Injury of the Hypothalamus in Patients With Hypoxic-Ischemic Brain Injury: A Diffusion Tensor Imaging Study.

Abstract

The survival rate for hypoxic-ischemic brain injury (HI-BI) is less than 20%. Several brain regions, including the caudate, hippocampus, and hypothalamus, are vulnerable to HI-BI. Hypothalamus is involved in regulation of temperature, sleep-wakefulness cycle, emotional behavior, and memory function. Using diffusion tensor imaging, we examined injury of the hypothalamus in patients with HI-BI. Twelve patients with HI-BI and 27 healthy control subjects were recruited. The region of interest was defined for the hypothalamus and the fractional anisotropy and apparent diffusion coefficient were measured. The fractional anisotropy value was significantly lower in the patient group compared with the control group (P < 0.05), whereas the apparent diffusion coefficient value was significantly higher compared with that of the control group (P < 0.05). In the individual analysis, 7 (58.3%) of 12 patients and 14 (58.3%) of 24 hemispheres showed a decrement or increment of more than two SDs in either fractional anisotropy or apparent diffusion coefficient values compared with the control group. Using diffusion tensor imaging, injury of the hypothalamus was demonstrated in patients with HI-BI. Our methodology and results of this study would be helpful in research on the hypothalamus in patients with HI-BI.