Akinetic mutism in a patient with mild traumatic brain injury: A diffusion tensor tractography study

Akinetic mutism (AM) is characterized by a complete absence of spontaneous behaviour and speech. We report on a patient with AM associated with injury of the prefronto-caudate tract and prefronto-thalamic tract following mild traumatic brain injury (TBI), diffusion tensor tractography (DTT). A 20-ye...

Full description

Saved in:
Bibliographic Details
Published in:Brain injury Vol. 31; no. 8; pp. 1159 - 1163
Main Authors: Jang, Sung Ho, Kwon, Hyeok Gyu
Format: Journal Article
Language:English
Published: England 01.01.2017
Subjects:
Akinetic Mutism - diagnostic imaging
Akinetic Mutism - etiology
Brain Injuries, Traumatic - complications
Brain Injuries, Traumatic - diagnostic imaging
Diffusion Tensor Imaging
Humans
Image Processing, Computer-Assisted
Male
Young Adult
caudate nucleus
diffusion tensor tractography
Akinetic mutism
mild traumatic brain injury
prefrontal cortex
ISSN:0269-9052, 1362-301X, 1362-301X
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Akinetic mutism (AM) is characterized by a complete absence of spontaneous behaviour and speech. We report on a patient with AM associated with injury of the prefronto-caudate tract and prefronto-thalamic tract following mild traumatic brain injury (TBI), diffusion tensor tractography (DTT). A 20-year-old man suffered from TBI resulting from a pedestrian car accident. Following the TBI, he developed abulia (decreased activity and speech) that worsened over approximately a year. His typical features of AM that remained stable from one year until two years after the TBI are: he showed no spontaneous movement or speech and remained recumbent with no spontaneous activity. On one-month DTT, the neural connectivity of the caudate nucleus to the medial prefrontal cortex was low in both hemispheres, and this neural connectivity was lower on two-year DTT. The orbitofrontal-thalamic tract was thin in the left hemisphere on one-month DTT, whereas this tract became thinner in both hemispheres on two-year DTT. Using serial DTTs, injuries of the prefronto-caudate tract and orbitofrontal-thalamic tract and degeneration of these injured neural tracts concurrent with aggravation of abulia to AM were demonstrated in a patient with mild TBI. ABBREVIATIONS AM akinetic mutism; BA Brodmann areas; CN caudate nucleus; CST corticospinal tract; CRT corticoreticulospinal tract; DTT diffusion tensor tractography; FAC Functional Ambulation Category; PFC prefrontal cortex; MMSE Mini-Mental State Examination; ROI region of interest; TBI traumatic brain injury.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
content type line 23
ObjectType-Report-1
ObjectType-Article-3
ISSN:0269-9052
1362-301X
1362-301X
DOI:10.1080/02699052.2017.1288265