Deafferentation in thalamic and pontine areas in severe traumatic brain injury. - Inria - Institut national de recherche en sciences et technologies du numérique Accéder directement au contenu
Article Dans Une Revue Journal de Neuroradiologie / Journal of Neuroradiology Année : 2015

Deafferentation in thalamic and pontine areas in severe traumatic brain injury.

Résumé

Severe traumatic brain injury (TBI) is characterized mainly by diffuse axonal injuries (DAI). The cortico-subcortical disconnections induced by such fiber disruption play a central role in consciousness recovery. We hypothesized that these cortico-subcortical deafferentations inferred from diffusion MRI data could differentiate between TBI patients with favorable or unfavorable (death, vegetative state, or minimally conscious state) outcome one year after injury. Cortico-subcortical fiber density maps were derived by using probabilistic tractography from diffusion tensor imaging data acquired in 24 severe TBI patients and 9 healthy controls. These maps were compared between patients and controls as well as between patients with favorable (FO) and unfavorable (UFO) 1-year outcome to identify the thalamo-cortical and ponto-thalamo-cortical pathways involved in the maintenance of consciousness. Thalamo-cortical and ponto-thalamo-cortical fiber density was significantly lower in TBI patients than in healthy controls. Comparing FO and UFO TBI patients showed thalamo-cortical deafferentation associated with unfavorable outcome for projections from ventral posterior and intermediate thalamic nuclei to the associative frontal, sensorimotor and associative temporal cortices. Specific ponto-thalamic deafferentation in projections from the upper dorsal pons (including the reticular formation) was also associated with unfavorable outcome. Fiber density of cortico-subcortical pathways as measured from diffusion MRI tractography is a relevant candidate biomarker for early prediction of one-year favorable outcome in severe TBI.
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Dates et versions

hal-01251644 , version 1 (06-01-2016)

Identifiants

  • HAL Id : hal-01251644 , version 1
  • PUBMED : 24997478

Citer

M Laouchedi, Damien Galanaud, C Delmaire, S Fernandez-Vidal, A Messé, et al.. Deafferentation in thalamic and pontine areas in severe traumatic brain injury.. Journal de Neuroradiologie / Journal of Neuroradiology, 2015, 42 (4), pp.202-11. ⟨hal-01251644⟩
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