTT). On the other hand, there has been no DTT study on dizziness caused by a CVP injury in patients with mild traumatic brain injury (TBI). In this study, DTT was used to examine the relationship between dizziness and CVP injury in patients with mild TBI. Forty-three patients with mild TBI and twenty-nine normal subjects were recruited. The patients were classified into two groups based on the dizziness score: group A, patients with a dizziness score less than 2 on the sub-item score for dizziness in the Rivermead Post-concussion Symptoms Questionnaire; group B, patients with a dizziness score above 2. The tract volume (TV) in group B was significantly lower than group A and the control group (p < 0.05). By contrast, the TV in group A was similar to the control group (p > 0.05). Regarding the correlation, the dizziness score of all patients showed a strong negative correlation with the TV of the CVP (r = −0.711, p < 0.05). DTT revealed the CVP injury in patients with dizziness after mild TBI. In addition, the severity of dizziness of these patients was closely related to the injury severity of the CVP.

Download Full-text

Relationship Between Hyperhidrosis and Hypothalamic Injury in Patients With Mild Traumatic Brain Injury

10.21203/rs.3.rs-112407/v1 ◽

2020 ◽

Author(s):

Sung Ho Jang ◽

Hyeok Gyu Kwon

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Patient Group ◽

Diffusion Tensor ◽

Clinical Feature ◽

Control Group ◽

Mild Tbi ◽

Paroxysmal Sympathetic Hyperactivity ◽

Apparent Diffusion ◽

Hypothalamic Injury

Abstract Hyperhidrosis is clinical symptom of various diseases and is an important clinical feature of paroxysmal sympathetic hyperactivity(PSH). Traumatic brain injury(TBI) is the most common condition associated with PSH, and PSH has been mainly reported in moderate and severe TBI. However, very little has been reported on PSH or hyperhidrosis in mild TBI patients. In this study, we used diffusion tensor imaging(DTI) to investigate the relationship between hyperhidrosis and hypothalamic injury in patients with mild TBI. Seven patients with hyperhidrosis after mild TBI and 21 healthy controls were recruited for this study. The Hyperhidrosis Disease Severity Scale was used for evaluation of sweating at the time of DTI scanning. The fractional anisotropy(FA) and apparent diffusion coefficient(ADC) DTI parameters were measured in the hypothalamus. In the patient group, the FA values for both sides of the hypothalamus were significantly lower than those of the control group (p<0.05). By contrast, the ADC values for both sides of the hypothalamus were significantly higher in the patient group than in the control group(p<0.05). In conclusion, we detected hypothalamic injuries in patients who showed hyperhidrosis after mild TBI. Based on the results, it appears that hyperhidrosis in patients with mild TBI is related to hypothalamic injury.

Download Full-text

Examining Microstructural White Matter in Active Duty Soldiers with a History of Mild Traumatic Brain Injury and Traumatic Stress

The Open Neuroimaging Journal ◽

10.2174/1874440001711010046 ◽

2017 ◽

Vol 11 (1) ◽

pp. 46-57 ◽

Cited By ~ 7

Author(s):

Michael N. Dretsch ◽

Rael T. Lange ◽

Jeffery S. Katz ◽

Adam Goodman ◽

Thomas A. Daniel ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

White Matter ◽

Mild Traumatic Brain Injury ◽

Psychological Health ◽

Traumatic Stress ◽

Diffusion Tensor ◽

Active Duty ◽

Control Group ◽

History Of

Background:There is a high comorbidity of posttraumatic stress (PTS) and mild traumatic brain injury (mTBI), with largely overlapping symptomatology, in military service members.Objective:To examine white matter integrity associated with PTS and mTBI as assessed using diffusion tensor imaging (DTI).Method:Seventy-four active-duty U.S. soldiers with PTS (n = 16) and PTS with co-morbid history of mTBI (PTS/mTBI; n = 28) were compared to a military control group (n = 30). Participants received a battery of neurocognitive and clinical symptom measures. The number of abnormal DTI values was determined (>2 SDs from the mean of the control group) for fractional anisotropy (FA) and mean diffusivity (MD), and then compared between groups. In addition, mean DTI values from white matter tracts falling into three categories were compared between groups: (i) projection tracts: superior, middle, and inferior cerebellar peduncles, pontine crossing tract, and corticospinal tract; (ii) association tracts: superior longitudinal fasciculus; and (iii) commissure tracts: cingulum bundle (cingulum-cingulate gyrus and cingulum-hippocampus), and corpus callosum.Results:The comorbid PTS/mTBI group had significantly greater traumatic stress, depression, anxiety, and post-concussive symptoms, and they performed worse on neurocognitive testing than those with PTS alone and controls. The groups differed greatly on several clinical variables, but contrary to what we hypothesized, they did not differ greatly on primary and exploratory analytic approaches of hetero-spatial whole brain DTI analyses.Conclusion:The findings suggest that psychological health conditions rather than pathoanatomical changes may be contributing to symptom presentation in this population.

Download Full-text

Severities in persistent mild traumatic brain injury related headache is associated with changes in supraspinal pain modulatory functions

Molecular Pain ◽

10.1177/17448069211037881 ◽

2021 ◽

Vol 17 ◽

pp. 174480692110378

Author(s):

Matthew Flowers ◽

Albert Leung ◽

Dawn M Schiehser ◽

Valerie Metzger-Smith ◽

Lisa Delano-Wood ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Parietal Cortex ◽

Resting State ◽

Premotor Cortex ◽

Sensory Response ◽

Control Group ◽

The Right ◽

Mild Headache

Emerging evidence suggests mild traumatic brain injury related headache (MTBI-HA) is a form of neuropathic pain state. Previous supraspinal mechanistic studies indicate patients with MTBI-HA demonstrate a dissociative state with diminished levels of supraspinal prefrontal pain modulatory functions and enhanced supraspinal sensory response to pain in comparison to healthy controls. However, the relationship between supraspinal pain modulatory functional deficit and severity of MTBI-HA is largely unknown. Understanding this relationship may provide enhanced levels of insight about MTBI-HA and facilitate the development of treatments. This study assessed pain related supraspinal resting states among MTBI-HA patients with various headache intensity phenotypes with comparisons to controls via functional magnetic resonance imaging (fMRI). Resting state fMRI data was analyzed with self-organizing-group-independent-component-analysis in three MTBI-HA intensity groups (mild, moderate, and severe) and one control group (n = 16 per group) within a pre-defined supraspinal pain network based on prior studies. In the mild-headache group, significant increases in supraspinal function were observed in the right premotor cortex (T = 3.53, p < 0.001) and the left premotor cortex (T = 3.99, p < 0.0001) when compared to the control group. In the moderate-headache group, a significant (T = −3.05, p < 0.01) decrease in resting state activity was observed in the left superior parietal cortex when compared to the mild-headache group. In the severe-headache group, significant decreases in resting state supraspinal activities in the right insula (T = −3.46, p < 0.001), right premotor cortex (T = −3.30, p < 0.01), left premotor cortex (T = −3.84, p < 0.001), and left parietal cortex (T = −3.94, p < 0.0001), and an increase in activity in the right secondary somatosensory cortex (T = 4.05, p < 0.0001) were observed when compared to the moderate-headache group. The results of the study suggest that the increase in MTBI-HA severity may be associated with an imbalance in the supraspinal pain network with decline in supraspinal pain modulatory function and enhancement of sensory/pain decoding.

Download Full-text

Iron Deposition Is Positively Related to Cognitive Impairment in Patients with Chronic Mild Traumatic Brain Injury: Assessment with Susceptibility Weighted Imaging

BioMed Research International ◽

10.1155/2015/470676 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 12

Author(s):

Liyan Lu ◽

Heli Cao ◽

Xiaoer Wei ◽

Yuehua Li ◽

Wenbin Li

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Substantia Nigra ◽

Mild Traumatic Brain Injury ◽

Red Nucleus ◽

Analysis Of Covariance ◽

Control Group ◽

Phase Images ◽

Lenticular Nucleus ◽

The Right

Background. This study aimed to evaluate the usability of SWI in assessment of brain iron to detect cognitive dysfunction in patients with chronic mild traumatic brain injury (mTBI).Methods. 39 patients with mTBI and 37 normal controls were given the Mini-Mental State Examination (MMSE) and underwent SWI scanning at least 6 months after injury. Angle radian values were calculated with phase images. The angle radian values were compared between groups using analysis of covariance, and their association with MMSE scores was analyzed using Spearman correlations.Results. Significantly higher angle radian values (p<0.05) were found in the head of the caudate nucleus, the lenticular nucleus, the hippocampus, the thalamus, the right substantia nigra, the red nucleus, and the splenium of the corpus callosum (SCC) in the mTBI group, compared to the control group. MMSE scores were negatively correlated with angle radian values in the right substantia nigra (r=-0.685,p<0.001).Conclusions. Patients with chronic mTBI might have abnormally high accumulations of iron, and their MMSE scores are negatively associated with angle radian values in the right substantia nigra, suggesting a role of SWI in the assessment of cognitive impairments of these patients.

Download Full-text