Differences in Corticoreticulospinal Tract Injuries According to Whiplash in Mild Traumatic Brain Injury Patients

Sung Ho Jang; Sang Seok Yeo; Jung Won Kwon; Young Hyeon Kwon

doi:10.3389/fneur.2019.01199

Differences in Corticoreticulospinal Tract Injuries According to Whiplash in Mild Traumatic Brain Injury Patients

Front Neurol. 2019 Nov 29:10:1199. doi: 10.3389/fneur.2019.01199. eCollection 2019.

Authors

Sung Ho Jang¹, Sang Seok Yeo², Jung Won Kwon², Young Hyeon Kwon¹

Affiliations

¹ Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Gyeongsan, South Korea.
² Department of Physical Therapy, College of Health Sciences, Dankook University, Seoul, South Korea.

Abstract

Background: This study investigated differences in postural control ability (PCA) and corticoreticulospinal tract (CRT) injury severity according to whiplash in patients with mild traumatic brain injury (mTBI). Methods: Thirty-one patients with mTBI and 21 healthy control subjects were recruited for this study. The balance error scoring system (BESS) was used for PCA assessment. Based on their whiplash history, the patients were classified into two groups: group A-mTBI with whiplash injury; group B-mTBI without whiplash injury. Fractional anisotropy (FA), apparent diffusion coefficient (ADC), and tract volume (TV) values were estimated for the reconstructed CRTs in all subjects. Results: Significant differences were observed among the total BESS scores of patient groups A and B and the control group (p < 0.05). The patient group A BESS score was significantly higher than that of patient group B, and that of the patient group B was significantly higher than that of the control group. No significant differences were detected among the FA and ADC values of the CRTs of the two patient groups and the control group (p > 0.05). However, the TV values of the CRT did reveal significant differences; the TV of patient group A was significantly lower than those of patient group B and the control group, and that of patient group B was significantly lower than that of the control group (p < 0.05). Conclusions: We observed greater CRT injury severity and PCA impairment in mTBI patients with whiplash than in mTBI patients without whiplash. The results indicate that whiplash might lead to a greater level of severity in axonal injuries in mTBI patients.

Keywords: balance error scoring system; corticoreticulospinal tract; diffusion tensor tractography; mild traumatic brain injury; postural control ability; whiplash injury.