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Regional volumes in brain stem and cerebellum are associated with postural impairments in young brain-injured patients
Drijkoningen, David Leunissen, Inge Caeyenberghs, Karen Hoogkamer, Wouter Sunaert, Stefan Duysens, Jacques Swinnen, Stephen P.
Drijkoningen, David
Leunissen, Inge
Caeyenberghs, Karen
Hoogkamer, Wouter
Sunaert, Stefan
Duysens, Jacques
Swinnen, Stephen P.
Abstract
Many patients with traumatic brain injury ( TBI ) suffer from postural control impairments that can profoundly affect daily life. The cerebellum and brain stem are crucial for the neural control of posture and have been shown to be vulnerable to primary and secondary structural consequences of TBI. The aim of this study was to investigate whether morphometric differences in the brain stem and cerebellum can account for impairments in static and dynamic postural control in TBI. TBI patients ( n = 18 ) and healthy controls ( n = 30 ) completed three challenging postural control tasks on the EquiTest® system ( Neurocom ). Infratentorial grey matter ( GM ) and white matter ( WM ) volumes were analyzed with cerebellum-optimized voxel-based morphometry using the spatially unbiased infratentorial toolbox. Volume loss in TBI patients was revealed in global cerebellar GM, global infratentorial WM, middle cerebellar peduncles, pons and midbrain. In the TBI group and across both groups, lower postural control performance was associated with reduced GM volume in the vermal/paravermal regions of lobules I–IV, V and VI. Moreover, across all participants, worse postural control performance was associated with lower WM volume in the pons, medulla, midbrain, superior and middle cerebellar peduncles and cerebellum. This is the first study in TBI patients to demonstrate an association between postural impairments and reduced volume in specific infratentorial brain areas. Volumetric measures of the brain stem and cerebellum may be valuable prognostic markers of the chronic neural pathology, which complicates rehabilitation of postural control in TBI.
Keywords
traumatic brain injury, voxel-based morphometry, cerebellum, brain stem, postural control, grey matter, white matter, spatially unbiased infratentorial template, volumetric analysis
Date
2015
Type
Journal article
Journal
Human Brain Mapping
Book
Volume
36
Issue
12
Page Range
4897-4909
Article Number
ACU Department
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled