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The temporal stem in traumatic brain injury: preliminary findings

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Abstract

The temporal stem (TS) of the temporal lobe is a major white matter (WM) region containing several major pathways that connect the temporal lobe with the rest of the brain. Because of its location, it may be particularly vulnerable to shear-strain effects resulting from traumatic brain injury (TBI). A case vignette is presented in a patient with severe brain injury and focal TS pathology. Also, 12 severe TBI subjects unselected for TS pathology were compared to demographically matched, neurologically-intact controls using diffusion tensor imaging (DTI) to examine white matter tracts associated with the TS, including the inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), arcuate fasciculus (AF), cingulum bundle (CB) and the uncinate fasciculus (UF). For each tract, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were computed and compared between the two groups and also examined in relationship to memory performance in the TBI subjects. Significant FA and ADC differences were observed in all tracts in the TBI patients compared to controls, with several relationships with memory outcome noted in the IFOF, ILF and AF. Based on these preliminary findings, the potential role of TBI-induced WM disconnection involving the TS is discussed as well as the relationship of TS damage to neurobehavioral outcome. The need for future studies specifically examining the role of TS injury in TBI is emphasized.

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Acknowledgments

Parts of this were funded by grants from the NIH (NINDS) NS43353 (G.L.C.) and the Dana Foundation (E.A.W.) along with a grant from the College of Family, Home and Social Science from Brigham Young University (E.D.B.). The technical assistance of Tracy Abildskov for various facets of the DTI analyses and illustration preparation and Jo Ann Petrie for manuscript preparation are also gratefully acknowledged.

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Authors and Affiliations

  1. Department of Psychology, Brigham Young University, 1001 SWKT, Provo, UT, 84602, USA

    Erin D. Bigler & Trevor C. Wu

  2. Neuroscience Center, Brigham Young University, Provo, UT, USA

    Erin D. Bigler

  3. The Brain Institute, University of Utah, Salt Lake City, UT, USA

    Erin D. Bigler

  4. Department of Psychiatry, University of Utah, Salt Lake City, UT, USA

    Erin D. Bigler

  5. Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA

    Stephen R. McCauley, Marianne MacLeod, Harvey S. Levin & Elisabeth A. Wilde

  6. Department of Neurology, Baylor College of Medicine, Houston, TX, USA

    Stephen R. McCauley, Harvey S. Levin & Elisabeth A. Wilde

  7. Department of Radiology, Baylor College of Medicine, Houston, TX, USA

    Zili Chu, Jill V. Hunter & Elisabeth A. Wilde

  8. Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA

    Stephen R. McCauley & Harvey S. Levin

  9. Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA

    Harvey S. Levin

  10. Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA

    Stephen R. McCauley, Harvey S. Levin & Elisabeth A. Wilde

  11. E.B. Singleton Department of Diagnostic Imaging, Texas Children’s Hospital, Houston, TX, USA

    Sanjeev Shah, Zili Chu & Jill V. Hunter

  12. Department of Psychology, University of Houston, Houston, TX, USA

    Ragini Yallampalli

  13. Vivian L. Smith Center for Neurologic Research, Department of Neurosurgery, The University of Texas Medical School at Houston, Houston, TX, USA

    Guy L. Clifton

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  1. Erin D. Bigler
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Bigler, E.D., McCauley, S.R., Wu, T.C. et al. The temporal stem in traumatic brain injury: preliminary findings. Brain Imaging and Behavior 4, 270–282 (2010). https://doi.org/10.1007/s11682-010-9105-0

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