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

Abstract : 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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https://hal.inria.fr/hal-01251644
Contributeur : Olivier Colliot <>
Soumis le : mercredi 6 janvier 2016 - 15:17:50
Dernière modification le : vendredi 31 août 2018 - 09:03:58

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

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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, Elsevier Masson, 2015, 42 (4), pp.202-11. 〈hal-01251644〉

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