Functional MRI and diffusion tractography correlates of functional recovery after a penetrating cephalic injury: A longitudinal case study

Motivation: Understanding brain changes occurring during recovery from a sword-inflicted head injury. Goal(s): To detect longitudinal changes in diffusion and functional MRI accompanying the patient’s functional recovery after the trauma. Approach: Diffusion MRI and tractometry to assess white matter tract changes and task-based and resting-state functional MRI to monitor changes in brain function. Results: Reduced diffusion metrics were found in the affected white matter tracts, which seemed to partially recover over time. Task-based fMRI showed significantly (p < 0.05) increased functional activity over time for the right-hand and language scans reflecting gradual clinical improvement in right hand, and language functions. Impact: This longitudinal case study reveals significant brain recovery post-penetrating trauma, which is less common in clinical practice, and highlights the value of diffusion and functional MRI in tracking brain changes that parallel rehabilitation progress.