Injury of the corticoreticular pathway in patients with mild traumatic brain injury: A diffusion tensor tractography study

Abstract

Background: Little is known about injury of the corticoreticular pathway (CRP) in patients with mild traumatic brain injury (TBI). The current study attempted to investigate injury of the CRP in patients with mild TBI, using diffusion tensor tractography (DTT).

Methods: This study recruited 29 consecutive patients with proximal weakness following mild TBI and 25 control subjects. The CRP was reconstructed and the fractional anisotropy (FA) value, apparent diffusion coefficient (ADC) value and fibre volume of the CRP were measured. The patients were classified according to the configurational classification of the CRP injury: type A—the CRP showed narrowing, type B—the CRP showed partial tearing at subcortical white matter or brainstem and type C—the CRP showed discontinuation at the subcortical white matter or brainstem.

Result: No significant differences in FA and ADC of the CRP were observed between the patient and control groups (p > 0.05). In contrast, the tract volume of the CRP was significantly lower in the patient group than in the control group (p < 0.05). According to the configurational classification of the CRP injury on DTT, the patients were classified as follows: among 58 hemispheres of 29 patients: type A-9 hemispheres (15.5%) of eight patients, type B-30 hemispheres (51.7%) of 22 patients and type C-13 hemispheres (22.4%) of 11 patients.

Conclusion: This study demonstrated injury of the CRP in patients who showed proximal weakness following mild TBI, using DTT.

• Corticoreticulospinal tract
• corticoreticular pathway
• diffusion tensor imaging
• mild traumatic brain injury
• motor weakness

Declaration of interest

This work was supported by the DGIST R&D Program of the Ministry of Science, ICT and Future Planning (15-BD-0401).

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.