中国神经再生研究(英文版) ›› 2020, Vol. 15 ›› Issue (11): 2063-2066.doi: 10.4103/1673-5374.282259

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

轻度脑创伤后震颤患者的齿状核-丘脑束系统损伤:病例对照研究

  

  • 出版日期:2020-11-15 发布日期:2020-08-21
  • 基金资助:
    教育部资助的韩国国家研究基金会(NRF)资助的韩国基础科学研究计划的支持(NRF-2018R1A6A3A11043447)

Injury of the dentatorubrothalamic tract in patients with post-traumatic tremor following mild traumatic brain injury: a case-control study

Sung Ho Jang1 , Han Do Lee2   

  1. 1 Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, Republic of Korea
    2 Department of Physical Medicine and Rehabilitation, College of Natural Science, Ulsan College University, Ulsan, Republic of Korea
  • Online:2020-11-15 Published:2020-08-21
  • Contact: Han Do Lee, PhD,lhd890221@hanmail.net.
  • Supported by:
    This study was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by
    the Ministry of Education (NRF-2018R1A6A3A11043447; to HDL).

摘要:

由于齿状核-丘脑束参与运动控制,因而,该神经纤维束损伤可导致脑创伤后运动功能障碍,包括共济失调,震颤或肌张力障碍。研究招募了27例轻度脑创伤后肢体震颤患者,应用弥散张量纤维束成像(DTT)技术对齿状核-丘脑束损伤程度进行分类,A型:齿状核-丘脑束变窄; B型:齿状核-丘脑束局部撕裂; C型:齿状核-丘脑束中断。与健康对照组相比,患者齿状核-丘脑束的分数各向异性(FA)和纤维数(FN)显著降低。根据齿状核-丘脑束损伤分类,在27例患者的54个大脑半球中,A型损伤发生在17例患者的22个大脑半球中,占40.7%;B型出现在10例患者的15个大脑半球中,占27.7%;C型损伤发生在6例患者的8个大脑半球中,占14.8%。结果表明,在确定轻度脑创伤患者创伤后震颤的原因时,基于弥散张量纤维束成像的齿状核-丘脑束评估非常有用。

orcid: 0000-0002-1668-2187 (Han Do Lee)

关键词: 齿状核-丘脑束, 轻度脑创伤, 创伤后震颤, 弥散张量纤维束成像, 感兴趣区, 分数各向异性, 纤维数

Abstract: Post-traumatic movement disorder is one of the sequelae of traumatic brain injury. The dentatorubrotha- lamic 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 hemi- spheres (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.

Key words: dentatorubrothalamic tract, diffusion tensor imaging, diffusion tensor tractography, fiber number, fractional anisotropy, mild traumatic brain injury, post-traumatic tremor, region of interest