Relation between cingulum injury and cognition in chronic patients with traumatic brain injury; diffusion tensor tractography study.
OBJECTIVE
Many diffusion tensor imaging (DTI) studies have reported an association between cingulum injury and cognition in patients with traumatic brain injury (TBI) using DTI parameters. In this study, we attempted to investigate the relation between cingulum injury and cognition in chronic patients with TBI, using the integrity of the cingulum as well as DTI parameters.


METHODS
Thirty five consecutive chronic patients with TBI were recruited. The intelligence quotient (IQ) of the Wechsler Intelligence Scale and Memory Assessment Scale (MAS) was used for assessment of cognition. The patients were classified into three groups, according to continuity to the lower portion of the genu of the corpus callosum: type A-both sides of the cingulum showed intact continuity, type B-either cingulum showed a discontinuation, and, type C-both cingulums showed discontinuation. We measured the fractional anisotropy (FA), apparent diffusion coefficient (ADC), and voxel number of both cingulums.


RESULTS
The IQ and MAS scores of type A and B were significantly higher than those of type C, respectively (p < 0.05), however, we did not observe a significant difference between type A and type B (p > 0.05). A positive correlation was observed between the FA value of the cingulum, and IQ and MAS, respectively (IQ r = 0.373, p < 0.05, MAS r = 0.357, p < 0.05), and between the voxel number and MAS (r = 0.500, p < 0.05). By contrast, we observed a negative correlation between the ADC value and IQ (r = -0.353, p < 0.05).


CONCLUSIONS
In terms of integrity to the basal forebrain and DTI parameters of the injured cingulum, DTI findings showed a close association with whole cognition and memory in chronic patients with TBI.
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
Seung Ok
SO
Baek
Oh Lyong
OL
Kim
Seong Ho
SH
Kim
Min Soo
MS
Kim
Su Min
SM
Son
Yoon Woo
YW
Cho
Woo Mok
WM
Byun
Sung Ho
SH
Jang
D000328:Adult; D016880:Anisotropy; D001930:Brain Injuries / Q000150:complications* / Q000473:pathology*; D002908:Chronic Disease; D003072:Cognition Disorders / Q000209:etiology*; D003337:Corpus Callosum / Q000473:pathology; D056324:Diffusion Tensor Imaging; D005260:Female; D006179:Gyrus Cinguli / Q000473:pathology*; D006801:Humans; D007360:Intelligence; D007361:Intelligence Tests; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D055815:Young Adult
Cognition; cingulum; diffusion tensor imaging; memory; traumatic brain injury