Objectives: We investigated an approach for the diagnosis of traumatic axonal injury\n(TAI) of the spinothalamic tract (STT) that was based on diffusion tensor tractography (DTT)\nresults and a statistical comparison of individual patients who showed central pain following mild\ntraumatic brain injury (mTBI) with the control group. Methods: Five right-handed female patients\nin their forties and with central pain following mTBI and 12 age-, sex-, and handedness-matched\nhealthy control subjects were recruited. After DTT reconstruction of the STT, we analyzed the STT\nin terms of three DTT parameters (fractional anisotropy (FA), mean diffusivity (MD), and fiber\nnumber (FN)) and its configuration (narrowing and tearing). To assess narrowing, we determined\nthe area of the STT on an axial slice of the subcortical white matter. Results: the FN values were\nsignificantly lower in at least one hemisphere of each patient when compared to those of the control\nsubjects (p < 0.05). Significant decrements from the STT area in the control group were observed in\nat least one hemisphere of each patient (p < 0.05). Regarding configurational analysis, the STT\nshowed narrowing and/or partial tearing in at least one hemisphere of each of the five patients.\nConclusions: Herein, we demonstrate a DTT-based approach for the diagnosis of TAI of the STT.\nThe approach involves a statistical comparison between DTT parameters of individual patients\nwho show central pain following mTBI and those of an age-, gender-, and handedness-matched\ncontrol group. We think that the method described in this study can be useful in the diagnosis of\nTAI of the STT in individual mTBI patients.
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