title: Relation between cognition and neural connection from injured cingulum to brainstem cholinergic nuclei in chronic patients with traumatic brain injury.
abstract: BACKGROUND
  This study investigated the relation between cognition and the neural connection from injured cingulum to brainstem cholinergic nuclei in patients with traumatic brain injury (TBI), using diffusion tensor tractography (DTT).
  
  
  METHODS
  Among 353 patients with TBI, 20 chronic patients who showed discontinuation of both anterior cingulums from the basal forebrain on DTT were recruited for this study. The Wechsler Intelligence Scale and the Memory Assessment Scale (MAS; short-term, verbal, visual and total memory) were used for assessment of cognition. Patients were divided into two groups according to the presence of a neural connection between injured cingulum and brainstem cholinergic nuclei.
  
  
  RESULTS
  Eight patients who had a neural connection between injured cingulum and brainstem cholinergic nuclei showed better short-term memory on MAS than 12 patients who did not (p < 0.05). However, other results of neuropsychological testing showed no significant difference (p > 0.05).
  
  
  CONCLUSIONS
  Better short-term memory in patients who had the neural connection between injured cingulum and brainstem cholinergic nuclei appears to have been attributed to the presence of cholinergic innervation to the cerebral cortex through the neural connection instead of the injured anterior cingulum. The neural connection appears to compensate for the injured anterior cingulum in obtaining cholinergic innervation.
authors.affiliation: Department of Physical Medicine and Rehabilitation and.
authors.forename: Jin-Sun
authors.initials: JS
authors.lastname: Yoo
authors.forename: Oh Lyong
authors.initials: OL
authors.lastname: Kim
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Kim
authors.forename: Min Su
authors.initials: MS
authors.lastname: Kim
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
mesh_terms: D000328:Adult; D000368:Aged; D020208:Brain Injury, Chronic / Q000503:physiopathology* / Q000523:psychology*; D001933:Brain Stem / Q000503:physiopathology*; D003071:Cognition; D060825:Cognitive Dysfunction / Q000209:etiology* / Q000503:physiopathology; D056324:Diffusion Tensor Imaging; D005260:Female; D006179:Gyrus Cinguli / Q000293:injuries / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008570:Memory, Short-Term; D008875:Middle Aged; D009431:Neural Conduction; D009483:Neuropsychological Tests; D020127:Recovery of Function; D012189:Retrospective Studies
keywords: Brain injury; brainstem cholinergic nuclei; cingulum; cognition; traumatic diffusion tensor imaging