Contralateral cerebellar hypometabolism: a predictor for stroke outcome?

Serrati, Carlo; Marchal, G; Rioux, Patrice; Viader, Fausto; Petit-Taboué, M.C.; Lochon, P.; Luet, Dominique; Derlon, J M; Baron, Jean‐Claude

doi:10.1136/jnnp.57.2.174

Cited by 68 publications

(46 citation statements)

References 19 publications

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“…The reversibility of CCD under thrombolytic therapy reflects the functional and initially reversible character of cerebellar flow asymmetry. This finding contrasts with previous studies without reperfusion that considered CCD a persistent phenomenon (Baron et al, 1980;Bowler et al, 1995;Infeld et al, 1995;Meneghetti et al, 1984;Serrati et al, 1994;Takasawa et al, 2002). Most of these studies were performed in the subacute or chronic stage.…”

Section: Figurecontrasting

confidence: 93%

“…The strokes we investigated were restricted to the MCA territory. With few exceptions (Infeld et al, 1995;Kamouchi et al, 2004;Serrati et al, 1994;Takasawa et al, 2002), previous reports included strokes from various vascular territories (Baron et al, 1980;Bowler et al, 1995;Kamouchi et al, 1996;Kim Figure 2 Reperfusion with different responses of CCD. In patient #1, CCD persisted despite a marked supratentorial reperfusion/ hyperperfusion.…”

Section: Discussionmentioning

confidence: 99%

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Crossed Cerebellar Diaschisis in Acute Human Stroke: A PET Study of Serial Changes and Response to Supratentorial Reperfusion

Sobesky

Thiel

Ghaemi

et al. 2005

J Cereb Blood Flow Metab

121

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Crossed cerebellar diaschisis (CCD) is well described in the chronic phase of stroke, but few data describe acute CCD and its serial changes after reperfusion. Using positron emission tomography (PET), we studied acute CCD with respect to supratentorial perfusion and outcome measures. In 19 acute stroke patients receiving intravenous thrombolysis (<3 h), 15O-water PET assessed CCD and supratentorial hypoperfusion volume before thrombolysis, 3, 24 h and 14 days later. Infarct volume at day 14 and NIHSS score at 3 months were assessed. Supratentorial hypoperfusion decreased from 25 cm3 (median) before thrombolysis to 0.1 cm3 at day 14. Baseline CCD was 13.4% and decreased continuously to 6.1% after 14 days. The NIHSS score decreased from 11 to 4 pts after 3 months. Infarct volume was 1.1 cm3. Crossed cerebellar diaschisis correlated to the hypoperfusion volume within the first 24 h after stroke, but not later. Hypoperfusion correlated to outcome measures at the early stage only. In contrast, CCD correlated to outcome values at all four measurements. Reperfusion with recovery of CCD was seen in patients with small infarcts and good clinical outcome and vice versa. Our data suggest that (i) CCD occurs as early as 3 h after stroke and might be reversible; (ii) acute CCD is closely related to the volume of supratentorial hypoperfusion. At later time points, however, CCD is disconnected from supratentorial perfusion but strongly associated to outcome measures; (iii) CCD is not susceptible to nonnutritional reperfusion and adds valuable information to interpret supratentorial reperfusion patterns.

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Section: Figurecontrasting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Crossed Cerebellar Diaschisis in Acute Human Stroke: A PET Study of Serial Changes and Response to Supratentorial Reperfusion

Sobesky

Thiel

Ghaemi

et al. 2005

J Cereb Blood Flow Metab

121

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“…However, few studies have reported a correlation between the clinical outcome and treatment response in patients and the quantitative value of CCD. [10][11][12][13]18,20 One reason is that PET and SPECT have been used as criterion standards for diagnosing and studying CCD, and the need to inject radioisotopes and the exposure to radiation have made long-term follow-up difficult. However, noninvasive ASL MR perfusion imaging has emerged as a valuable method that can be used to obtain brain-flow information noninvasively and repeatedly.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7][8] CCD is not only a secondary result of supratentorial infarction but also a prognostic indicator of neurologic improvement and clinical outcomes after infarction. [9][10][11][12][13] For example, in one study, CCD in the chronic stage was associated with neurologic improvement after infarction in the territory of the middle cerebral artery. 12 In another study, CCD in the early subacute stage of supratentorial infarction indicated a worse clinical outcome.…”

mentioning

confidence: 99%

“…[9][10][11][12][13] For example, in one study, CCD in the chronic stage was associated with neurologic improvement after infarction in the territory of the middle cerebral artery. 12 In another study, CCD in the early subacute stage of supratentorial infarction indicated a worse clinical outcome. 10 Furthermore, a PET study of acute stroke that evaluated multiple time points revealed that after reperfusion with thrombolysis, CCD recovery was observed in patients with relatively small infarcts and was strongly associated with clinical outcome measures.…”

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confidence: 99%

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Correlation of Asymmetry Indices Measured by Arterial Spin-Labeling MR Imaging and SPECT in Patients with Crossed Cerebellar Diaschisis

Kang

Sohn

Kim

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Crossed cerebellar diaschisis, not only a secondary result of supratentorial infarction but also an indicator of clinical outcomes, has frequently been reported on PET and SPECT but has been rarely described with arterial spin-labeling MR imaging. The purpose of this study was to determine the ability of arterial spin-labeling MR imaging to evaluate crossed cerebellar diaschisis compared with that of SPECT. To our knowledge, this is the first study to validate arterial spin-labeling in crossed cerebellar diaschisis by using SPECT as a reference standard.

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Enhanced regional cerebral metabolic interactions in thalamic circuitry predicts motor recovery in hemiparetic stroke

et al. 1996

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We applied a multiple regression/discriminant analysis to resting metabolic data from patients with first hemiparetic suprathalamic infarctions to determine if metabolic interdependencies, which may separate recovered (N=12) from nonrecovered (N=9) patients, suggest important motor-recovery pathways. Recovered, vs. nonrecovered, patients showed an enhanced ipsilesional thalamic-contralesional cerebellar metabolic interdependency. This pattern correctly classified 91% of recovered and 88% of nonrecovered patients. Metabolic interactions involving bilateral supplementary motor area, ipsilesional thalamus, and contralesional cerebellum distinguished all recovered patients from age/sex-matched controls (N=12). These results suggest that altered functional interactions in thalamic circuitry may reflect plastic reorganization associated with motor recovery from hemiparesis.

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Contralateral cerebellar hypometabolism: a predictor for stroke outcome?

Cited by 68 publications

References 19 publications

Crossed Cerebellar Diaschisis in Acute Human Stroke: A PET Study of Serial Changes and Response to Supratentorial Reperfusion

Crossed Cerebellar Diaschisis in Acute Human Stroke: A PET Study of Serial Changes and Response to Supratentorial Reperfusion

Correlation of Asymmetry Indices Measured by Arterial Spin-Labeling MR Imaging and SPECT in Patients with Crossed Cerebellar Diaschisis

Enhanced regional cerebral metabolic interactions in thalamic circuitry predicts motor recovery in hemiparetic stroke

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