Associations between white matter integrity and postural control in adults with traumatic brain injury

PLoS One. 2023 Nov 27;18(11):e0288727. doi: 10.1371/journal.pone.0288727. eCollection 2023.

Abstract

Abnormalities of postural sway have been extensively reported in traumatic brain injury (TBI). However, the underlying neural correlates of balance disturbances in TBI remain to be elucidated. Studies in children with TBI have reported associations between the Sensory Organization Test (SOT) and measures of white matter (WM) integrity with diffusion tensor imaging (DTI) in brain areas responsible for multisensory integration. This study seeks to replicate those associations in adults as well as explore relationships between DTI and the Limits of Stability (LOS) Test. Fifty-six participants (43±17 years old) with a history of TBI were tested 30 days to 5 years post-TBI. This study confirmed results in children for associations between the SOT and the medial lemniscus as well as middle cerebellar peduncle, and revealed additional associations with the posterior thalamic radiation. Additionally, this study found significant correlations between abnormal LOS scores and impaired WM integrity in the cingulum, corpus callosum, corticopontine and corticospinal tracts, fronto-occipital fasciculi, longitudinal fasciculi, medial lemniscus, optic tracts and thalamic radiations. Our findings indicate the involvement of a broad range of WM tracts in the control of posture, and demonstrate the impact of TBI on balance via disruptions to WM integrity.

MeSH terms

  • Adult
  • Brain / diagnostic imaging
  • Brain Injuries, Traumatic* / diagnostic imaging
  • Child
  • Diffusion Tensor Imaging / methods
  • Humans
  • Middle Aged
  • Postural Balance
  • White Matter* / diagnostic imaging

Grants and funding

This research was supported by the Intramural Research Program of the National Institutes of Health (Protocol #10-CC-0118), and by the Center for Neuroscience and Regenerative Medicine. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.