Top

Neuroradiology

Published in:

01-11-2014 | Diagnostic Neuroradiology

Injury of the lower ascending reticular activating system in patients with hypoxic–ischemic brain injury: diffusion tensor imaging study

Authors: Sung Ho Jang, Seong Ho Kim, Hyoung Won Lim, Sang Seok Yeo

Published in: Neuroradiology | Issue 11/2014

Abstract

Introduction

Many studies have reported on vulnerable areas and neural tracts of the brain after hypoxic–ischemic brain injury (HI-BI). However, little is known about injury of the ascending reticular activating system (ARAS). We attempted to investigate on injury of the lower portion of the ARAS in patients with HI-BI using diffusion tensor tractography (DTT).

Methods

Fourteen consecutive patients with HI-BI and 10 control subjects were recruited for this study. We classified the patients into two subgroups according to the preservation of arousal: subgroup A (eight patients)—intact arousal and subgroup B (six patients)—impaired arousal. The lower portion of the ARAS between the pontine reticular formation and the thalamus was reconstructed using the probabilistic tractography method. Fractional anisotropy (FA), mean diffusivity (MD), and tract volume (TV) were measured.

Results

The FA value and TV were decreased in subgroup B compared with those of the control group, although no difference was observed in the MD value (p < 0.05). However, for all DTT parameters, no difference was observed between subgroup A and the control group and between subgroup A and subgroup B (p > 0.05).

Conclusion

Injury of the lower portion of the ARAS was found between the pontine reticular formation and the thalamus in patients with impaired arousal after HI-BI. We believe that analysis using DTT could be helpful in the evaluation of patients with impaired arousal after HI-BI.

Lu-Emerson C, Khot S (2010) Neurological sequelae of hypoxic-ischemic brain injury. NeuroRehabilitation 26:35–45PubMed

Howard RS, Holmes PA, Siddiqui A et al (2012) Hypoxic-ischaemic brain injury: imaging and neurophysiology abnormalities related to outcome. QJM 105:551–561PubMedCrossRef

Anderson CA, Arciniegas DB (2010) Cognitive sequelae of hypoxic-ischemic brain injury: a review. NeuroRehabilitation 26:47–63PubMed

Khot S, Tirschwell DL (2006) Long-term neurological complications after hypoxic-ischemic encephalopathy. Semin Neurol 26:422–431PubMedCrossRef

Dougherty JH Jr, Rawlinson DG, Levy DE et al (1981) Hypoxic-ischemic brain injury and the vegetative state: clinical and neuropathologic correlation. Neurology 31:991–997PubMedCrossRef

Hoesch RE, Koenig MA, Geocadin RG (2008) Coma after global ischemic brain injury: pathophysiology and emerging therapies. Crit Care Clin 24:44–25, vii-viiiCrossRef

Mills VM, Cassidy JW, Katz DI (1997) Neurologic rehabilitation: a guide to diagnosis, prognosis, and treatment planning. Blackwell Science, Malden, MA

Chalela JA, Wolf RL, Maldjian JA et al (2001) MRI identification of early white matter injury in anoxic-ischemic encephalopathy. Neurology 56:481–485PubMedCrossRef

Cummings JL, Tomiyasu U, Read S et al (1984) Amnesia with hippocampal lesions after cardiopulmonary arrest. Neurology 34:679–681PubMedCrossRef

10.

Hawker K, Lang AE (1990) Hypoxic-ischemic damage of the basal ganglia. Case reports and a review of the literature. Mov Disord 5:219–224PubMedCrossRef

11.

Hong JH, Jang SH (2010) Diffusion tensor imaging of neural tract injury in a patient with hypoxic-ischemic brain injury. Neural Regen Res 5:1825–1828

12.

Huang BY, Castillo M (2008) Hypoxic-ischemic brain injury: imaging findings from birth to adulthood. Radiographics 28:417–439, quiz 617PubMedCrossRef

13.

Lee AY, Shin DG, Park JS et al (2012) Neural tracts injuries in patients with hypoxic ischemic brain injury: diffusion tensor imaging study. Neurosci Lett 528:16–21PubMedCrossRef

14.

Basser PJ, Pierpaoli C (1996) Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI. J Magn Reson B 111:209–219PubMedCrossRef

15.

Mori S, Crain BJ, Chacko VP et al (1999) Three-dimensional tracking of axonal projections in the brain by magnetic resonance imaging. Ann Neurol 45:265–269PubMedCrossRef

16.

Assaf Y, Pasternak O (2008) Diffusion tensor imaging (DTI)-based white matter mapping in brain research: a review. J Mol Neurosci 34:51–61PubMedCrossRef

17.

Puig J, Pedraza S, Blasco G et al (2011) Acute damage to the posterior limb of the internal capsule on diffusion tensor tractography as an early imaging predictor of motor outcome after stroke. AJNR Am J Neuroradiol 32:857–863PubMedCrossRef

18.

Jang SH, Chang CH, Lee J et al (2013) Functional role of the corticoreticular pathway in chronic stroke patients. Stroke 44:1099–1104PubMedCrossRef

19.

Yeo SS, Chang PH, Jang SH (2013) The ascending reticular activating system from pontine reticular formation to the thalamus in the human brain. Front Hum Neurosci 7:416PubMedCrossRefPubMedCentral

20.

Edlow BL, Takahashi E, Wu O et al (2012) Neuroanatomic connectivity of the human ascending arousal system critical to consciousness and its disorders. J Neuropathol Exp Neurol 71:531–546PubMedCrossRefPubMedCentral

21.

Edlow BL, Haynes RL, Takahashi E et al (2013) Disconnection of the ascending arousal system in traumatic coma. J Neuropathol Exp Neurol 72:505–523PubMedCrossRefPubMedCentral

22.

Kremer S, Renard F, Noblet V et al (2010) Diffusion tensor imaging in human global cerebral anoxia: correlation with histology in a case with autopsy. J Neuroradiol 37:301–303PubMedCrossRef

23.

Luyt CE, Galanaud D, Perlbarg V et al (2012) Diffusion tensor imaging to predict long-term outcome after cardiac arrest: a bicentric pilot study. Anesthesiology 117:1311–1321PubMedCrossRef

24.

Neil JJ (2008) Diffusion imaging concepts for clinicians. J Magn Reson Imaging 27:1–7PubMedCrossRef

25.

Scheurer E, Lovblad KO, Kreis R et al (2011) Forensic application of postmortem diffusion-weighted and diffusion tensor MR imaging of the human brain in situ. AJNR Am J Neuroradiol 32:1518–1524PubMedCrossRef

26.

Cavanna AE, Shah S, Eddy CM et al (2011) Consciousness: a neurological perspective. Behav Neurol 24:107–116PubMedCrossRef

27.

Smith SM, Jenkinson M, Woolrich MW et al (2004) Advances in functional and structural MR image analysis and implementation as FSL. Neuroimage 23(Suppl 1):S208–S219PubMedCrossRef

28.

Afifi AK, Bergman RA (2005) Functional neuroanatomy: text and atlas, 2nd edn. Lange Medical Books/McGraw-Hill, New York

29.

Daube JR (1986) Medical neurosciences: an approach to anatomy, pathology, and physiology by systems and levels, 2nd edn. Little, Brown and Co, Boston

30.

Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198PubMedCrossRef

31.

Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness. A practical scale. Lancet 2:81–84PubMedCrossRef

32.

Giacino JT, Ashwal S, Childs N et al (2002) The minimally conscious state: definition and diagnostic criteria. Neurology 58:349–353PubMedCrossRef

33.

Seo JP, Jang SH (2013) Different characteristics of the corticospinal tract according to the cerebral origin: DTI study. AJNR Am J Neuroradiol 34:1359–1363PubMedCrossRef

34.

Cervos-Navarro J, Diemer NH (1991) Selective vulnerability in brain hypoxia. Crit Rev Neurobiol 6:149–182PubMed

35.

Howard R, Trend P, Russell RW (1987) Clinical features of ischemia in cerebral arterial border zones after periods of reduced cerebral blood flow. Arch Neurol 44:934–940PubMedCrossRef

36.

Newcombe VF, Williams GB, Scoffings D et al (2010) Aetiological differences in neuroanatomy of the vegetative state: insights from diffusion tensor imaging and functional implications. J Neurol Neurosurg Psychiatry 81:552–561PubMedCrossRef

37.

Lee SK, Kim DI, Kim J et al (2005) Diffusion-tensor MR imaging and fiber tractography: a new method of describing aberrant fiber connections in developmental CNS anomalies. Radiographics 25:53–65, discussion 66–58PubMedCrossRef

38.

Yamada K, Sakai K, Akazawa K et al (2009) MR tractography: a review of its clinical applications. Magn Reson Med Sci 8:165–174PubMedCrossRef

39.

Georgiopoulos M, Katsakiori P, Kefalopoulou Z et al (2010) Vegetative state and minimally conscious state: a review of the therapeutic interventions. Stereotact Funct Neurosurg 88:199–207PubMedCrossRef

Title: Injury of the lower ascending reticular activating system in patients with hypoxic–ischemic brain injury: diffusion tensor imaging study
Authors: Sung Ho Jang
Seong Ho Kim
Hyoung Won Lim
Sang Seok Yeo
Publication date: 01-11-2014
Publisher: Springer Berlin Heidelberg
Published in: Neuroradiology / Issue 11/2014
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-014-1419-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Injury of the lower ascending reticular activating system in patients with hypoxic–ischemic brain injury: diffusion tensor imaging study

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 11/2014

Post-operative orbital imaging: a focus on implants and prosthetic devices

CT angiography after carotid artery stenting: assessment of the utility of adaptive statistical iterative reconstruction and model-based iterative reconstruction

ᅟ

CTA-enhanced perfusion CT: an original method to perform ultra-low-dose CTA-enhanced perfusion CT

The three-dimensional shape analysis of the M1 segment of the middle cerebral artery using MRA at 3T

Infundibular dilation and aneurysm at the origin of the posterior communicating artery: differential diagnosis by CT angiography