The caudate nucleus, which is vulnerable to hypoxic-ischemic brain injury (HI-BI), is important to cognitive function because it is connected to the prefrontal cortex. Using diffusion tensor tractography (DTT), no study on injury of the prefronto-caudate tract in a patient with HI-BI has been reported so far. Here, we report a patient with severe apathy who showed injury of the prefronto-caudate tract following HI-BI, which was demonstrated by DTT. A 38-year-old female patient suffered HI-BI induced by carbon monoxide poisoning following attempted suicide for a period of approximately four hours. From the onset, the patient showed severe apathy (7 months after onset-the Apathy Scale score was 24 [full score: 42]). Brain MR images taken at seven months after onset showed no abnormality. On 7-month DTT, the neural connectivity of the caudate nucleus to the medial prefrontal cortex (Brodmann area: 10 and 12) and orbitofrontal cortex (Brodmann area: 11 and 13) was decreased in both hemispheres. Using DTT, injury of the prefronto-caudate tract was demonstrated in a patient who showed severe apathy following HI-BI. We believe that injury of the prefronto-caudate tract might be a pathogenetic mechanism of apathy in patients with HI-BI.

中文翻译：

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由于额叶前额叶的损伤而引起的严重冷漠。

尾状核易受缺氧缺血性脑损伤（HI-BI）的影响，因为它与前额叶皮层相连，因此对认知功能很重要。迄今为止，尚无关于使用弥散张量束缚线描记术（DTT）的HI-BI患者前额尾肌束损伤的研究。在这里，我们报道了一名严重冷漠的患者，其在HI-BI后表现出额额叶前额管损伤，这已通过DTT证实。一名38岁的女性患者在自杀未遂后大约​​一小时内因一氧化碳中毒而导致HI-BI。从发病开始，患者表现出严重的冷漠（发病后7个月-冷漠量表评分为24 [满分：42]）。发病后七个月拍摄的脑部MR图像未见异常。在7个月的DTT上，在两个半球中尾状核与内侧前额叶皮层（Brodmann区域：10和12）和眶额叶皮层（Brodmann区域：11和13）的神经连通性均降低。使用DTT，在HI-BI后表现出严重冷漠的患者中，显示了额前额叶的损伤。我们认为，前额叶尾部的损伤可能是HI-BI患者冷漠的发病机制。