{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T14:59:02Z","timestamp":1775833142771,"version":"3.50.1"},"reference-count":50,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Research Foundation of Korea (NRF) grant funded by the Korean Government(MSIP)","award":["2021R1A2B5B01001386"],"award-info":[{"award-number":["2021R1A2B5B01001386"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Some studies have reported that a core vestibular projection (CVP) injury is associated with dizziness following a brain injury using diffusion tensor tractography (DTT). On the other hand, there has been no DTT study on dizziness caused by a CVP injury in patients with mild traumatic brain injury (TBI). In this study, DTT was used to examine the relationship between dizziness and CVP injury in patients with mild TBI. Forty-three patients with mild TBI and twenty-nine normal subjects were recruited. The patients were classified into two groups based on the dizziness score: group A, patients with a dizziness score less than 2 on the sub-item score for dizziness in the Rivermead Post-concussion Symptoms Questionnaire; group B, patients with a dizziness score above 2. The tract volume (TV) in group B was significantly lower than group A and the control group (p &lt; 0.05). By contrast, the TV in group A was similar to the control group (p &gt; 0.05). Regarding the correlation, the dizziness score of all patients showed a strong negative correlation with the TV of the CVP (r = \u22120.711, p &lt; 0.05). DTT revealed the CVP injury in patients with dizziness after mild TBI. In addition, the severity of dizziness of these patients was closely related to the injury severity of the CVP.<\/jats:p>","DOI":"10.3390\/diagnostics11112070","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T12:46:23Z","timestamp":1636461983000},"page":"2070","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Relationship between Dizziness and the Core Vestibular Projection Injury in Patients with Mild Traumatic Brain Injury"],"prefix":"10.3390","volume":"11","author":[{"given":"Sung-Ho","family":"Jang","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu 42415, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0835-4060","authenticated-orcid":false,"given":"Chang-Hoon","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Yeungnam University, Daegu 42415, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae-Woon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology, College of Medicine, Yeungnam University, Daegu 42415, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6654-302X","authenticated-orcid":false,"given":"Hyeok-Gyu","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, College of Health Science, Eulji University, Sungnam-si 13135, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1080\/02699050701472109","article-title":"Dizziness after traumatic brain injury: Results from an interview study","volume":"21","author":"Maskell","year":"2007","journal-title":"Brain Inj."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1080\/02699050500488041","article-title":"Dizziness after traumatic brain injury: Overview and measurement in the clinical setting","volume":"20","author":"Maskell","year":"2006","journal-title":"Brain Inj."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"47","DOI":"10.3233\/VES-2004-14105","article-title":"Prevalence of dizziness and vertigo in an urban elderly population","volume":"14","author":"Jonsson","year":"2004","journal-title":"J. Vestib. Res."},{"key":"ref_4","unstructured":"Morris, L., and Gottshall, K. (2014). Physical Therapy Management of the Patient with Vestibular Dysfunction from Head Trauma, Davis Company."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1055\/s-0033-1354599","article-title":"Posttraumatic vertigo and dizziness","volume":"Volume 33","author":"Fife","year":"2013","journal-title":"Seminars in Neurology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/00129492-200403000-00009","article-title":"Characterizing and treating dizziness after mild head trauma","volume":"25","author":"Hoffer","year":"2004","journal-title":"Otol. Neurotol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.brainresrev.2010.12.002","article-title":"The thalamocortical vestibular system in animals and humans","volume":"67","author":"Lopez","year":"2011","journal-title":"Brain Res. Rev."},{"key":"ref_8","unstructured":"Siegel, A., Sapru, H.N., and Siegel, H. (2019). Essential Neuroscience, Wolters Kluwer. [4th ed.]."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"31","DOI":"10.3389\/fnint.2014.00031","article-title":"The vestibular system: A spatial reference for bodily self-consciousness","volume":"8","author":"Pfeiffer","year":"2014","journal-title":"Front. Integr. Neurosci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"59","DOI":"10.3389\/fnint.2014.00059","article-title":"Vestibular pathways involved in cognition","volume":"8","author":"Hitier","year":"2014","journal-title":"Front. Integr. Neurosci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2445","DOI":"10.1152\/jn.00731.2013","article-title":"Sensory convergence in the parieto-insular vestibular cortex","volume":"111","author":"Shinder","year":"2014","journal-title":"J. Neurophysiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/S0361-9230(03)00055-8","article-title":"Central vestibular system: Vestibular nuclei and posterior cerebellum","volume":"60","author":"Barmack","year":"2003","journal-title":"Brain Res. Bull."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"79","DOI":"10.3389\/fncir.2015.00079","article-title":"Vestibular Interactions in the Thalamus","volume":"9","author":"Wijesinghe","year":"2015","journal-title":"Front. Neural. Circuits"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1016\/S1474-4422(08)70164-9","article-title":"Moderate and severe traumatic brain injury in adults","volume":"7","author":"Maas","year":"2008","journal-title":"Lancet Neurol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1212\/WNL.45.7.1253","article-title":"Mild traumatic brain injury: Pathophysiology, natural history, and clinical management","volume":"45","author":"Alexander","year":"1995","journal-title":"Neurology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1080\/02699050119160","article-title":"Diagnostic criteria and differential diagnosis of mild traumatic brain injury","volume":"15","author":"Twijnstra","year":"2001","journal-title":"Brain Inj."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1080\/02699050902748356","article-title":"Prevalence and structure of symptoms at 3 months after mild traumatic brain injury in a national cohort","volume":"23","author":"Lannsjo","year":"2009","journal-title":"Brain Inj."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1080\/02699050600744327","article-title":"Symptoms and disability until 3 months after mild TBI","volume":"20","author":"Lundin","year":"2006","journal-title":"Brain Inj."},{"key":"ref_19","first-page":"657","article-title":"The association between the postconcussion symptoms and clinical outcomes for patients with mild traumatic brain injury","volume":"62","author":"Yang","year":"2007","journal-title":"J. Trauma"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1136\/jnnp.49.11.1227","article-title":"Neuropsychological and psychosocial consequences of minor head injury","volume":"49","author":"Dikmen","year":"1986","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1016\/j.apmr.2004.02.012","article-title":"Outcome after mild to moderate traumatic brain injury: The role of dizziness","volume":"85","author":"Chamelian","year":"2004","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1097\/JNN.0b013e31828a418b","article-title":"Symptoms associated with mild traumatic brain injury\/concussion: The role of bother","volume":"45","author":"Bergman","year":"2013","journal-title":"J. Neurosci. Nurs."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1148\/radiol.14132670","article-title":"Detection of central white matter injury underlying vestibulopathy after mild traumatic brain injury","volume":"272","author":"Alhilali","year":"2014","journal-title":"Radiology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"41","DOI":"10.3389\/fnana.2015.00041","article-title":"Diffusion tensor imaging of the human cerebellar pathways and their interplay with cerebral macrostructure","volume":"9","author":"Keser","year":"2015","journal-title":"Front. Neuroanat."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1007\/s00429-014-0971-x","article-title":"Structural and functional connectivity mapping of the vestibular circuitry from human brainstem to cortex","volume":"221","author":"Kirsch","year":"2016","journal-title":"Brain Struct. Funct."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Salman, M.M., Kitchen, P., Halsey, A., Wang, M.X., Tornroth-Horsefield, S., Conner, A.C., Badaut, J., Iliff, J.J., and Bill, R.M. (2021). Emerging roles for dynamic aquaporin-4 subcellular relocalization in CNS water homeostasis. Brain.","DOI":"10.1093\/brain\/awab311"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1038\/s41583-021-00514-z","article-title":"Aquaporin 4 and glymphatic flow have central roles in brain fluid homeostasis","volume":"22","author":"Salman","year":"2021","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e141159","DOI":"10.1172\/jci.insight.141159","article-title":"Direct imaging of glymphatic transport using H217O MRI","volume":"6","author":"Alshuhri","year":"2021","journal-title":"JCI Insight"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"183573","DOI":"10.1016\/j.bbamem.2021.183573","article-title":"The effects of trifluoperazine on brain edema, aquaporin-4 expression and metabolic markers during the acute phase of stroke using photothrombotic mouse model","volume":"1863","author":"Sylvain","year":"2021","journal-title":"Biochim. Biophys. Acta Biomembr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1016\/j.cell.2020.03.037","article-title":"Targeting aquaporin-4 subcellular localization to treat central nervous system edema","volume":"181","author":"Kitchen","year":"2020","journal-title":"Cell"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e9349","DOI":"10.1097\/MD.0000000000009349","article-title":"Central vestibular disorder due to ischemic injury on the parieto-insular vestibular cortex in patients with middle cerebral artery territory infarction: Observational study","volume":"96","author":"Yeo","year":"2017","journal-title":"Medicine"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.neulet.2017.12.010","article-title":"Lateral medullary syndrome following injury of the vestibular pathway to the core vestibular cortex: Diffusion tensor imaging study","volume":"665","author":"Yeo","year":"2018","journal-title":"Neurosci. Lett"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Kwon, H.G., Chang, C.H., and Jang, S.H. (2020). Diagnosis of dizziness due to a core vestibular projection injury in a patient with intracerebral hemorrhage. Diagnostics, 10.","DOI":"10.3390\/diagnostics10040220"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1007\/BF00868811","article-title":"The rivermead post concussion symptoms questionnaire: A measure of symptoms commonly experienced after head injury and its reliability","volume":"242","author":"King","year":"1995","journal-title":"J. Neurol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"S208","DOI":"10.1016\/j.neuroimage.2004.07.051","article-title":"Advances in functional and structural MR image analysis and implementation as FSL","volume":"23","author":"Smith","year":"2004","journal-title":"Neuroimage"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.neuroimage.2006.09.018","article-title":"Probabilistic diffusion tractography with multiple fibre orientations: What can we gain?","volume":"34","author":"Behrens","year":"2007","journal-title":"Neuroimage"},{"key":"ref_37","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, L. Erlbaum Associates. [2nd ed.]."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s12031-007-0029-0","article-title":"Diffusion tensor imaging (DTI)-based white matter mapping in brain research: A review","volume":"34","author":"Assaf","year":"2008","journal-title":"J. Mol. Neurosci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/j.neuroimage.2008.03.021","article-title":"Voxel-based analysis derived from fractional anisotropy images of white matter volume changes with aging","volume":"41","author":"Pagani","year":"2008","journal-title":"Neuroimage"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1089\/neu.1995.12.555","article-title":"The pathobiology of traumatically induced axonal injury in animals and humans: A review of current thoughts","volume":"12","author":"Povlishock","year":"1995","journal-title":"J. Neurotrauma"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s11682-012-9156-5","article-title":"A review of magnetic resonance imaging and diffusion tensor imaging findings in mild traumatic brain injury","volume":"6","author":"Shenton","year":"2012","journal-title":"Brain Imaging Behav."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Jang, S.H. (2018). Traumatic Axonal Injury in Mild Traumatic Brain Injury, InTech.","DOI":"10.5772\/intechopen.70988"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1093\/arclin\/17.4.319","article-title":"Patient complaints within 1 month of mild traumatic brain injury: A controlled study","volume":"17","author":"Paniak","year":"2002","journal-title":"Arch. Clin. Neuropsychol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1080\/026990596124205","article-title":"Prevalence of impairments 5 years after a head injury, and their relationship with disabilities and outcome","volume":"10","author":"Masson","year":"1996","journal-title":"Brain Inj."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"S286","DOI":"10.1016\/j.apmr.2013.07.029","article-title":"Mild traumatic brain injury after motor vehicle collisions: What are the symptoms and who treats them? A population-based 1-year inception cohort study","volume":"95","author":"Hartvigsen","year":"2014","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1007\/s00586-005-0970-y","article-title":"Cervical vertigo and dizziness after whiplash injury","volume":"15","author":"Endo","year":"2006","journal-title":"Eur. Spine J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1212\/WNL.0b013e3181ccc746","article-title":"Vertigo with an isolated lesion in brainstem vestibular nucleus and nerve","volume":"74","author":"Hong","year":"2010","journal-title":"Neurology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2825108","DOI":"10.1155\/2020\/2825108","article-title":"Associations between age-related changes in the core vestibular projection pathway and balance ability: A diffusion tensor imaging study","volume":"2020","author":"Yeo","year":"2020","journal-title":"Behav. Neurol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"165","DOI":"10.2463\/mrms.8.165","article-title":"MR tractography: A review of its clinical applications","volume":"8","author":"Yamada","year":"2009","journal-title":"Magn. Reson. Med. Sci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"573775","DOI":"10.3389\/fbioe.2020.573775","article-title":"Design and validation of a human brain endothelial microvessel-on-a-chip open microfluidic model enabling advanced optical imaging","volume":"8","author":"Salman","year":"2020","journal-title":"Front. Bioeng. Biotechnol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/11\/2070\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:27:59Z","timestamp":1760167679000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/11\/2070"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,9]]},"references-count":50,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["diagnostics11112070"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics11112070","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,9]]}}}