Injury of the dorsolateral prefronto-thalamic tract in a patient with depression following mild traumatic brain injury: A case report.
BACKGROUND
Depression, a prevalent psychiatric disorder, is associated with abnormality in the prefrontal cortex, particularly the left dorsolateral prefrontal cortex. In this study, we report on a patient with severe depression who showed injury of the dorsolateral prefronto-thalamic tract following mild traumatic brain injury, which was demonstrated by diffusion tensor tractography (DTT).


RESULTS
A 63-year-old female patient suffered an in-car accident. The patient lost consciousness for approximately 10 minutes and experienced posttraumatic amnesia approximately 30 minutes from the time of the accident. Her Glasgow Coma Scale score was 15. No specific lesion was observed on the conventional brain magnetic resonance imaging. Since the onset of head trauma, she had shown continuous depression and on 32 month evaluation, she exhibited severe depression (Beck Depression Inventory-II: 42 [full score: 63 score] and Patient Health Questionnaire-9: 24 [full score: 27 score]).


RESULTS
On 32-month DTT, partical tearing of the dorsolateral prefronto-thalamic tract was observed in the right hemisphere and thinning in the left hemisphere.


CONCLUSIONS
Injury of the dorsolateral prefronto-thalamic tract was demonstrated in a patient with depression following mild traumatic brain injury, using DTT. We believe that injury of the dorsolateral prefronto-thalamic tract might be a pathogenetic mechanism of depression in patients with brain injury.
aDepartment of Physical Medicine and Rehabilitation bDepartment of Diagnostic Radiology, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
Sung Ho
SH
Jang
Ji Hyun
JH
Yi
Hyeok Gyu
HG
Kwon
D001924:Brain Concussion / Q000150:complications* / Q000175:diagnosis; D003863:Depression / Q000175:diagnosis / Q000209:etiology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000293:injuries*; D013788:Thalamus / Q000000981:diagnostic imaging / Q000293:injuries*
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