Correlation Analysis of Quantitative Diffusion Parameters in Ipsilateral Cerebral Peduncle during Wallerian Degeneration with Motor Function Outcome after Cerebral Ischemic Stroke

Liu, Xiang; Tian, Wei; Qiu, Xing; Li, Juntao; Thomson, Scott C.; Li, Li-Lin

doi:10.1111/j.1552-6569.2011.00617.x

Cited by 18 publications

(11 citation statements)

References 22 publications

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“…Our results complement those of Nelles et al, who demonstrated significant correlation between fiber disruption on spatial CST analysis and motor scores in patients with acute anterior choroidal artery infarcts 27. In contrast, Liu et al reported that FA ratio and ipsilateral FA values at 2 weeks after stroke correlated with motor outcome, while there was no correlation in the first 2 weeks28; interestingly, they found elevated FA values in the first hours after stroke, possibly secondary to myelin fiber swelling, followed by a phase of significant FA reduction possibly due to loss of structural integrity of fiber tracts 15. The evolving major changes of brain architecture during the first days after stroke likely result in FA and FN values which may not be a true reflection of the structural integrity of the CST.…”

Section: Discussionsupporting

confidence: 89%

Degree of corticospinal tract damage correlates with motor function after stroke

Maraka

Jiang

Jafari-Khouzani

et al. 2014

Ann Clin Transl Neurol

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ObjectivesDirect injury to the corticospinal tract (CST) is a major factor defining motor impairment after stroke. Diffusion tensor imaging (DTI) tractography allows definition of the CST. We sought to determine whether DTI-based assessment of the degree of CST damage correlates with motor impairment at each phase of ischemic stroke.MethodsWe evaluated patients at the acute (3–7 days), subacute (30 days), and chronic (90 days) phases of ischemic stroke with DTI and clinical motor scores (upper extremity Fugl-Myer test [UE-FM], motor items of the National Institutes of Health Stroke Scale [mNIHSS]). The CST was identified and virtual fiber numbers (FN) were calculated for the affected and contralateral CST. We used Spearman correlation to study the relationship of FN ratio (FNr) (affected/unaffected CST) with motor scores at each time point, and the regression model to study the association of the acute parameters with chronic motor scores.ResultsWe studied 23 patients. Mean age was 66.7 (±12) years. FNr correlated with UE-FM score in the acute (r = 0.50, P = 0.032), subacute (r = 0.57, P = 0.007), and chronic (r = 0.67, P = 0.0008) phase, and with mNIHSS in the acute (r = −0.48, P = 0.043), subacute (r = −0.58, P = 0.006), and chronic (r = −0.75, P = 0.0001) phase. The combination of acute NIHSS and FNr significantly predicted chronic UE-FM score (r = 0.74, P = 0.0001).InterpretationDTI-defined degree of CST injury correlates with motor impairment at each phase of ischemic stroke. The combination of baseline FNr and NIHSS predicts motor outcome. DTI-derived CST assessment could become a surrogate marker of motor impairment in the design of neurorestorative clinical trials.

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Section: Discussionsupporting

confidence: 89%

Degree of corticospinal tract damage correlates with motor function after stroke

Maraka

Jiang

Jafari-Khouzani

et al. 2014

Ann Clin Transl Neurol

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“…Perfusion MRI utilizing exogenous contrast agents has had mixed results to date, is contraindicated in some patients, and in cases of ischemia remains largely qualitative in nature owing to difficulties in accurately quantifying regional arterial input functions [5]. Alternatively, noninvasive MRI methods for characterizing CCD would have few patient restrictions and thus are of particular interest for more readily evaluating novel stroke rehabilitation techniques [6] and functional outcomes [7; 8]. …”

Section: Introductionmentioning

confidence: 99%

Crossed cerebellar diaschisis after stroke identified noninvasively with cerebral blood flow-weighted arterial spin labeling MRI

Strother

Buckingham

Faraco

et al. 2016

European Journal of Radiology

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Background and Purpose Crossed cerebellar diaschisis (CCD) is most commonly investigated using hemodynamic PET and SPECT imaging. However, noninvasive MRI offers advantages of improved spatial resolution, allowing hemodynamic changes to be compared directly with structural findings and without concerns related to ionizing radiation exposure. The aim of this study was to evaluate relationships between CCD identified from cerebral blood flow (CBF)-weighted arterial spin labeling (ASL) MRI with cerebrovascular reactivity (CVR)-weighted blood oxygenation level dependent (BOLD) MRI, Wallerian degeneration, clinical motor impairment, and corticospinal tract involvement. Methods Subjects (n=74) enrolled in an ongoing observational stroke trial underwent CBF-weighted ASL and hypercapnic CVR-weighted BOLD MRI. Hemispheric asymmetry indices for basal cerebellar CBF, cerebellar CVR, and cerebral peduncular area were compared between subjects with unilateral supratentorial infarcts (n=18) and control subjects without infarcts (n=16). CCD required (1) supratentorial infarct and (2) asymmetric cerebellar CBF (>95% confidence interval relative to controls). Results In CCD subjects (n=9), CVR (p=0.04) and cerebral peduncular area (p < 0.01) were significantly asymmetric compared to controls. Compared to infarct subjects not meeting CCD criteria (n=9), CCD subjects had no difference in corticospinal tract location for infarct (p=1.0) or motor impairment (p=0.08). Conclusions CCD correlated with cerebellar CVR asymmetry and Wallerian degeneration. These findings suggest that noninvasive MRI may be a useful alternative to PET or SPECT to study structural correlates and clinical consequences of CCD following supratentorial stroke.

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“…Our sample was smaller than eight of the studies we are aware of that have demonstrated an association between CST-FA and motor function Cho, Kim, Choi, et al, 2007;Jang et al, 2010;Kim et al, 2015;Kwon et al, 2012;Liu et al, 2012;Puig et al, 2013;Puig et al, 2011), and slightly larger than seven others (Grassel et al, 2010;Koyama et al, 2012;Kusano et al, 2009;Kuzu et al, 2012;Liang et al, 2007;Lindenberg et al, 2012;Ma, Liu, Li, Zhou, & Zhou, 2014). We also included participants with either ischemic or hemorrhagic stroke.…”

Section: Discussionmentioning

confidence: 99%

“…In terms of the latter, various methods have been used to explore the relationship between FA metrics of the CST and motor impairment [FA of the ipsilesional region (Liang et al, ; Lindenberg et al, ; Puig et al, ), FA ratio of ipsilesional to contralesional region (Koyama et al, ; Puig et al, ), and FA asymmetry (Lindenberg et al, ; Stinear et al, )]. Finally, some studies restricted inclusion criteria, and only included subjects with severe motor deficits (Cho, Kim, Kim, et al, ; Jang et al, ; Kwon et al, ; Liu et al, ; Song et al, ). Our selection criteria led to a more heterogenous group, representative of a typical inpatient rehabilitation sample at our center.…”

Section: Discussionmentioning

confidence: 99%

Proprioception and motor performance after stroke: An examination of diffusion properties in sensory and motor pathways

Findlater

Mazerolle

Pike

et al. 2019

Human Brain Mapping

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Proprioceptive and motor impairments commonly occur after stroke. Relationships between corticospinal tract (CST) fractional anisotropy (FA) and motor recovery have been identified. However, the relationship between sensory tract microstructure and proprioceptive recovery remains unexplored. Using probabilistic tractography, we examined the relationship between diffusion metrics in three tracts known to contain proprioceptive information (a) dorsal‐column medial‐lemniscal (DCML), (b) postcentral gyrus to supramarginal gyrus (POCG‐SMG), (c) postcentral gyrus to Heschl's gyrus (POCG‐HG) and proprioception at 1 (n = 26) and 6 months (n = 19) poststroke. Proprioception was assessed using two robotic tasks. Motor performance was also assessed robotically and compared to CST diffusion metrics. At 1‐month poststroke, a nonsignificant relationship (r = −0.43, p = 0.05) was observed between DCML‐FA and proprioceptive impairment. A moderate relationship was identified between POCG‐SMG FA and POCG‐HG FA and proprioceptive impairment (r = −0.47, p = 0.001 and r = −0.51, p = 0.008, respectively). No relationships were significant at 6 months poststroke. Similar to previous studies, lower CST‐FA correlated with motor impairment at 1 month poststroke (r = −0.58, p = 0.002). While CST‐FA is considered a predictor of motor impairment, our findings suggest that the relationship between FA and tracts containing proprioceptive information is not as straightforward and highlights the importance of sensory association areas in proprioception.

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Correlation Analysis of Quantitative Diffusion Parameters in Ipsilateral Cerebral Peduncle during Wallerian Degeneration with Motor Function Outcome after Cerebral Ischemic Stroke

Abstract: The rFA and ipsilateral FA values after 2 weeks of stroke onset correlate with the motor function outcome.

Cited by 18 publications

References 22 publications

Degree of corticospinal tract damage correlates with motor function after stroke

Degree of corticospinal tract damage correlates with motor function after stroke

Crossed cerebellar diaschisis after stroke identified noninvasively with cerebral blood flow-weighted arterial spin labeling MRI

Proprioception and motor performance after stroke: An examination of diffusion properties in sensory and motor pathways

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