Diagnosis of Conversion Disorder Using Diffusion Tensor Tractography and Transcranial Magnetic Stimulation in a Patient with Mild Traumatic Brain Injury

  title={Diagnosis of Conversion Disorder Using Diffusion Tensor Tractography and Transcranial Magnetic Stimulation in a Patient with Mild Traumatic Brain Injury},
  author={Sung Ho Jang and You Sung Seo},
We report on a patient with mild traumatic brain injury (TBI) who was diagnosed with conversion disorder for severe weakness of an arm, which was demonstrated using diffusion tensor tractography (DTT) and transcranial magnetic stimulation (TMS). A 23-year-old right-handed female suffered from head trauma resulting from a pedestrian car accident. She underwent rehabilitative management for memory impairment and central pain. At 14 months after onset, she complained of severe weakness of her… Expand
4 Citations
Diffusion-Tensor-Tractography-Based Diagnosis for Injury of Corticospinal Tract in a Patient with Hemiplegia Following Traumatic Brain Injury
This paper reports a mechanism for corticospinal tract injury in a patient with hemiplegia following traumatic brain injury (TBI) based on diffusion tensor tractography (DTT) finding, the first report to use DTT to detect that the discontinuation of the left CST in the cerebral cortex and injury lesions below the lower pons and between the upper and upper pons are responsible for motor weakness in a patients. Expand
Injury of Corticospinal Tract in a Patient with Subarachnoid Hemorrhage as Determined by Diffusion Tensor Tractography: A Case Report
Diffusion tensor tractography of the corticospinal tract (DTT) is reported in a patient with paresis of all four limbs following subarachnoid hemorrhage (SAH), demonstrating two different pathophysiological entitles contributing to this patient’s motor weakness after SAH. Expand
Structural Characteristic of the Arcuate Fasciculus in Patients with Fluent Aphasia Following Intracranial Hemorrhage: A Diffusion Tensor Tractography Study
The structural difference of the AF in patients following ICH in the left hemisphere was associated with various types of fluent aphasia, and the structural characteristics of the left arcuate fasciculus reconstructed using diffusion tensor image (DTI) were investigated. Expand
Relationship between Visual Perception and Microstructural Change of the Superior Longitudinal Fasciculus in Patients with Brain Injury in the Right Hemisphere: A Preliminary Diffusion Tensor Tractography Study
The microstructural changes of the right SLF play an important role in visual perception, and both pathways contribute to spatial neglect, but leftward lateralization of theright SFL activity after a stroke does not contribute to general visual perception. Expand


Demonstration of Injury of the Corticospinal Tract in a Patient with Suspected Motor Conversion Disorder.
  • S. Jang, J. Seo
  • Medicine
  • American journal of physical medicine & rehabilitation
  • 2017
A 54-year-old, right-handed woman presented with a 4-year history of quadriparesis when she suddenly showed weakness of the right upper and lower extremities while arguing with other people, and her right-sided weakness became slowly aggravated and spread to the left side. Expand
Limb-Kinetic Apraxia Due to Injury of the Corticofugal Tract from the Secondary Motor Area in a Stroke Patient.
During a 2-week period of intensive rehabilitation, the patient showed significant motor recovery in the left extremities to the extent of a nearly normal state including finger flexor and extensor. Expand
Motor recovery mechanism of diffuse axonal injury: a combined study of transcranial magnetic stimulation and functional MRI.
fMRI revealed that both normal subjects and patients with DAI showed increased contralateral primary sensori-motor cortex activation during affected hand movement, which may indicate the heterogeneity of the axons in the recovery process of the corticospinal tract. Expand
The clinical characteristics of motor function in chronic hemiparetic stroke patients with complete corticospinal tract injury.
Investigation of the clinical characteristics of motor function in chronic hemiparetic stroke patients with complete CST injury found that motor weaknesses of distal joint musculature and upper extremities were more severe than those of proximal joint musculation and lower extremities following complete injury of the CST in stroke. Expand
Limb-kinetic apraxia due to injury of corticofugal tracts from secondary motor area in patients with corona radiata infarct
The results suggest that LKA ascribed to injury of the CFTs from the secondary motor area could be accompanied by Injury of the CST ascribing to the corona radiata infarct. Expand
The relation between motor function of stroke patients and diffusion tensor imaging findings for the corticospinal tract
It appears that the corticospinal tract is related to motor function of upper and lower extremities, with particular relation to motor functions of upper extremities including the hand, compared with other motor functions. Expand
Diagnostic value of Hoover sign and motor-evoked potentials in acute somatoform unilateral weakness and sensory impairment mimicking vascular stroke
A somatoform conversion reaction should be considered in children presenting with acute unilateral weakness and sensory alterations, which is corroborated by a normal Hoover sign and intact MEP, according to a study of three adolescents in which two had complete hemiplegia and one had weakness of the left leg. Expand
Electrophysiological correlates of motor conversion disorder
It is suggested that suppression of corticospinal excitability during movement imagination is an electrophysiological correlate of the patients' inability to move voluntarily and provides some insight into the pathophysiology of this disorder. Expand
Non-Invasive Brain Stimulation in Conversion (Functional) Weakness and Paralysis: A Systematic Review and Future Perspectives
How NIBS might help in FW is elucidates and recommendations for future study designs using NIBS in this condition are given and a systematic review of the literature was conducted. Expand
Three-dimensional white matter tractography by diffusion tensor imaging in ischaemic stroke involving the corticospinal tract
3D white matter tractography was used to show the corticospinal tract in eight patients with acute or early subacute ischaemic stroke involving the posterior limb of the internal capsule or corona radiata and to assess involvement of the tract. Expand