Injury of the inferior cerebellar peduncle in patients with mild traumatic brain injury: A diffusion tensor tractography study

Abstract

Objectives: No study on injury of the inferior cerebellar peduncle (ICP) in patients with mild traumatic brain injury (mTBI) has been reported. This study, using diffusion tensor tractography (DTT), attempted to demonstrate injury of the ICP in patients with mTBI.

Methods: Three patients with mTBI resulting from a car accident and 18 normal healthy control subjects were enrolled in this study. Diffusion tensor imaging data were acquired at 2 months (patient 1) and 3 months (patients 2 and 3) after onset and the ICP was reconstructed. The Balance Error Scoring System was used for evaluation of balance at the same time diffusion tensor imaging scanning was performed.

Results: The ICPs were discontinued at the upper portion of the vertical cerebellar branch and the transverse cerebellar branch (patient 1) and the proximal portion of the transverse cerebellar branch (patients 2 and 3) compared to the normal control subjects. Regarding DTT parameters, in the three patients, the fibre number of the ICPs was decreased by more than 2 SD compared with those of subjects in the control group.

Conclusion: Evaluation of the ICP using DTT would be useful in patients with a balance problem after mTBI.

Keywords:

• Inferior cerebellar peduncle
• mild traumatic brain injury
• diffusion tensor imaging
• balance

Abbreviations:

• ADC
• apparent diffusion coefficient
• BESS
• Balance Error Scoring System
• DTI
• diffusion tensor imaging
• DTT
• diffusion tensor tractography
• FA
• fractional anisotropy
• FN
• fibre number
• GCS
• Glasgow Coma Scale
• ICP
• inferior cerebellar peduncle
• LOC
• loss of consciousness
• mTBI
• mild traumatic brain injury
• PTA
• post-traumatic amnesia
• TBI
• traumatic brain injury

Declaration of interest

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2015R1D1A4A01020385). The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.