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Mild Traumatic Brain Injury Predisposes to Thalamic Reticular Nucleus Impairment and Thalamocortical Dysrhythmia

Yi-Tien Li^1,2, Duen-Pang Kuo^2,3, Yun-Ting Lee², Yung-Chieh Chen^2,3, Hsiao-Wen Chung⁴, and Cheng-Yu Chen^2,3,5,6
¹Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan, ²Translational Imaging Research Center, Taipei Medical University Hospital, Taipei, Taiwan, ³Department of Medical Imaging, Taipei Medical University Hospital, Taipei, Taiwan, ⁴Graduate Institute of Biomedical Electrics and Bioinformatics, Taipei, Taiwan, ⁵Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ⁶Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan

This study is the first to provide strong evidence that thalamocortical dysrhythmia (TCD) is involved in mild traumatic brain injury (mTBI) and plays a crucial role in prolonged symptoms. The impaired cortical–thalamic tracts and thalamic reticular nuclei are recognized as two origins of TCD.

Figure 2. Thalamocortical functional connectivity changes and their clinical significance in mTBI.

(A) Patients with mTBI exhibited significantly reduced thalamo-DMN anticorrelation (black arrows) during WM 1-back and 2-back task conditions compared with the HCs.

Thalamo-DMN anticorrelation strength exhibited (B) a significant positive correlation with participants’ PSQI and PCSQ scores and (C) a significant negative correlation with participants’ arithmetic ability and WMI during the WM 1-back and 2-back task conditions.

Figure 1. Structural evidence of two TCD origins in mTBI revealed by DTI.

(A) Significantly decreased FA (top row) and increased RD (bottom) at the bilateral thalamic borders (yellow arrows) were observed in patients with mTBI compared with HCs (p<0.01, FDR corrected). The ovals covered by translucent dark blue indicate the location of the bilateral thalamus. These maps were masked by the threshold of group-averaged FA > 0.2.

(B) A significant reduction in thalamocortical tract density was found in the mTBI group compared with the HC group (p<0.01, FDR corrected).