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Injury of the Hypothalamus in Patients With Hypoxic–Ischemic Brain Injury

A Diffusion Tensor Imaging Study

Jang, Sung Ho, MD; Kwon, Hyeok Gyu, PhD

American Journal of Physical Medicine & Rehabilitation: March 2018 - Volume 97 - Issue 3 - p 160–163
doi: 10.1097/PHM.0000000000000813
Original Research Articles

Objectives The survival rate for hypoxic–ischemic brain injury (HI-BI) is less than 20%. Several brain regions, including the caudate, hippocampus, and hypothalamus, are vulnerable to HI-BI. Hypothalamus is involved in regulation of temperature, sleep-wakefulness cycle, emotional behavior, and memory function. Using diffusion tensor imaging, we examined injury of the hypothalamus in patients with HI-BI.

Methods Twelve patients with HI-BI and 27 healthy control subjects were recruited. The region of interest was defined for the hypothalamus and the fractional anisotropy and apparent diffusion coefficient were measured.

Results The fractional anisotropy value was significantly lower in the patient group compared with the control group (P < 0.05), whereas the apparent diffusion coefficient value was significantly higher compared with that of the control group (P < 0.05). In the individual analysis, 7 (58.3%) of 12 patients and 14 (58.3%) of 24 hemispheres showed a decrement or increment of more than two SDs in either fractional anisotropy or apparent diffusion coefficient values compared with the control group.

Conclusions Using diffusion tensor imaging, injury of the hypothalamus was demonstrated in patients with HI-BI. Our methodology and results of this study would be helpful in research on the hypothalamus in patients with HI-BI.

From the Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Gyeongsan, Republic of Korea (SHJ); and Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Pusan, Republic of Korea (HGK).

All correspondence should be addressed to: Hyeok Gyu Kwon, PhD, Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, 57 Oryundae-ro, Geumjeong-gu, Pusan, 46252, Republic of Korea.

This work was supported by the Medical Research Center Program (2015R1A5A2009124) through the National Research Foundation of Korea funded by the Ministry of Science, ICT, and Future Planning.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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