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The relation between loss of consciousness, severity of traumatic brain injury and injury of ascending reticular activating system in patients with traumatic brain injury

Jang, Sung Ho MD; Kim, Oh Lyong MD; Kim, Seong Ho MD; Kim, Jong Bum MD

American Journal of Physical Medicine & Rehabilitation: June 12, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHM.0000000000001243
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Objective Loss of consciousness(LOC) is an indicator of the severity of traumatic brain injury(TBI) and the ascending reticular activating system(ARAS) has been considered as a main structure for consciousness. However, no study on the relation between LOC and ARAS injury in TBI has been reported. We investigated the relation between LOC, severity of TBI, and ARAS injury using diffusion tensor tractography(DTT).

Design 120 patients were recruited. Three components of ARAS, fractional anisotropy(FA) and tract volume(TV) were measured.

Results In lower dorsal and ventral ARAS, FA and TV value in mild group were higher than those of moderate and severe groups, and there was no difference between moderate and severe groups. In upper ARAS, FA value in mild group was higher than in moderate group, and in moderate group was higher than in severe group. TV value in mild group was higher than that of severe group. LOC showed moderate negative correlations with TV value of lower dorsal ARAS(r=-0.348), FA value of lower ventral ARAS(r=-0.343), and FA value of upper ARAS(r=-0.416).

Conclusion Injury severity was different among three TBI groups in upper ARAS but did not differ between moderate and severe groups in lower dorsal and ventral ARAS.

Professor, Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University

Professor, Department of Neurosurgery, College of Medicine, Yeungnam University

Professor, Department of Neurosurgery, College of Medicine, Yeungnam University

Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University

Corresponding author: Jong Bum Kim, MD, Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University 317-1, Daemyung dong, Namku, Daegu, 705-717, Republic of Korea, Tel: 82-53-620-4098, FAX: 82-53-625-3508, e-mail: bum9839@naver.com

CONFLICTS OF INTEREST.

All authors report no conflict of interest

All authors report no funding, grants, or equipment for this project

All authors report no financial benefits

All authors report no previous research, manuscript, or abstract in any form

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