Unusual Brain Trauma Injury

Unusual head trauma is rare with various mechanisms of occurrence. The injuries can be similar to those of road accidents but sometimes with significant complexities. The objective was to determine the frequency of this pathology in our practice, describe the different mechanisms and report the craniocerebral lesions caused by this type of trauma. Materials and Method: This was a descriptive study with retrospective collection spread over a period of 3 years. After selecting the files, the patients and/or their companions were contacted by telephone to inquire about them and then returned to the consultation for reassessment. Disease history and information were obtained from patients’ medical records. Result: The frequency of this pathology was 1.78% and his incidence was 0.4 cases per month. The average age of the patients was 13.47 years. All the victims were male. 41.17% of patients were in school. The mechanisms of trauma were the hoof blow 47.1%, the horn blow 29.4% and the stone blow 11.7% respectively. 23.5% of patients were confused and 11.7% children were in coma. One patient presented an anisocoria. The motor deficit was present in 5 cases. CT-scan made it possible to highlight a skull depressing fracture 58.8% and confirm a craniocerebral wound in 35.3%. The average time between patient admission to hospital and completion of surgery was 24.5 hours. The surgery had consisted of the trimming of cranio-cerebral wounds, exploration, duroplasty and lifting of skull depressing fracture. After 15 months of follow-up, the evolution was favorable in 53.3%, the morbidity was 33.4% and the mortality 17.6%. Conclusion: These are rare but serious conditions because they are fatal and disabling. An early and multidisciplinary management can hope to have a good favorable.

Translational perspective: is cinnamon a suitable agent for cognitive impairment and Alzheimer’s disease associated with brain trauma?

Cinnamon, is an exotic spice and a major constituent of our food which is commonly used in different areas of the world for the treatment of various diseases (Kawatra et al., 2015). Besides 让s anti-inflammatory, anti-diabetic and anti-cancer properties, cinnamon also exerts strong brain protective and pro-cogrdtive effects in various models of neurodegeneration (Kawatra et al., 2015;Kelestemur et al., 2016)(Figure 1).

Biomarkers in acute brain trauma: A narrative review

Biomarkers have been used to diagnose, prognose, evaluate, and identify the severity and outcomes in traumatic brain injury (TBI) patients. This study explored if it is possible to predict the outcome of TBI patients by estimating the biomarkers in cerebrospinal fluid and serum. We searched data bases and literature about biomarkers, and found forty epidemiologic studies from 92 potentially relevant articles. However, limited data are available about postanoxic encephalopathy. It showed that presently, neurofilament, S100B, glial fibrillary acidic protein, and ubiquitin carboxyl terminal hydrolase-L1 seemed to have the best potential as diagnostic biomarkers for distinguishing focal and diffuse injury, whereas C-Tau, neuron-specific enolase, S100B, glial fibrillary acidic protein, and spectrin breakdown products appear to be candidates for reflective biomarkers of TBI. Point-of-care biomarkers are needed in TBI which is one of the most important additional risk factors in road traffic injuries. In a holistic approach, more researches about biomarkers of TBI are required. These biomarkers are very useful for treatment of patients with TBI.

STUDY APPLIED ON BA IN PATIENTS WITH BRAIN TRAUMA

目的:探讨脑电地形图在脑外伤病人中的应用价值。方法:在124例脑外伤病人中,检查了脑电地形图。结果:脑电地形图在这些病人中改变是明显的。结论:脑电地形图在脑外伤病人中有重要应用价值。

CONTRAST STUDY ON BA AND CT IN PATIENTS WITH BRAIN TRAUMA

目的:探讨脑电地形图与脑CT在脑外伤诊断中的应用价值。方法:脑电地形图和脑CT在124例脑外伤患者中被检查了,并且进行了对比。结果:在硬膜内和外血肿等器质病变中,BA和CT的定性和定位诊断是一致的,在脑震荡和脑外伤后综合征等功能性病变中,BA是阳性而CT是阴性。结论:脑电地形图在脑外伤的诊断中有重要应用价值。

Morphometric changes in the cortex following acute mild traumatic brain injury

Morphometric changes in cortical thickness(CT),cortical surface area(CSA),and cortical volume(CV) can reflect pathological changes after acute mild traumatic brain injury(m TBI).Most previous studies focused on changes in CT,CSA,and CV in subacute or chronic m TBI,and few studies have examined changes in CT,CSA,and CV in acute m TBI.Furthermore,acute m TBI patients typically show transient cognitive impairment,and few studies have reported on the relationship between cerebral morphological changes and cognitive function in patients with m TBI.This prospective cohort study included 30 patients with acute m TBI(15 males,15 females,mean age 33.7 years) and 27 matched healthy controls(12 males,15 females,mean age 37.7 years) who were recruited from the Second Xiangya Hospital of Central South University between September and December 2019.High-resolution T1-weighted images were acquired within 7 days after the onset of m TBI.The results of analyses using Free Surfer software revealed significantly increased CSA and CV in the right lateral occipital gyrus of acutestage m TBI patients compared with healthy controls,but no significant changes in CT.The acute-stage m TBI patients also showed reduced executive function and processing speed indicated by a lower score in the Digital Symbol Substitution Test,and reduced cognitive ability indicated by a longer time to complete the Trail Making Test-B.Both increased CSA and CV in the right lateral occipital gyrus were negatively correlated with performance in the Trail Making Test part A.These findings suggest that cognitive deficits and cortical alterations in CSA and CV can be detected in the acute stage of m TBI,and that increased CSA and CV in the right lateral occipital gyrus may be a compensatory mechanism for cognitive dysfunction in acute-stage m TBI patients.This study was approved by the Ethics Committee of the Second Xiangya Hospital of Central South University,China(approval No.086) on February 9,2019.

MRS and diffusion tensor image in mild traumatic brain injuries

Objective:To analyze characters of magnetic resonance spectroscopy(MRS) and diffusion tensor imaging(DTI) in the diagnosis of mild trauma brain injuries(MTBI) in frontal lobe and to compare with conventional magnetic resonance imaging(MRI).Methods:A total of 21 patients were selected,who all aged 12-51 years old and had injury within 24 hours.Computer tomography (CT) and the Glasgow Coma Scale were used to evaluate the degree of injury.All patients were diagnosed as MTBI,and 19 had conventional MRI,MRS and DTI.The major parameters of MRS were Probe-P sequence,TE= 144 or 35 ms,and both single voxel spectrum and chemical shift imging were included.The major parameters of DTI were diffusion directions =15,b value = 1000 s/mm^2. Frational anisotropic(FA) map and average ADC map were obtained to evaluate DTI result. Positive deletion ratio was observed and the imaging changes were compared between injured side and normal side.Results:All 21 patients had CT scan and Glasgow scale.A total of 19 patients had conventional MRI.DTI and MRS.Results of CT and conventional MRI showed no significant abnormality in lobe,and Glasgow scale showed mild type.MRS result showed significant decrease in N-acetyl aspartate(NAA) and NAA/creatine(Cr) in 13 cases(68.4%) (P【0.001),and increase in lactic acid(Lac) in 7 cases(36.8%).FA mapping of the frontal lobe displayed significant changes in 7 cases(36.8%),with 5 out of the 7 cases having increase in FA value.And there was no significant difference in average ADC.Conclusions:MRS and DTI might be more sensible than other methods,such as CT and conventional MRI in diagnosis of MTBI.The particular changes were reduced NAA and increased Lac for MRS.and increased FA values for DTI.

Pentraxin 3 contributes to neurogenesis after traumatic brain injury in mice

Emerging evidence indicates that pentraxin 3 is an acute-phase protein that is linked with the immune response to inflammation.It is also a newly discovered marker of anti-inflammatory A2 reactive astrocytes,and potentially has multiple protective effects in stroke;however,its role in the adult brain after traumatic brain injury is unknown.In the present study,a moderate model of traumatic brain injury in mice was established using controlled cortical impact.The models were intraventricularly injected with recombinant pentraxin 3(the recombinant pentraxin 3 group)or an equal volume of vehicle(the control group).The sham-operated mice underwent craniotomy,but did not undergo the controlled cortical impact.The potential neuroprotective and neuroregenerative roles of pentraxin 3 were investigated on days 14 and 21 after traumatic brain injury.Western blot assay showed that the expression of endogenous pentraxin 3 was increased after traumatic brain injury in mice.Furthermore,the neurological severity test and wire grip test revealed that recombinant pentraxin 3 treatment reduced the neurological severity score and increased the wire grip score,suggesting an improved recovery of sensory-motor functions.The Morris water maze results demonstrated that recombinant pentraxin 3 treatment reduced the latency to the platform,increased the time spent in the correct quadrant,and increased the number of times traveled across the platform,thus suggesting an improved recovery of cognitive function.In addition,to investigate the effects of pentraxin 3 on astrocytes,specific markers of A2 astrocytes were detected in primary astrocyte cultures in vitro using western blot assay.The results demonstrated that pentraxin 3 administration activates A2 astrocytes.To explore the protective mechanisms of pentraxin 3,immunofluorescence staining was used.Intraventricular injection of recombinant pentraxin 3 increased neuronal maintenance in the peri-injured cortex and ipsilateral hippocampus,increased the number of doublecortin-positive neural progenitor cells in the subventricular and subgranular zones,and increased the number of bromodeoxyuridine(proliferation)and neuronal nuclear antigen(mature neuron)double-labeled cells in the hippocampus and peri-injured cortex.Pentraxin 3 administration also increased the number of neurospheres and the number of bromodeoxyuridine and doublecortin double-labeled cells in neurospheres,and enhanced the proliferation of neural progenitor cells in primary neural progenitor cell cultures in vitro.In conclusion,recombinant pentraxin 3 administration activated A2 astrocytes,and consequently improved the recovery of neural function by increasing neuronal survival and enhancing neurogenesis.All experiments were approved by the Animal Ethics Committee of the First Affiliated Hospital of Chongqing Medical University,China on March 1,2016.

Traumatic axonal injury of the cingulum in patients with mild traumatic brain injury: a diffusion tensor tractography study

The cingulum,connecting the orbitofrontal cortex to the medial temporal lobe,involves in diverse cognition functions including attention,memory,and motivation.To investigate the relationship between the cingulum injury and cognitive impairment in patients with chronic mild traumatic brain injury,we evaluated the integrity between the anterior cingulum and the basal forebrain using diffusion tensor tractography in 73 patients with chronic mild traumatic brain injury(39 males,34 females,age 43.29±11.42 years)and 40 healthy controls(22 males,18 females,age 40.11±16.81 years).The patients were divided into three subgroups based on the integrity between the anterior cingulum and the basal forebrain on diffusion tensor tractography:subgroup A(n=19 patients)– both sides of the anterior cingulum were intact;subgroup B(n=36 patients)– either side of the anterior cingulum was intact;and subgroup C(18 patients)– both sides of the anterior cingulum were discontinued.There were significant differences in total Memory Assessment Scale score between subgroups A and B and between subgroups A and C.There were no significant differences in diffusion tensor tractography parameters(fractional anisotropy,apparent diffusion coefficient,and fiber volume)between patients and controls.These findings suggest that the integrity between the anterior cingulum and the basal forebrain,but not diffusion tensor tractography parameter,can be used to predict the cognitive function of patients with chronic mild traumatic brain injury.This study was approved by Yeungnam University Hospital Institutional Review Board(approval No.YUMC-2014-01-425-010)on August 16,2017.

Structural and functional connectivity in traumatic brain injury

Traumatic brain injury survivors often experience cognitive deficits and neuropsychiatric symptoms.However,the neurobiological mechanisms underlying specific impairments are not fully understood.Advances in neuroimaging techniques（such as diffusion tensor imaging and functional MRI）have given us new insights on structural and functional connectivity patterns of the human brain in both health and disease.The connectome derived from connectivity maps reflects the entire constellation of distributed brain networks.Using these powerful neuroimaging approaches,changes at the microstructural level can be detected through regional and global properties of neuronal networks.Here we will review recent developments in the study of brain network abnormalities in traumatic brain injury,mainly focusing on structural and functional connectivity.Some connectomic studies have provided interesting insights into the neurological dysfunction that occurs following traumatic brain injury.These techniques could eventually be helpful in developing imaging biomarkers of cognitive and neurobehavioral sequelae,as well as predicting outcome and prognosis.

Traumatic brain injury and palliative care:a retrospective analysis of 49 patients receiving palliative care during 2013–2016 in Turkey

Traumatic brain injury（TBI）,which is seen more in young adults,affects both patients and their families.The need for palliative care in TBI and the limits of the care requirement are not clear.The aim of this study was to investigate the length of stay in the palliative care center（PCC）,Turkey,the status of patients at discharge,and the need for palliative care in patients with TBI.The medical records of 49 patients with TBI receiving palliative care in PCC during 2013–2016 were retrospectively collected,including age and gender of patients,the length of stay in PCC,the cause of TBI,diagnosis,Glasgow Coma Scale score,Glas gow Outcome Scale score,Karnofsky Performance Status score,mobilization status,nutrition route（oral,percutaneous endoscopic gastrostomy）,pressure ulcers,and discharge status.These patients were aged 45.4 ± 20.2 years.The median length of stay in the PCC was 34.0 days.These included TBI patients had a Glasg ow Coma Scale score ≤ 8,were not mobilized,received tracheostomy and percutaneous endoscopic gastrostomy nutrition,and had pressure ulcers.No difference was found between those who were discharged to their home or other places（rehabilitation centre,intensive care unit and death） in respect of mobilization,percutaneous endoscopic gastrostomy,tracheostomy and pressure ulcers.TBI patients who were followed up in PCC were determined to be relatively young patients（45.4 ± 20.2 years） with mobilization and nutrition problems and pressure ulcer formation.As TBI patients have complex health conditions that require palliative care from the time of admittance to intensive care unit,provision of palliative care services should be integrated with clinical applications.

Umbilical cord-derived mesenchymal stem cell transplantation combined with hyperbaric oxygen treatment for repair of traumatic brain injury

Transplantation of umbilical cord-derived mesenchymal stem cells（UC-MSCs） for repair of traumatic brain injury has been used in the clinic. Hyperbaric oxygen（HBO） treatment has long been widely used as an adjunctive therapy for treating traumatic brain injury. UC-MSC transplantation combined with HBO treatment is expected to yield better therapeutic effects on traumatic brain injury. In this study, we established rat models of severe traumatic brain injury by pressurized fluid（2.5–3.0 atm impact force）. The injured rats were then administered UC-MSC transplantation via the tail vein in combination with HBO treatment. Compared with monotherapy, aquaporin 4 expression decreased in the injured rat brain, but growth-associated protein-43 expression, calaxon-like structures, and CM-Dil-positive cell number increased. Following combination therapy, however, rat cognitive and neurological function significantly improved. UC-MSC transplantation combined with HBO therapyfor repair of traumatic brain injury shows better therapeutic effects than monotherapy and significantly promotes recovery of neurological functions.

Clinical Observation of Hemodynamic and Cerebral Protective Effects of Different Doses of Dexmedetomidine in Patients with Traumatic Brain Injury

Background: Patients with craniocerebral trauma may suffer ischemic brain injury and neurological dysfunction due to immune inflammation and neuroendocrine reactions. Dexmedetomidine (Dex) is one of the commonly used anesthetic drugs in clinic. Studies have shown Dex has the function of protecting brain nerves and inhibiting inflammation. However, there are few studies on the effects of different doses of dexmedetomidine on patients undergoing surgery. The purpose of this study is to observe the effects of different doses of Dex on hemodynamics and brain protection in patients undergoing brain trauma surgery. Materials and Methods: Eighty patients with craniocerebral trauma surgery were randomly divided into study group (group A, n = 40) and control group (group B, n = 40) by random number table method. Dex pump volume was 0.5 μg/kg/h in group A and 1.0 μg/kg/h in group B. Heart rate (HR) and mean arterial pressure (MAP) were recorded before anesthesia induction (T0), immediately after endotracheal intubation (T1) and at the end of operation (T2). The serum levels of central nervous system specific protein (S-100β) and neuron specific enolase (NSE) were measured and compared between the two groups at T0 and T2. Results: HR and MAP in group A were significantly higher than those in group B at T2, and the difference was statistically significant (P P β and NSE in both groups at T2 were lower than those at T0, and the concentrations of S-100β and NSE in group A were significantly lower than those in group B at T2 (P Conclusions: 0.5 μg/kg dose of Dex is stable in hemodynamics and has a better protective effect on brain function in patients with traumatic brain injury.

Motor recovery via aberrant pyramidal tract in a patient with traumatic brain injury A diffusion tensor tractography study

The aberrant pyramidal tract is the collateral pathway of the pyramidal tract through the medial lemniscus in the brainstem. A 21-year-old man presented with right hemiparesis due to a traumatic intracerebral hemorrhage in the left corona radiata. His motor function recovered almost to the normal state at 10 months after onset. Through diffusion tensor tractography, the pyramidal tract in the affected （left） hemisphere showed discontinuation at the pontine level at 13 months after onset. An aberrant pyramidal tract was observed, which originated from the primary motor cortex and the supplementary motor area and descended through the corona radiata, then through the posterior limb of the internal capsule and the medial lemniscus pathway from the midbrain to the pons, finally entered into the pyramidal tract area at the pontomedullary junction, it suggests that the motor functions of the right extremities in this patient had recovered by this aberrant pyramidal tract.

Changes in platelet parameters and secondary brain injury in acute craniocerebral trauma

Changes in platelet parameters are important in secondary brain injury in acute craniocerebral trauma We selected 163 patients with craniocerebral trauma who were admitted within 24 hours with nonoperative therapy. Platelet parameters of 40 healthy subjects served as controls. Platelet number was decreased, while mean platelet volume and platelet distribution width values were increased, at 1 and 3 days after injury. Platelet number was lower and mean platelet volume and platelet distribution width were larger in patients with traumatic cerebral infarction and those in Glasgow Coma Scale score 〈 8 group. Platelet number was negatively correlated to volume of cerebral edema, but positively correlated to Glasgow Outcome Scale score. These data indicate that changes in platelet parameters may be utilized to indicate the state of central nervous system injury and patient prognosis .

Study of the AQP4 expression in traumatic brain edema and multimodal MRI imaging

The aquaporin-4(AQP4)is a highly selective membrane protein.It is important for the body to maintain the water balance between internal and external environment of cells,the studies have found that the abnormal expression of AQP4 is related to the occurrence of many diseases.The cerebral edema is the most common and serious complication of brain trauma,and its pathogenesis is closely related to AQP4.The development of multimodal magnetic resonance imaging(M-MRI)could been provided imaging basis for accurate diagnosis of traumatic brain edema.In recent years,the correlation between AQP4 and M-MRI has become a hotspot of research.This paper reviews the research progress on the correlation between AQP4 expression in traumatic cerebral edema and M-MRI.

Detection of the Severity of Brain Injury in Head Trauma Patients Using Biochemical Blood Markers and Its Correlation with Glasgow Coma Scale

Head trauma is one of common injury related mortality and morbidity. Blood biomarkers are valuable tools for the identification and characterization of initial injury and secondary pathological processes for traumatic brain injury (TBI). This study evaluated the performance of a recently developed visfatin and its correlation with other blood circulating biomarkers that reflect specific pathological mechanisms including neuro inflammatory, neuron injury and oxidative damage in moderate to severe TBI patients. Peripheral blood was taken from TBI patients (n = 78) at hospital admission, maximum 6 hours post-injury. Severity and neurological outcome were assessed using the Glasgow Coma Scale (GCS) and blood level of: visfatin, neuron specific enolase (NSE), malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH). Concentrations of visfatin (28 ± 1.68 μg/L, 25 ± 2.09 μg/L) was significantly higher (p < 0.0001) in sever and moderate groups of TBI patients respectively compared to control group (7.62 ± 0.87 μg/L), NSE concentrations also were significantly higher (p < 0.0001) in both groups of TBI patients (20.47 ± 3 ng/ml, 13.49 ± 2.66 ng/ml) compared to control group (4.3 ± 0.52 ng/ml), MDA was significantly elevated (p < 0.001) in sever TBI patients group (6.88 ± 0.58 μmol/L) compared to control group (5.12 ± 0.76 μmol/L), while SOD (245.12 ± 24.2 U/L, 276.097 ± 30.8 U/L) and GSH (112.07 ± 2.09 μmol/L, 119.26 ± 2.7 μmol/L) were highly significantly decreased (p < 0.0001) in TBI patients compared to control group (304.17 ± 27.17 U/L and 151.64 ± 9.9 μmol/L) respectively. Visfatin was positively correlated with NSE and MDA, while there was negative correlation with SOD and GSH. In conclusion blood level of visfatin in correlation with other blood biomarkers can be used for prediction of severity of TBI cases.

Prognostic Factors to Reduce ICU Overtriage in Elderly Patients with Isolated Mild Traumatic Brain Injury

Introduction: Elderly patients with mild traumatic brain injury (mTBI) are frequently admitted to an intensive care unit (ICU), which is potentially both harmful and unnecessary. It is not known which patients may be safely observed in a non-ICU setting, potentially improving ICU utilization. The purpose of this study was to identify factors that predict which geriatric patients with traumatic brain injury may be admitted to a level of care other than the ICU. Methods: Adults ≥65+ years admitted with positive radiologic study demonstrating isolated mTBI (defined as Glasgow Coma Scale (GCS) 13 - 15) that was initially managed nonoperatively between January 2011-December 2016 were identified. Primary outcomes evaluated included over triage and Glasgow Outcome Scale (GOS). Results: 207 were identified. Most patients presented with GCS 15 (77.8%) and were admitted to ICU (85.5%). 27% (n = 55) met overtriage criteria. The most common TBI was subdural hemorrhage (SDH) (48.8%) followed by subarachnoid hemorrhage (SAH) (22.2%). Hemorrhage progression developed in 8.7% of subjects, but there was no difference across TBI type. 21.7% of patients developed a ≥2 point decrease in GCS during their hospital stay. Upon discharge, 89.9% had a GOS ≥ 4 - 5. Presence/type of a single intracranial hemorrhage (ICH) was not significantly associated with outcome, but presence of bilateral or multiple lesions was significantly associated with poor outcome (p = 0.04). Conclusions: Overtriage of patients to an ICU is costly, resource intensive, and avoidable. Here, we suggest a conservative framework to assist the determination of which patients can be safely observed in non-ICU setting. Future studies should determine if this framework is generalizable to the entire geriatric population who present with mTBI.

The levels of serum cystatin C, brain natriuretic peptide in traumatic patients and correlation analysis with traumatic severity

Objective:To observe the levels of serum cystatin C (Cys C), brain natriuretic peptide (BNP) in traumatic patients and correlation analysis with traumatic severity.Methods:120 emergency traumatic patients in emergency department of our hospital were rolled from December 2015 to December 2016, who were divided into minor trauma group (n=41), severe trauma group (n=43) and critical trauma group (n=36) according to the injury severity score (ISS). The levels of serum Cys C, BNP of the patients in the 3 groups were detected on 0 h, 24 h, 3 d and 7 d after admission respectively. Pearson correlation analysis of the levels of serum Cys C, BNP and ISS.Results: There were no significant differences in the levels of serum Cys C, BNP on 0 hours between the three groups;There were no significant differences in the levels of serum Cys C, BNP on 0 h, 24 h, 3 d and 7 d in minor trauma group;The levels of serum Cys C, BNP on 24 h, 3 d and 7 d were all higher than those of 0 h in severe trauma group, and the levels of serum Cys C on 3 d and 7 d were both higher than those of 24 h;The levels of serum Cys C, BNP on 24 h, 3 d and 7 d were all higher than those of 0 h in critical trauma group, the levels of serum Cys C, BNP on 3 d and 7 d were both higher than those of 24 h, and the levels of serum Cys C on 7 d were higher than those of 3 d;The levels of serum Cys C, BNP in severe trauma and critical trauma groups were significantly higher compared with minor trauma group on 24 h, 3 d and 7 d. Pearson correlation analysis, the level of serum Cys C were positively correlated with ISS, the level of serum BNP were positively correlated with ISS.Conclusion:Different levels of traumatic patients had different levels of serum Cys C, BNP increased at different times. Pearson correlation analysis showed that the levels of serum Cys C, BNP were both positively correlated with traumatic severity, which suggested that the levels of serum Cys C, BNP may be important indicators of traumatic severity and could provide important reference value for clinical evaluation of traumatic severity.

Functional connectivity of paired default mode network subregions in patients with eye trauma

AIM:To study functional brain abnormalities in patients with eye trauma(ET)and to discuss the pathophysiological mechanisms of ET.METHODS:Totally 31 ET patients and 31 healthy controls(HCs)were recruited.The age,gender,and educational background characteristics of the two groups were similar.After functional magnetic resonance imaging(fMRI)scanning,the subjects’spontaneous brain activity was evaluated with the functional connectivity(FC)method.Receiver operating characteristic(ROC)curve analysis was used to classify the data.Pearson’s correlation analysis was used to explore the relationship between FC values in specific brain regions and clinical behaviors in patients with ET.RESULTS:Significantly increased FC between several regions was identified including the medial prefrontal cortex(MPFC)and left hippocampus formations(HF),the MPFC and left inferior parietal lobule(IPL),the left IPL and left medial temporal lobe(MTL),the left IPL and right MTL,and the right IPL and left MTL.No decreased region-to-region connectivity was detected in default mode network(DMN)sub-regions in patients with ET.Compared with HCs,ET patients exhibited significantly increased FC between several paired DMN regions,as follows:posterior cingulate cortex(PCC)and right HF(HF.R,t=2.196,P=0.032),right inferior parietal cortices(IPC.R)and left MTL(MTL.L,t=2.243,P=0.029),and right MTL(MTL.R)and HF.R(t=2.236,P=0.029).CONCLUSION:FC values in multiple brain regions of ET patients are abnormal,suggesting that these brain regions in ET patients may be dysfunctional,which may help to reveal the pathophysiological mechanisms of ET.