Blended Motor-Sensory Nerve Bundles on Diffused Tensor Imaging: Evidence of Brain Plasticity in a Patient with 36-year Sequelae from Encephalitis

Abstract

BACKGROUND: Brain plasticity refers to the extraordinary ability of the brain to modify its structure and function following changes within the body or in the external environment. However, it is not easy to find it on non-invasive imaging modality. CASE REPORT: In this article, we report the case of a 36-year-old male patient with sequelae of encephalitis. The patient had general epilepsy with multiple hospital admissions. MRI 3.0 Tesla showed his cerebral hemispheres were asymmetrical both morphologically and tractographically; there was a scar at the right temporo-occipital region, and an atrophy of the right temporal lobe, hippocampus and pontine. DTI reconstruction showed asymmetrical cortico-spinal and thalamo-cortical tracts with posterior thalamo-cortical tract was partly damaged by the scar. Blended motor-sensory nerve bundles were observed only on the left side of the patient’s brain but not on the right or healthy subjects. DTI quantification showed the lower line number, lower FA and higher ADC in the patient compared to healthy subjects and within the patient with decreased functionality on the side of the scar. CONCLUSION: Non-invasive DTI with 3D image reconstruction on the patient showed evidence of brain plasticity appeared on cortico-spinal and thalamo-cortical tracts and can inform diagnosis and treatment strategies.