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RESEARCH ARTICLE
Year : 2019  |  Volume : 14  |  Issue : 9  |  Page : 1556-1561

Traumatic axonal injury of the cingulum in patients with mild traumatic brain injury: a diffusion tensor tractography study


1 Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Daegu, Republic of Korea
2 Department of Neurosurgery, College of Medicine, Yeungnam University, Namku, Daegu, Republic of Korea

Correspondence Address:
Han Do Lee
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Daegu
Republic of Korea
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Source of Support: This work was supported by the Medical Research Center Program (2015R1A5A2009124) through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (to SHJ and SHK), Conflict of Interest: None


DOI: 10.4103/1673-5374.255977

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The cingulum, connecting the orbitofrontal cortex to the medial temporal lobe, involves in diverse cognition functions including attention, memory, and motivation. To investigate the relationship between the cingulum injury and cognitive impairment in patients with chronic mild traumatic brain injury, we evaluated the integrity between the anterior cingulum and the basal forebrain using diffusion tensor tractography in 73 patients with chronic mild traumatic brain injury (39 males, 34 females, age 43.29 ± 11.42 years) and 40 healthy controls (22 males, 18 females, age 40.11 ± 16.81 years). The patients were divided into three subgroups based on the integrity between the anterior cingulum and the basal forebrain on diffusion tensor tractography: subgroup A (n = 19 patients) – both sides of the anterior cingulum were intact; subgroup B (n = 36 patients) – either side of the anterior cingulum was intact; and subgroup C (18 patients) – both sides of the anterior cingulum were discontinued. There were significant differences in total Memory Assessment Scale score between subgroups A and B and between subgroups A and C. There were no significant differences in diffusion tensor tractography parameters (fractional anisotropy, apparent diffusion coefficient, and fiber volume) between patients and controls. These findings suggest that the integrity between the anterior cingulum and the basal forebrain, but not diffusion tensor tractography parameter, can be used to predict the cognitive function of patients with chronic mild traumatic brain injury. This study was approved by Yeungnam University Hospital Institutional Review Board (approval No. YUMC-2014-01-425-010) on August 16, 2017.


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