scholarly journals Injury of Corticospinal Tract in a Patient with Subarachnoid Hemorrhage as Determined by Diffusion Tensor Tractography: A Case Report

2020 ◽  
Vol 10 (3) ◽  
pp. 177 ◽  
Author(s):  
Chan-Hyuk Park ◽  
Hyeong Ryu ◽  
Chang-Hwan Kim ◽  
Kyung-Lim Joa ◽  
Myeong-Ok Kim ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Diffusion Tensor Tractography ◽  
Lower Limbs ◽  
Anterior Communicating Artery ◽  
Motor Weakness ◽  
Corona Radiata ◽  
The Right

We report diffusion tensor tractography (DTT) of the corticospinal tract (CST) in a patient with paresis of all four limbs following subarachnoid hemorrhage (SAH) with intraventricular hemorrhage (IVH) after the rupture of an anterior communicating artery (ACoA) aneurysm rupture. The 73-year-old female was admitted to our emergency room in a semi-comatose mental state. After coil embolization—an acute SAH treatment—she was transferred to our rehabilitation department with motor weakness development, two weeks after SAH. Upon admission, she was alert but she complained of motor weakness (upper limbs: MRC 3/5, and lower limbs: MRC 1/5). Four weeks after onset, DTT showed that the bilateral CSTs failed to reach the cerebral cortex. The left CST demonstrated a wide spread of fibers within the corona radiata as well as significantly lower tract volume (TV) and higher fractional anisotropy (FA) as well as mean diffusivity (MD) compared to the controls. On the other hand, the right CST shifted to the posterior region at the corona radiata, and MD values of the right CST were significantly higher when compared to the controls. Changes in both CSTs were attributed to vasogenic edema and compression caused by untreated hydrocephalus. We demonstrate in this case, two different pathophysiological entitles, contributing to this patient’s motor weakness after SAH.

scholarly journals Diffusion-Tensor-Tractography-Based Diagnosis for Injury of Corticospinal Tract in a Patient with Hemiplegia Following Traumatic Brain Injury

Diagnostics ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 156 ◽  
Author(s):  
Chan-Hyuk Park ◽  
Su-Hong Kim ◽  
Han-Young Jung
Keyword(s):  
Traumatic Brain Injury ◽  
Cerebral Cortex ◽  
Brain Injury ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
The Body ◽  
Diffusion Tensor Tractography ◽  
Motor Weakness ◽  
Level Of Consciousness ◽  
The Right

This paper reports a mechanism for corticospinal tract injury in a patient with hemiplegia following traumatic brain injury (TBI) based on diffusion tensor tractography (DTT) finding. A 73-year-old male with TBI resulting from a fall, without medical history, was diagnosed as having left convexity epidural hematoma (EDH). He underwent craniotomy and suffered motor weakness on the right side of the body. Two weeks after onset, he was transferred to a rehabilitation department with an alerted level of consciousness. Four weeks after onset, his motor functions were grade 1 by the Medical Research Council’s (MRC) standards in the right-side limbs and grade 4 in the left-side limbs. The result of DTT using the different regions of interest (ROIs) showed that most of the right corticospinal tract (CST) did not reach the cerebral cortex around where the EDH was located, and when the ROI was placed on upper pons, a disconnection of the CST was shown and a connection of the CST in ROI with the middle pons appeared. However, the right CST was connected to the cerebral cortex below the pons regardless of ROI. This study is the first report to use DTT to detect that the discontinuation of the left CST in the cerebral cortex and injury lesions below the lower pons and between the upper and lower pons are responsible for motor weakness in a patient.

Migraine affects white-matter tract integrity: A diffusion-tensor imaging study

Cephalalgia ◽  
2015 ◽  
Vol 35 (13) ◽  
pp. 1162-1171 ◽  
Author(s):  
Catherine D Chong ◽  
Todd J Schwedt
Keyword(s):  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Imaging Study ◽  
White Matter Tract ◽  
Inferior Longitudinal Fasciculus ◽  
Left And Right ◽  
The Right

Background Specific white-matter tract alterations in migraine remain to be elucidated. Using diffusion tensor imaging (DTI), this study investigated whether the integrity of white-matter tracts that underlie regions of the “pain matrix” is altered in migraine and interrogated whether the number of years lived with migraine modifies fibertract structure. Methods Global probabilistic tractography was used to assess the anterior thalamic radiations, the corticospinal tracts and the inferior longitudinal fasciculi in 23 adults with migraine and 18 healthy controls. Results Migraine patients show greater mean diffusivity (MD) in the left and right anterior thalamic radiations, the left corticospinal tract, and the right inferior longitudinal fasciculus tract. Migraine patients also show greater radial diffusivity (RD) in the left anterior thalamic radiations, the left corticospinal tract as well as the left and right inferior longitudinal fasciculus tracts. No group fractional anisotropy (FA) differences were identified for any tracts. Migraineurs showed a positive correlation between years lived with migraine and MD in the right anterior thalamic radiations ( r = 0.517; p = 0.012) and the left corticospinal tract ( r = 0.468; p = 0.024). Conclusion Results indicate that white-matter integrity is altered in migraine and that longer migraine history is positively correlated with greater alterations in tract integrity.

Injuries of the Cingulum and Fornix After Rupture of an Anterior Communicating Artery Aneurysm

Neurosurgery ◽  
2011 ◽  
Vol 70 (4) ◽  
pp. 819-823 ◽  
Author(s):  
Ji Heon Hong ◽  
Byung Yeon Choi ◽  
Chul Hoon Chang ◽  
Seong Ho Kim ◽  
Young Jin Jung ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Memory Impairment ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Diffusion Tensor Tractography ◽  
Anterior Communicating Artery ◽  
Imaging Parameters ◽  
Age And Sex

Abstract BACKGROUND: After rupture of an anterior communicating artery (ACoA) aneurysm, the anterior cingulum and the fornix can be vulnerable to injury. However, very little is known about this topic. OBJECTIVE: To investigate injuries of the cingulum and fornix in patients with an ACoA aneurysm rupture with diffusion tensor tractography. METHODS: Eleven consecutive patients with an ACoA aneurysm rupture and 11 age- and sex-matched normal control subjects were recruited. Diffusion tensor imaging was scanned at an average of 54.1 days (range, 29–97 days) after onset of ACoA aneurysm rupture. RESULTS: We found that 6 (54.5%) and 7 (63.6%) of 11 patients revealed no trajectory of the anterior cingulum and the fornical body on diffusion tensor tractography, respectively. In terms of diffusion tensor imaging parameters, we found that the fractional anisotropy value and tract volume of the cingulum and fornix were decreased (P < .05) and that mean diffusivity values were increased (P < .05), except for those of the left fornix, which showed no difference (P > .05). CONCLUSION: We found injuries of the cingulum and fornix in patients with an ACoA aneurysm rupture. It is our belief that sustained memory impairment of patients with an ACoA aneurysm rupture might be related to injury of the cingulum and fornix. Therefore, we recommend evaluation of the cingulum and fornix with diffusion tensor tractography for patients with an ACoA aneurysm rupture.

Selective Diffusion Changes of The Visual Pathways in Patients with Migraine: A 3-T Tractography Study

Cephalalgia ◽  
2008 ◽  
Vol 28 (10) ◽  
pp. 1061-1068 ◽  
Author(s):  
MA Rocca ◽  
E Pagani ◽  
B Colombo ◽  
P Tortorella ◽  
A Falini ◽  
...  
Keyword(s):  
Structural Changes ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Clinical Manifestations ◽  
Mean Diffusivity ◽  
Structural Mri ◽  
Visual Aura ◽  
Selective Diffusion ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Using diffusion tensor (DT) tractography, we quantified optic radiation (OR) structural changes in seven migraine patients with (MA) and eight without visual aura (MoA) and their relation to clinical manifestations and T2-visible burden. The corticospinal tract and the corpus callosum were studied as ‘control’ white matter (WM). No difference was found for any of the WM fibre bundles metrics between controls and MoA patients. MA patients had reduced average fractional anisotropy (FA) of both OR compared with controls and reduced average FA of the right OR compared with MoA patients. They also showed higher right OR mean diffusivity than controls. OR metrics were not correlated with clinical and magnetic resonance imaging (MRI) metrics. DT tractography reveals OR changes in MA patients that might represent a phenotypic biomarker of the disease given the lack of correlation with clinical and structural MRI metrics.

Structural brain changes after 4 wk of unilateral strength training of the lower limb

2013 ◽  
Vol 115 (2) ◽  
pp. 167-175 ◽  
Author(s):  
H. S. Palmer ◽  
A. K. Håberg ◽  
M. S. Fimland ◽  
G. M. Solstad ◽  
V. Moe Iversen ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Strength Training ◽  
Isometric Contraction ◽  
Healthy Adult ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Cortical Activation ◽  
Maximum Voluntary Isometric Contraction ◽  
The Right ◽  
Unilateral Strength Training

Strength training enhances muscular strength and neural drive, but the underlying neuronal mechanisms remain unclear. This study used magnetic resonance imaging (MRI) to identify possible changes in corticospinal tract (CST) microstructure, cortical activation, and subcortical structure volumes following unilateral strength training of the plantar flexors. Mechanisms underlying cross-education of strength in the untrained leg were also investigated. Young, healthy adult volunteers were assigned to training ( n = 12) or control ( n = 9) groups. The 4 wk of training consisted of 16 sessions of 36 unilateral isometric plantar flexions. Maximum voluntary isometric contraction torque was tested pre- and posttraining. MRI investigation included a T1-weighted scan, diffusion tensor imaging and functional MRI. Probabilistic fiber tracking of the CST was performed on the diffusion tensor imaging images using a two-regions-of-interest approach. Fractional anisotropy and mean diffusivity were calculated for the left and right CST in each individual before and after training. Standard functional MRI analyses and volumetric analyses of subcortical structures were also performed. Maximum voluntary isometric contraction significantly increased in both the trained and untrained legs of the training group, but not the control group. A significant decrease in mean diffusivity was found in the left CST following strength training of the right leg. No significant changes were detected in the right CST. No significant changes in cortical activation were observed following training. A significant reduction in left putamen volume was found after training. This study provides the first evidence for strength training-related changes in white matter and putamen in the healthy adult brain.

Foix-Chavany-Marie syndrome caused by a disconnection between the right pars opercularis of the inferior frontal gyrus and the supplementary motor area

2012 ◽  
Vol 117 (5) ◽  
pp. 844-850 ◽  
Author(s):  
Juan Martino ◽  
Enrique Marco de Lucas ◽  
Francisco Javier Ibáñez-Plágaro ◽  
José Manuel Valle-Folgueral ◽  
Alfonso Vázquez-Barquero
Keyword(s):  
Supplementary Motor Area ◽  
Diffusion Tensor ◽  
Anterior Part ◽  
Inferior Frontal Gyrus ◽  
Motor Area ◽  
Lower Limbs ◽  
Rare Type ◽  
Orofacial Movement ◽  
Pars Opercularis ◽  
The Right

Foix-Chavany-Marie syndrome (FCMS) is a rare type of suprabulbar palsy characterized by an automaticvoluntary dissociation of the orofacial musculature. Here, the authors report an original case of FCMS that occurred intraoperatively while resecting the pars opercularis of the inferior frontal gyrus. This 25-year-old right-handed man with an incidentally diagnosed right frontotemporoinsular tumor underwent surgery using an asleep-awake-asleep technique with direct cortical and subcortical electrical stimulation and a transopercular approach to the insula. While resecting the anterior part of the pars opercularis the patient suffered sudden anarthria and bilateral facial weakness. He was unable to speak or show his teeth on command, but he was able to voluntarily move his upper and lower limbs. This syndrome lasted for 8 days. Postoperative diffusion tensor imaging tractography revealed that connections of the pars opercularis of the right inferior frontal gyrus with the frontal aslant tract (FAT) and arcuate fasciculus (AF) were damaged. This case supplies evidence for localizing the structural substrate of FCMS. It was possible, for the first time in the literature, to accurately correlate the occurrence of FCMS to the resection of connections between the FAT and AF, and the right pars opercularis of the inferior frontal gyrus. The FAT has been recently described, but it may be an important connection to mediate supplementary motor area control of orofacial movement. The present case also contributes to our knowledge of complication avoidance in operculoinsular surgery. A transopercular approach to insuloopercular gliomas can generate FCMS, especially in cases of previous contralateral lesions. The prognosis is favorable, but the patient should be informed of this particular hazard, and the surgeon should anticipate the surgical strategy in case the syndrome occurs intraoperatively in an awake patient.

Changes in mild cognitive impairment and its subtypes as seen on diffusion tensor imaging

2012 ◽  
Vol 24 (9) ◽  
pp. 1483-1493 ◽  
Author(s):  
Senthil Thillainadesan ◽  
Wei Wen ◽  
Lin Zhuang ◽  
John Crawford ◽  
Nicole Kochan ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Multiple Testing ◽  
Diffusion Tensor ◽  
Internal Capsule ◽  
Anterior Cingulate ◽  
Corona Radiata ◽  
Amnestic Mci ◽  
Subcortical Regions ◽  
The Right

ABSTRACTBackground: Previous studies using diffusion tensor imaging (DTI) have observed microstructural abnormalities in white matter regions in both Alzheimer's disease and mild cognitive impairment (MCI). The aim of this work was to examine the abnormalities in white matter and subcortical regions of MCI and its subtypes in a large, community-dwelling older aged cohortMethods: A community-based sample of 396 individuals without dementia underwent medical assessment, neuropsychiatric testing, and neuroimaging. Of these, 158 subjects were classified as MCI and 238 as cognitively normal (controls) based on international MCI consensus criteria. Regional fractional anisotropy (FA) and mean diffusivity (MD) measures were calculated from the DTI and compared between groups. The false discovery rate correction was applied for multiple testing.Results: Subjects with MCI did not have significant differences in FA compared with controls after correction for multiple testing, but had increased MD in the right putamen, right anterior limb of the internal capsule, genu and splenium of the corpus callosum, right posterior cingulate gyrus, left superior frontal gyrus, and right and left corona radiata. When compared with controls, changes in left anterior cingulate, left superior frontal gyrus, and right corona radiata were associated with amnestic MCI (aMCI), whereas changes in the right putamen, right anterior limb of the internal capsule, and the right corona radiata were associated with non-amnestic MCI (naMCI). On logistic regression, the FA values in the left superior gyrus and MD values in the anterior cingulate distinguished aMCI from naMCI.Conclusions: MCI is associated with changes in white matter and subcortical regions as seen on DTI. Changes in some anterior brain regions distinguish aMCI from naMCI.

scholarly journals Characteristics of Brain Structure in HIV Male Patients with Syphilis Co-Infection: A Cross-Sectional Study.

2021 ◽  
Author(s):  
Yu Qi ◽  
Yuan-Yuan Wang ◽  
Wei Wang ◽  
Xu-Ze Liu ◽  
Jing Liu ◽  
...  
Keyword(s):  
Corpus Callosum ◽  
Diffusion Tensor ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Infected Male ◽  
Syphilis Infection ◽  
Cross Sectional ◽  
Corona Radiata ◽  
Male Patients ◽  
The Right

Abstract Background To investigate the effect of syphilis infection on the microstructure of white matter (WM) in HIV-infected male patients through comparing the differences of WM between HIV-infected male patients with and without syphilitic infection using diffusion tensor imaging (DTI).Methods 27 HIV-infected male patients with current syphilis or a history of syphilis (HIV+/syphilis+) and 29 HIV-infected male patients without syphilis co-infection history (HIV+/syphilis-) were enrolled. All patients received DTI and comprehensive neuropsychological assessment. Clinical data were compared between the two groups with T-test, Mann-Whitney U Test and Chi-square Test. Tract-based spatial statistics (TBSS) was adopted to analyze the DTI metrics. Multiple linear regression analysis was conducted to investigate the relationships between DTI metrics and clinical variables and cognitive performance. Results In the HIV+/syphilis+ group, decreased AD was found in the right superior corona radiata (SCR-R) and body of corpus callosum (BCC); increased RD was found in the bilateral posterior corona radiata (PCR), the right posterior thalamic radiation (PTR-R), the left SCR (SCR-L), splenium of corpus callosum (SCC) and BCC; decreased FA was found in multiple regions. AD in BCC was negatively correlated with CD4/CD8 ratios. AD in SCR-R was positively correlated with CD4/CD8 ratios. Patients in HIV+/syphilis+ group had a lower score in complex motor skills (CMS). RD in SCC and SCR-L was negatively correlated with CMS; RD in PTR-R was positively correlated with CMS. AD in SCR-R was positively correlated with CMS. Conclusions Compared with patients simply infected with HIV, the integrity of WM is more seriously impaired in HIV-infected patients with syphilis co-infection, and it may accelerate the impairment of cognitive function.

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