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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.01199

Differences in corticoreticulospinal tract injury according to whiplash in mild traumatic brain injury patients

Sung Ho Jang1,  Sang Seok Yeo2, 3,  Jung Won Kwon2, 3 and  Young Hyeon Kwon1*
  • 1College of Medicine, Yeungnam University, South Korea
  • 2Dankook University, South Korea
  • 3Department of Physical Therapy, College of Health Science, Korea University, South Korea

Background: This study investigated differences in postural control ability (PCA) and corticoreticulospinal tract (CRT) injury severity according to whiplash in patients with mild traumatic brain injury (mTBI).
Methods: Thirty-one patients with mTBI and 21 healthy control subjects were recruited for this study. The balance error scoring system (BESS) was used for PCA assessment. Based on their history of whiplash, the patients were classified into two groups: group A – mTBI with whiplash injury and group B – mTBI without whiplash injury. Fractional anisotropy (FA), apparent diffusion coefficient (ADC), and tract volume (TV) values were estimated for the reconstructed CRTs in all subjects.
Results: Significant differences were observed among the total BESS scores of patient groups A and B and the control group (p < 0.05); the patient group A BESS score was significantly higher than that of patient group B, and that of the patient group B was significantly higher than that of the control group. No significant differences were detected in the FA and ADC values of the CRTs of the two patient groups and the control group (p > 0.05). However, the TV values of the CRT showed significant differences; the TV of patient group A was significantly lower than that of patient group B and the control group, and that of patient group B was significantly lower than that of the control group (p < 0.05).
Conclusions: We observed greater CRT injury severity and PCA impairment in mTBI patients with whiplash than in mTBI patients without whiplash. The results indicate that whiplash can increase the severity of axonal injury in mTBI patients.

Keywords: Corticoreticulospinal tract, Diffusion tensor tractography, Balance error scoring system, postural control ability, Whiplash injury, mild traumatic brain injury

Received: 12 Mar 2019; Accepted: 28 Oct 2019.

Copyright: © 2019 Jang, Yeo, Kwon and Kwon. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mr. Young Hyeon Kwon, College of Medicine, Yeungnam University, Gyeongsan, 38541, North Gyeongsang, South Korea,