Research Reports - Traumatic axonal injury of the corticospinal tract in patients with mild traumatic brain injury

Brain Inj. 2015;29(1):110-114

Seo JP(1), Jang SH

Abstract Background: 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). Methods: 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. Results: 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. Conclusions: 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.

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