Brain scan shows neural disruptions after trauma

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A new brain-scanning technique could precisely identify disruptions in neural pathways following traumatic brain injury (TBI).

Termed high-definition fibre tracking (HDFT), the technique is based on processing multiple magnetic resonance imaging (MRI) scans with computer algorithms to reveal fibre tracts — each of which contains millions of neuronal connections.

‘With it, we can virtually dissect 40 major fibre tracts in the brain to find damaged areas and quantify the proportion of fibres lost relative to the uninjured side of the brain or to the brains of healthy individuals,’ said study co-author Dr Walter Schneider from Pittsburgh University. ‘Now we can clearly see breaks and identify which parts of the brain have lost connections.’

Ultimately, it could help predict how patients progress, plan rehabilitation and maximise recovery.

The first example of its use was in the case of motor-accident victim who awoke from a three-week coma with bleeding and swelling on the right side of the brain and loss of use of the left leg, arm and hand.

HDFT scans of the study patient’s brain were performed four and 10 months after he was injured; he also had another scan performed with current diffusion tensor imaging.

Only the HDFT scan identified a lesion in a motor fibre pathway of the brain that correlated with the patient’s symptoms of left-sided weakness, including mostly intact fibres in the region controlling his left leg and extensive breaks in the region controlling his left hand.

The patient eventually recovered movement in his left leg and arm by six months after the accident, but still could not use his wrist and fingers effectively 10 months later.

‘HDFT has the potential to be a game changer in the way we handle TBI and other brain disorders,’ said co-author David Okonkwo, also of Pittsburgh University.