Relationship between superior longitudinal fasciculus injury and visual pursuit in patients with impaired consciousness following hypoxic-ischemic brain injury.

OBJECTIVE

Visual pursuit disturbance, a common and early indicator of recovery in disorders of consciousness, may be associated with superior longitudinal fasciculus (SLF) injury. By using diffusion tensor tractography (DTT), we investigated the relationship between visual pursuit disturbance and injury of the SLF in patients with impaired consciousness following hypoxic-ischemic brain injury (HI-BI).

METHODS

Twenty patients with impaired consciousness and 11 controls were recruited. All patients were divided into two groups according to visual function scale on the Coma Recovery Scale-Revised (CRS-R): group A (0 ~ 2 score), 13 patients; group B (3 ~ 5 score), 7 patients. The SLF was analyzed to obtain DTT parameters values.

RESULTS

Significant differences were observed in fractional anisotropy (FA), apparent diffusion coefficient (ADC), and fiber number (FN) between patient groups A and B and the control group (p < 0.05). In the comparison of groups A and B, three DTT parameters were different for the right, left, and both SLF except for the ADC of left SLF (p < 0.05). A moderate positive correlation was observed between the CRS-R visual function scale and FA and FN values for both SLF.

CONCLUSION

We believe that SLF injury is a pathophysiological mechanism in visual pursuit disturbance of patients with impaired consciousness following HI-BI.