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Motor recovery via aberrant pyramidal tract in a patient with traumatic brain injury A diffusion tensor tractography study

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Neural Regeneration Research 2013年第1期8卷 90-94页

作者： Sang Seok Yeo Sung Ho jang Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University

The aberrant pyramidal tract is the collateral pathway of the pyramidal tract through the medial lemniscus in the brainstem. A 21-year-old man presented with right hemiparesis due to a traumatic intracerebral hemorrhage in the left corona radiata. His motor function recovered almost to the normal state at 10 months after onset. Through diffusion tensor tractography, the pyramidal tract in the affected （left） hemisphere showed discontinuation at the pontine level at 13 months after onset. An aberrant pyramidal tract was observed, which originated from the primary motor cortex and the supplementary motor area and descended through the corona radiata, then through the posterior limb of the internal capsule and the medial lemniscus pathway from the midbrain to the pons, finally entered into the pyramidal tract area at the pontomedullary junction, it suggests that the motor functions of the right extremities in this patient had recovered by this aberrant pyramidal tract.

关键词： neural regeneration neuroimaging diffusion tensor imaging diffusion tensor tractography transcranial magnetic stimulation pyramidal tract aberrant pyramidal tract motor paralysis motorrecovery traumatic brain injury head trauma intracerebral hemorrhage grant-supported paper photographs-containing paper neuroregeneration

Aberrant pyramidal tract in a patient with corona radiata infarct A diffusion tensor tractography study

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Neural Regeneration Research 2011年第13期6卷 1027-1030页

作者： ji Heon Hong Sung Ho jang Department of Physical Therapy Yeungnam College of Science & TechnologyNamkuDaegu 705-703Republic of Korea Department of Physical Medicine and Rehabilitation College of MedicineYeungnam UniversityDaegu 705-717Republic of Korea

The aberrant pyramidal tract refers to the collateral pathway of the pyramidal tract through the medial lemniscus in the brainstem. A 63-year-old male patient presented with severe paralysis of the left extremities due to a right corona radiata infarct. He was able to extend the affected fingers against resistance at 2 months after stroke onset. At 6 months after stroke onset, he was able to perform some fine motor activities, as well as to walk with a nearly normal gait. Functional MRI, which was performed at 6 months after onset, showed that the contralateral primary sensorimotor cortex was activated during affected （left） hand movements. Diffusion tensor tractography results showed that at 2 weeks after stroke onset, pyramidal tracts of the affected hemisphere originated from the primary motor cortex and descended along the known pathway of the pyramidal tract with an aberrant pyramidal tract, which was bypassed through the medial lemniscus from the midbrain to the lower pons. However, the pyramidal tract from midbrain to pons in the affected hemisphere could not be depicted by diffusion tensor tractography at 6 months after stroke onset; instead, only the aberrant pyramidal tract existed for the course of the disappeared pyramidal tract. Results from this study indicate that the main motor functions of the affected extremities appeared to be controlled via the aberrant pyramidal tract with degeneration of the pyramidal tract in the brainstem of the affected hemisphere.

关键词： diffusion tensor tractography pyramidal tract aberrant pyramidal tract motor recovery cerebral infarct

Motor recovery in a patient with an infarct in the medullary pyramid via the corticospinal tract passing through the small spared area within the infarcted medullary pyramid

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Neural Regeneration Research 2011年第15期6卷 1185-1188页

作者： Hyeok Gyu Kwon Sung Ho jang Department of Physical Therapy Graduate School of Rehabilitation ScienceDaegu University Department of Physical Medicine and Rehabilitation College of MedicineYeungnam University

The present study reported a 58-year-old male patient who exhibited complete paralysis of the right extremities at stroke *** MR images showed an infarct in the left medullary pyramid and a small spared area on the medial side of the *** gained the ability to extend the affected fingers against gravity and to dorsiflex the affected ankle without gravity at 3 months after stroke *** tensor imaging results showed that at 6 months after stroke onset,the corticospinal tract of the affected（left） hemisphere descended through the small spared area of the infarcted medullary *** motor-evoked potential was elicited from the affected（left） hemisphere at 2 weeks after stroke onset; however,motor-evoked potential was elicited at 6 months as shown by transcranial magnetic stimulation *** motor function of the affected side of this patient appears to have been recovered via the corticospinal tract that passed through the small spared area within the infarcted medullary pyramid.

关键词： diffusion tensor tractography diffusion tensor imaging corticospinal tract stroke medulla

Motor recovery via aberrant pyramidal tract in a patient with a cerebral peduncle infarct

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Neural Regeneration Research 2011年第13期6卷 1023-1026页

作者： Sang Seok Yeo Sung Ho jang Department of Rehabilitation Science Graduate SchoolDaegu UniversityDaegu 705-714Republic of Korea Department of Physical Medicine and Rehabilitation College of MedicineYeungnam UniversityDaegu 705-717Republic of Korea

The presence of the aberrant pyramidal tract has been demonstrated by several studies; however, little is known about its role in motor recovery in stroke patients. In the present study, we reported a 69-year-old right-handed female patient with an infarct in the mid to lateral portion of the left cerebra peduncle, who showed an aberrant pyramidal tract by diffusion tensor tractography. The patient presented with severe weakness of the right extremities at stroke onset. The patient showed progressive motor recovery as much as being able to extend the affected extremities against some resistance at 6 months after onset. At 20 months after stroke onset, motor function of the left extremities had recovered to a nearly normal state. Diffusion tensor tractography results showed that the PT was disrupted at the lower midbrain of the affected （left） hemisphere at 3 weeks after stroke onset and this disruption was not changed at 20 months. An aberrant pyramidal tract in the left hemisphere was also observed, which originated from the primary motor cortex and descended through the corona radiata, posterior limb of the internal capsule, thalamus, the medial lemniscus pathway from the midbrain to the pons, and then entered into the pyramidal tract area at the pontomedullary junction. Transcranial magnetic stimulation did not elicit motor evoked potential from the affected hand muscle at 3 weeks, but it elicited motor evoked potential with mildly delayed latency and low amplitude in the affected hand muscle at 20 months. The main motor functions of the affected extremities in this patient appeared to be recovered via this aberrant pyramidal tract.

关键词： diffusion tensor imaging aberrant pyramidal tract hemiparesis motor recovery cerebral infarct, cerebral peduncle

Functional magnetic resonance imaging and diffusion tensor tractography of the corticopontocerebellar tract in the human brain

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Neural Regeneration Research 2011年第1期6卷 76-80页

作者： ji Heon Hong Sung Ho jang Department of Physical Medicine and Rehabilitation College of MedicineYeungnam University

The anatomical organization of the corticopontocerebellar tract （CPCT） in the human brain remains poorly understood. The present study investigated probabilistic tractography of the CPCT in the human brain using diffusion tensor tractography with functional magnetic resonance imaging. CPCT data was obtained from 14 healthy subjects. CPCT images were obtained from functional magnetic resonance imaging and diffusion tensor tractography, revealing that the CPCT originated from the primary sensorimotor cortex and descended to the pontine nucleus through the corona radiata, the posterior limb of the internal capsule, and the cerebral peduncle. After crossing the pons through the transverse pontine fibers, the CPCT entered the cerebellum via the middle cerebral peduncle. However, some variation was detected in the midbrain （middle cerebral peduncle and/or medial lemniscus） and pons （ventral and/or dorsal transverse pontine fibers）. The CPCT was analyzed in 3 dimensions from the cerebral cortex to the cerebellum. These results could be informative for future studies of motor control in the human brain.

关键词： functional magnetic resonance imaging diffusion tensor image corticopontocerebellar tract: motor control: ataxia

Perilesional reorganization of somatosensory function following traumatic cortical contusion A case report

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Neural Regeneration Research 2011年第11期6卷 830-833页

作者： Mi Young Lee Sung Ho jang Department of Physical Therapy College of Health and Therapy Daegu Haany University Daegu Republic of Korea Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University Daegu 705-717 Republic of Korea

The present study reports on a 23-year-old male patient with somatosensory dysfunction of the left hand following cortical contusion. His somatosensory dysfunction recovered to a nearly normal state at 6 months after injury. Functional MRI results demonstrated that the contralateral primary sensorimotor cortex centered on the primary somatosensroy cortex was activated during touch stimulation of the patient＇s right hand and either hand of control subjects. By contrast, the anterior area of the lesion centered on the precentral knob in the right hemisphere was activated during touch stimulation of the left hand. These findings show that the somatosensory function of the affected hand appears to have been recovered by the somatosensory cortex reorganizing into the anterior area of the contused primary somatosensory cortex.

关键词： stroke somatosensory recovery brain mapping brain plasticity brain injury functional MRI neural regeneration

Recovery of corticospinal tract injury following subdural hematoma removal A diffusion tensor imaging study

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Neural Regeneration Research 2010年第20期5卷 1555-1558页

作者： ji Heon Hong Sung Ho jang Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University

Subdural hematoma can cause compression or damage to the neural tracts in the brain;however,very little is known about this *** report on a patient with subdural hematoma who was evaluated by diffusion tensor imaging prior to and after trephination and drainage of subdural hematoma.A 58-year-old male patient and ten age-matched normal control subjects were *** patient showed mild hemiparesis for 3 weeks prior to *** hemiparesis recovered to a nearly normal state at 5 weeks post-surgery when the follow up diffusion tensor image was *** diffusion tensor image parameters,fractional anisotropy and apparent diffusion coefficient,were measured along the corticospinal ***-operative diffusion tensor image showed that the corticospinal tract of the affected hemisphere seemed to be injured or ***,the follow up diffusion tensor image showed recovery of this corticospinal tract to a normal *** would appear that diffusion tensor images are a useful tool for evaluation of the effects of subdural hematomas on neural tracts.

关键词： subdural hematoma diffusion tensor imaging hemiparesis corticospinal tract

Motor recovery by anterior choroidal artery territory in a patient with middle cerebral artery infarct

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Neural Regeneration Research 2010年第17期5卷 1357-1360页

作者： ji Heon Hong Sung Ho jang Department of Physical Medicine and Rehabilitation College of MedicineYeungnam UniversityDaegu 705-717Republic of Korea

In this study,the uninjured periventricular area of a female patient who presented with complete paralysis of the left extremities following middle cerebral artery infarction was analyzed using diffusion tensor tractography,transcranial magnetic stimulation,and functional magnetic resonance *** tensor tractography revealed interrupted corticospinal tract at the infarct lesion in the corona radiata at 2 weeks after onset,which descended through the spared periventricular area at 6 months after *** magnetic stimulation and functional magnetic resonance imaging revealed a motor pathway of the affected hand that was compatible with the lateral corticospinal *** 6 months after onset,motor function in the affected extremities recovered to normal levels,which suggested that motor function in the affected hand recovered by the corticospinal tract that passed through the spared periventricular *** arterial territory of the spared periventricular area corresponded with the anterior choroidal *** results suggest that care should be taken in spared periventricular areas in patients with lesions at the corona radiata level.

关键词： hemiparesis diffusion tensor imaging magnetic stimulation functional MRI stroke

Compression of the bilateral corticospinal tracts by bilateral pontine hemorrhage A diffusion tensor tractography study

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Neural Regeneration Research 2011年第4期6卷 317-320页

作者： Hyeok Gyu Kwon Sung Ho jang Department of Physical Therapy Graduate School of Rehabilitation ScienceDaegu UniversityDaegu 705-717Republic of Korea Department of Physical Medicine and Rehabilitation College of MedicineYeungnam UniversityDaegu 705-717Republic of Korea

Bilateral spontaneous pontine hemorrhage is rare. In addition, bilateral corticospinal tract （CST） involvement in the pons may accompany serious motor sequelae. A 45-year-old right-handed woman was admitted for bilateral pontine hemorrhage. The patient presented with moderate quadriparesis at stroke onset and quickly recovered to the point of being able to extend the muscles of all four extremities against resistance, at 2 weeks from onset. At 4 weeks after stroke onset, she was able to perform all fine motor activities, as well as to walk with a normal gait. Diffusion tensor tractography results showed that the CSTs of both hemispheres originated from the primary sensorimotor cortex and descended through the corona radiata, the posterior limb of the internal capsule, midbrain, anterior pons, and the anterior medulla, along the known pathway of the CST. However, at midbrain and pons, the CSTs were compressed posterolaterally. The contralateral primary sensorimotor cortex, centered on the precentral knob, was activated during movement of either hand of the patient, as shown by functional MRI, which indicates the preservation of lateral CST. Findings from this study suggest that diffusion tensor tractography may be helpful in the elucidation of the CST status in patients with pontine hemorrhage.

关键词： diffusion tensor imaging diffusion tensor tractography functional MRI corticospinal tract stroke motor recovery pontine hemorrhage