J Korean Phys Ther.  2023 Dec;35(6):190-194. 10.18857/jkpt.2023.35.6.190.

Injury of the Thalamocortical Pathway Between the Mediodorsal Nuclei and the Prefrontal Cortex in a Patient with Traumatic Brain Injury

• Yeo SS

• KMID: 2552685
• DOI: http://doi.org/10.18857/jkpt.2023.35.6.190

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.

Keyword

Diffusion tensor imaging; Traumatic brain injury; Mediodorsal nuclei; Prefrontal cortex; Cognition