The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
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Injury of the Thalamocortical Pathway Between the Mediodorsal Nuclei and the Prefrontal Cortex in a Patient with Traumatic Brain Injury

  • Sang Seok Yeo (Department of Physical Therapy, College of Health Welfare Sciences, Dankook University)
  • Received : 2023.11.20
  • Accepted : 2023.12.26
  • Published : 2023.12.31
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Abstract

Purpose: Traumatic brain injury (TBI) refers to brain damage caused by external forces or trauma. TBIs can vary in severity and result from accidents, falls, sports injuries, assaults, or other forms of physical trauma. The prefrontal cortex (PFC) is known have roles in various cognitive functions. We report on a patient with traumatic brain injury who showed prefrontal symptoms after injury of thalamocortical connections between mediodorsal nuclei (MD) of thalamus and PFC. Methods: A 54-year-old, male patient suffered a TBI as a result of a heavy object falling on his head. After onset of TBI, he showed typical symptoms of prefrontal lobe injury, including personality changes, memory impairment, and general cognition problem. The thalamocortical connections between MD and PFC (ventrolateral prefrontal cortex (VLPFC), dorsolateral prefrontal cortex (DLPFC), and obrbitofrontal cortex (OFC)) were reconstructed using diffusion tensor tractography. In terms of fractional anisotropy value, the right thalamocortical connections to the OFC were significantly lower than those of control subjects. Results: The value of mean diffusivity in the right thalamocortical connections to the DLPFC was significantly higher than that of control subjects. By contrast, both VLPFC and left OFC showed significant decrement in the tract volume of thalamocortical connections compared with that of control subjects. Conclusion: We reported on a patient who showed cognitive and neuropsychiatric impairment due to global injury of the thalamocoritcal connections between MD and PFC following TBI.

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References

  1. Chen Q, Bharadwaj V, Irvine KA et al. Mechanisms and treatments of chronic pain after traumatic brain injury. Neurochem Int. 2023:105630. 
  2. Dams-O'Connor K, Juengst SB, Bogner J et al. Traumatic brain injury as a chronic disease: insights from the united states traumatic brain injury model systems research program. Lancet Neurol. 2023;22(6):517-28. 
  3. Akira M, Yuichi T, Tomotaka U et al. The outcome of neurorehabilitation efficacy and management of traumatic brain injury. Front Hum Neurosci. 2022;16:870190. 
  4. McNerney MW, Gurkoff GG, Beard C et al. The rehabilitation potential of neurostimulation for mild traumatic brain injury in animal and human studies. Brain Sci. 2023;13(10). 
  5. Noel F, Gagnon MP, Lajoie J et al. Inpatient physical therapy in moderate to severe traumatic brain injury in in older adults: a scoping review. Int J Environ Res Public Health. 2023;20(4). 
  6. Mesulam MME. Principles of behavioral neurology and cognitive neurology. 2nd Edition. New York, Oxford University, 2000:44-5. 
  7. Frey S, Petrides M. Orbitofrontal cortex: a key prefrontal region for encoding information. Proc Natl Acad Sci U S A. 2000;97(15):8723-7. 
  8. Frey S, Petrides M. Orbitofrontal cortex and memory formation. Neuron. 2002;36(1):171-6. 
  9. Hoffmann M. The human frontal lobes and frontal network systems: an evolutionary, clinical, and treatment perspective. ISRN Neurol. 2013;2013:892459. 
  10. Klein JC, Rushworth MF, Behrens TE et al. Topography of connections between human prefrontal cortex and mediodorsal thalamus studied with diffusion tractography. Neuroimage. 2010;51(2):555-64. 
  11. Jang SH, Yeo SS. Thalamocortical connections between the mediodorsal nucleus of the thalamus and prefrontal cortex in the human brain: a diffusion tensor tractographic study. Yonsei Med J. 2014;55(3):709-14. 
  12. Ahn HJ, Chin J, Park A et al. Seoul neuropsychological screening battery-dementia version (snsb-d): a useful tool for assessing and monitoring cognitive impairments in dementia patients. J Korean Med Sci. 2010;25(7):1071-6. 
  13. Williams JM. Memory assessment scales: professional manual. Odessa, FL, Psychological Assessment Resourses, 1991:4-5. 
  14. Cummings JL, Mega M, Gray K et al. The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994;44(12):2308-14. 
  15. Morris JC. The clinical dementia rating (cdr): current version and scoring rules. Neurology. 1993;43(11):2412-4. 
  16. Assaf Y, Pasternak O. Diffusion tensor imaging (dti)-based white matter mapping in brain research: a review. J Mol Neurosci. 2008;34(1):51-61. 
  17. Seo JP, Jang SH. Different characteristics of the corticospinal tract according to the cerebral origin: dti study. AJNR Am J Neuroradiol. 2013;34(7):1359-63. 
  18. Levy BJ, Wagner AD. Cognitive control and right ventrolateral prefrontal cortex: reflexive reorienting, motor inhibition, and action updating. Ann N Y Acad Sci. 2011;1224:40-62. 
  19. Badre D, Wagner AD. Left ventrolateral prefrontal cortex and the cognitive control of memory. Neuropsychologia. 2007;45(13):2883-901. 
  20. Tanji J, Hoshi E. Role of the lateral prefrontal cortex in executive behavioral control. Physiol Rev. 2008;88(1):37-57. 
  21. Hughes BL, Beer JS. Orbitofrontal cortex and anterior cingulate cortex are modulated by motivated social cognition. Cereb Cortex. 2012;22(6):1372-81. 
  22. Eckert U, Metzger CD, Buchmann JE et al. Preferential networks of the mediodorsal nucleus and centromedian-parafascicular complex of the thalamus-a dti tractography study. Hum Brain Mapp. 2012;33(11):2627-37. 
  23. Yamada K, Sakai K, Akazawa K et al. Mr tractography: a review of its clinical applications. Magn Reson Med Sci. 2009;8(4):165-74.