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

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

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A change in injured corticospinal tract originating from the premotor cortex to the primary motor cortex in a patient with intracerebral hemorrhage

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Neural Regeneration Research 2012年第12期7卷 939-942页

作者： Sang Seok Yeo Sung ho jang Department of Physical Medicine and Rehabilitation College of MedicineYeungnam University

Many studies have attempted to elucidate the motor recovery mechanism of stroke, but the majority of these studies focus on cerebral infarct and relatively little is known about the motor recovery mechanism of intracerebral hemorrhage. In this study, we report on a patient with intracerebral hemorrhage who displayed a change in injured corticospinal tract originating from the premotor cortex to the primary motor cortex on diffusion tensor imaging. An 86-year-old woman presented with complete paralysis of the right extremities following spontaneous intracerebral hemorrhage in the left frontoparietal cortex. The patient showed motor recovery, to the extent of being able to extend affected fingers against gravity and to walk independently on even ground at 5 months after onset. Diffusion tensor imaging showed that the left corticospinal tract originated from the premotor cortex at 1 month after intracerebral hemorrhage and from the left primary motor cortex and premotor cortex at 5 months after intracerebral hemorrhage. The change of injured corticospinal tract originating from the premotor cortex to the primary motor cortex suggests motor recovery of intracerebral hemorrhage.

关键词： diffusion tensor imaging corticospinal tract motor recovery reorganization

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Improvement of ataxia in a patient with cerebellar infarction by recovery of injured cortico-ponto-cerebellar tract and dentato-rubro-thalamic tract: a diffusion tensor tractography study

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Neural Regeneration Research 2019年第8期14卷 1470-1472页

作者： Sung ho jang Hyeok Gyu Kwon Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University Daegu Republic of Korea Department of Physical Therapy College of Health Science Eulji University Gyeonggi Republic of Korea

Coordinated movement is generated by communication between the cerebrum and cerebellum via the cerebellar peduncles (CPs). The CPs are classified into three types (superior, middle, and inferior), and each includes a variety of neural tracts. Among those tracts, the cortico-ponto-cerebellar tract (CPCT), a middle CP, is involved in motor planning and initiation of movement, while the dentato-rubro-thalamic tract (DRTT), a superior CP, is involved in motor coordination, movement timing, verbal fluency, and working memory (Kase et al., 1993.

关键词： Improvement of ataxia injured cortico-ponto-cerebellar tractography study

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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

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The usefulness of diffusion tensor imaging in detection of diffuse axonal injury in a patient with head trauma

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Neural Regeneration Research 2012年第6期7卷 475-478页

作者： Hyeok Gyu Kwon Sung ho jang Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University

Diffuse axonal injury is the predominant mechanism of injuries in patients with traumatic brain injury. Neither conventional brain computed tomography nor magnetic resonance imaging has shown sufficient sensitivity in the diagnosis of diffuse axonal injury. In the current study, we attempted to demonstrate the usefulness of diffusion tensor imaging in the detection of lesion sites of diffuse axonal injury in a patient with head trauma who had been misdiagnosed as having a stroke. A 44-year-old man fell from a height of about 2 m. Brain magnetic resonance imaging （32 months after onset） showed leukomalactic lesions in the isthmus of the corpus callosum and the left temporal lobe. He presented with mild quadriparesis, intentional tremor of both hands, and trunkal ataxia. From diffusion tensor imaging results of 33 months after traumatic brain injury onset, we found diffuse axonal injury in the right corticospinal tract （centrum semiovale, pons）, both fomices （columns and crus）, and both inferior cerebellar peduncles （cerebellar portions）. We think that diffusion tensor imaging could be a useful tool in the detection of lesion sites of diffuse axonal injury in patients with head trauma.

关键词： traumatic brain injury diffuse axonal injury diffusion tensor imaging head trauma

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Traumatic axonal injury of the medial lemniscus pathway in a patient with traumatic brain injury: validation by diffusion tensor tractography

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Neural Regeneration Research 2016年第1期11卷 130-131页

作者： Sung ho jang Hyeok Gyu Kwon Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University

Traumatic brain injury（TBI）is a common disability-causing neurological *** successful rehabilitation of TBI patients,a thorough evaluation of the presence and extent of neural injury is essential for determining the... 详细信息

关键词： tensor rehabilitation medial axonal disability traumatic thorough neurological radiata tracts

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Corticospinal tract recovery in a patient with traumatic transtentorial herniation

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Neural Regeneration Research 2013年第5期8卷 469-473页

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

Transtentorial herniation is one of the causes of motor weakness in traumatic brain injury. In this study, we report on a patient who underwent decompressive craniectomy due to traumatic intracerebral hemorrhage. Brain CT images taken after surgery showed intracerebral hemorrhage in the left fronto-temporal lobe and left transtentorial herniation. The patient presented with severe paralysis of the right extremities at the time of intracerebral hemorrhage onset, but the limb motor function recovered partially at 6 months after onset and to nearly normal level at 27 months. Through diffusion tensor tractography, the left corticospinal tract was disrupted below the cerebral peduncle at 1 month after onset and the disrupted left corticospinal tract was reconstructed at 27 months. These findings suggest that recovery of limb motor function in a patient with traumatic transtentorial herniation can come to be true by recovery of corticospinal tract.

关键词： neural regeneration neuroimaging diffusion tensor imaging diffusion tensor tractography ttanscranial magnetic stimulation traumatic brain injury intracerebral hemorrhage transtentorfa herniation corticospinal tract motor paralysis neuroimaing grants-supported paper photographs-containing paper neuroregeneration

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Recovery of a degenerated corticospinal tract after injury in a patient with intracerebral hemorrhage:confirmed by diffusion tensor tractography imaging

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Neural Regeneration Research 2015年第5期10卷 829-831页

作者： You Sung Seo Sung ho jang Department of Physical Medicine and Rehabilitation College of MedicineYeungnam University

The corticospinal tract （CST） is a major neuronal tract of motor function in the human brain （York, 1987; Davidoff, 1990; jang, 2014）. Recovery of an injured CST is one of the motor recovery mechanisms in stroke patients （Hendricks et al., 2003; jang et al., 2006, 2007; Swayne et al., 2008; Kwon et al., 2011, 2013; Kwon and jang, 2012; Yeo and jang, 2013; Rong et al., 2014）. Diffusion tensor tractography （DTT）, derived from diffusion tensor imaging （DTI）, and transcra- nial magnetic stimulation （TMS） have been widely used in demonstrating the recovery of an injured CST （Hendricks et al., 2003; jang et al., 2006, 2007; Swayne et al., 2008; Pannek et al., 2009; Kwon et al., 2011, 2013; Kwon and jang, 2012; Yeo and jang, 2013; Rong et al., 2014）. DTT has the advan- tage of enabling visualization of the architecture and integ- rity of the CST at the subcortical level in three dimensions （Mori et al., 1999; Kunimatsu et al., 2004）.

关键词： Recovery of a degenerated corticospinal tract after injury in a patient with intracerebral hemorrhage CST DTT ICH TMS

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Peri-infarct reorganization at the centrum semiovale and corona radiata A diffusion tensor tractography and functional MRI study

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Neural Regeneration Research 2011年第11期6卷 826-829页

作者： Ji Heon hong Sung ho jang Department of Physical Therapy Yeungnam College of Science & Technology Namgu Daegu 705-717 Republic of Korea Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University Daegu 705-717 Republic of Korea

Peri-infarct reorganization has been reported in stroke patients with a lesion at the cerebral cortex, corona radiata, or pons, separately. however, there have been no reports describing the patients with peri-infarct reorganization at multiple levels. The present study reported a patient with a middle cerebral artery infarct who showed complete paralysis of the right extremities at stroke onset. Results showed that at 3 years after stroke onset, patient＇s motor function of the affected hand appeared to have been recovered by the motor tract, which reorganized into the anterior areas of the infarcted centrum semiovale and corona radiata, as demonstrated by diffusion tensor tractography study analyzed using functional MRI activation results. This result indicates that the human brain can show extensive brain plasticity and that saving the adjacent area or penumbra around the infarct even though the lesion from multiple levels is important for functional recovery after stroke.

关键词： diffusion tensor imaging functional MRI centrum semiovale corticospinal tract perilesional reorganization motor recovery neural regeneration

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Injury of the dentatorubrothalamic tract in patients with post-traumatic tremor following mild traumatic brain injury: a case-control study

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Neural Regeneration Research 2020年第11期15卷 2063-2066页

作者： Sung ho jang Han Do Lee Department of Physical Medicine and Rehabilitation College of MedicineYeungnam UniversityDaeguRepublic of Korea Department of Physical Medicine and Rehabilitation College of Natural ScienceUlsan College UniversityUlsanRepublic of Korea

Post-traumatic movement disorder is one of the sequelae of traumatic brain injury. The dentatorubrothalamic tract(DRTT) is reported to be involved in the control of movement. Therefore, injury of the DRTT can be accompanied by abnormal movements, including ataxia, tremor, or dystonia. We investigated DRTT injuries in 27 patients who showed post-traumatic tremor in at least one of four extremities following mild traumatic brain injury. We classified DRTT injuries based on diffusion tensor tractography parameters and configuration: type A: the DRTT showed narrowing, type B: the DRTT showed partial tearing, and type C: the DRTT showed discontinuation. Fractional anisotropy and fiber number of the DRTT were significantly decreased in patients compared with the healthy controls. Based on our DRTT injury classification, among the 54 hemispheres of the 27 patients, type A injury occurred in 22 hemispheres(40.7%) of 17 patients, type B injury was present in 15 hemispheres(27.7%) of 10 patients, and type C injury was observed in 8 hemispheres(14.8%) of 6 patients. Our results suggest that diffusion tensor tractography-based evaluation of the DRTT would be useful when determining cause of post-traumatic tremor in patients with mild traumatic brain injury. The study protocol was approved by the Institutional Review Board of Yeungnam University hospital(YUMC-2018-09-007) on September 5, 2018.

关键词： dentatorubrothalamic tract diffusion tensor imaging diffusion tensor tractography fiber number fractional anisotropy mild traumatic brain injury post-traumatic tremor region of interest

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