Disrupted Regional Cerebral Blood Flow and Functional Connectivity in Pontine Infarction: A Longitudinal MRI Study

Wei, Ying; Wu, Luobing; Wang, Yingying; Liu, Jingchun; Miao, Peifang; Wang, Kaiyu; Wang, Caihong; Cheng, Jingliang

doi:10.3389/fnagi.2020.577899

Cited by 11 publications

(14 citation statements)

References 55 publications

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“…Compared with within the 7th day after stroke onset, the change in FC between the cl_VA and ip_postcentral increased significantly at 1, 3, and 6 months after stroke onset in patients with thalamic infarction. A previous study investigated a similar trend of FC changes, which decreased at the acute stage of stroke and then gradually increased thereafter [29]. More severe symptoms were associated with decreased functional connectivity, and recovery of behavioral function was associated with increased functional connectivity [30,31].…”

Section: Discussionmentioning

confidence: 78%

“…In our study, there were no significant differences in FC changes between ROIs and the sensorimotor cortex in patients with PI. Wei et al [29] explored longitudinal FC alterations during the follow-up period in patients with the left pontine infarction (LPI) and right pontine infarction (RPI) groups, using brain regions with altered cerebral blood flow (CBF) in longitudinal analysis as seed-ROIs. In the RPI group, there were no brain regions with significant longitudinal differences among the four time points.…”

Section: Discussionmentioning

confidence: 99%

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Longitudinal Changes of Sensorimotor Resting-State Functional Connectivity Differentiate between Patients with Thalamic Infarction and Pontine Infarction

et al. 2021

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Purpose. We investigated the disparate influence of lesion location on functional damage and reorganization of the sensorimotor brain network in patients with thalamic infarction and pontine infarction. Methods. Fourteen patients with unilateral infarction of the thalamus and 14 patients with unilateral infarction of the pons underwent longitudinal fMRI measurements and motor functional assessment five times during a 6-month period (<7 days, at 2 weeks, 1 month, 3 months, and 6 months after stroke onset). Twenty-five age- and sex-matched controls underwent MRI examination across five consecutive time points in 6 months. Functional images from patients with left hemisphere lesions were first flipped from the left to the right side. The voxel-wise connectivity analyses between the reference time course of each ROI (the contralateral dorsal lateral putamen (dl-putamen), pons, ventral anterior (VA), and ventral lateral (VL) nuclei of the thalamus) and the time course of each voxel in the sensorimotor area were performed for all five measurements. One-way ANOVA was used to identify between-group differences in functional connectivity (FC) at baseline stage (<7 days after stroke onset), with infarction volume included as a nuisance variable. The family-wise error (FWE) method was used to account for multiple comparison issues using SPM software. Post hoc repeated-measure ANOVA was applied to examine longitudinal FC reorganization. Results. At baseline stage, significant differences were detected between the contralateral VA and ipsilateral postcentral gyrus (cl_VA-ip_postcentral), contralateral VL and ipsilateral precentral gyrus (cl_VL-ip_precentral). Repeated measures ANOVA revealed that the FC change of cl_VA-ip_postcentral differ significantly among the three groups over time. The significant changes of FC between cl_VA and ip_postcentral at different time points in the thalamic infarction group showed that compared with 7 days after stroke onset, there was significantly increased FC of cl_VA-ip_postcentral at 1 month, 3 months, and 6 months after stroke onset. Conclusions. The different patterns of sensorimotor functional damage and reorganization in patients with pontine infarction and thalamic infarction may provide insights into the neural mechanisms underlying functional recovery after stroke.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Longitudinal Changes of Sensorimotor Resting-State Functional Connectivity Differentiate between Patients with Thalamic Infarction and Pontine Infarction

et al. 2021

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“…The MK and MD values are dependent on the complexity of the tissue microstructure in the ROI and are the most representative parameters of DKI, which can show the degree of limited diffusion of water molecules and the complexity of tissue microstructure. The more complex the structure, the more evident the limited diffusion of water molecules and the larger the MK and MD values[ 17 - 20 ]; whereas there was a significant increase in CBF value on T2WI of the cerebral infarction area, which was closely correlated with MK, MD, and T2WI.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional arterial spin labeling and diffusion kurtosis imaging in evaluating perfusion and infarct area size in acute cerebral ischemia

Jiang¹,

Zhong²,

Zuo³

2022

WJCC

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BACKGROUND Early thrombolytic therapy is crucial to treat acute cerebral infarction, especially since the onset of thrombolytic therapy takes 1-6 h. Therefore, early diagnosis and evaluation of cerebral infarction is important. AIM To investigate the diagnostic value of magnetic resonance multi-delay three-dimensional arterial spin labeling (3DASL) and diffusion kurtosis imaging (DKI) in evaluating the perfusion and infarct area size in patients with acute cerebral ischemia. METHODS Eighty-four patients who experienced acute cerebral ischemia from March 2019 to February 2021 were included. All patients in the acute stage underwent magnetic resonance-based examination, and the data were processed by the system’s own software. The apparent diffusion coefficient (ADC), average diffusion coefficient (MD), axial diffusion (AD), radial diffusion (RD), average kurtosis (MK), radial kurtosis (fairly RK), axial kurtosis (AK), and perfusion parameters post-labeling delays (PLD) in the focal area and its corresponding area were compared. The correlation between the lesion area of cerebral infarction under MK and MD and T2-weighted imaging (T2WI) was analyzed. RESULTS The DKI parameters of focal and control areas in the study subjects were compared. The ADC, MD, AD, and RD values in the lesion area were significantly lower than those in the control area. The MK, RK, and AK values in the lesion area were significantly higher than those in the control area. The MK/MD value in the infarct lesions was used to determine the matching situation. MK/MD < 5 mm was considered matching and MK/MD ≥ 5 mm was considered mismatching. PLD1.5s and PLD2.5s perfusion parameters in the central, peripheral, and control areas of the infarct lesions in MK/MD-matched and -unmatched patients were not significantly different. PLD1.5s and PLD2.5s perfusion parameter values in the central area of the infarct lesions in MK/MD-matched and -unmatched patients were significantly lower than those in peripheral and control areas. The MK and MD maps showed a lesion area of 20.08 ± 5.74 cm 2 and 22.09 ± 5.58 cm 2 , respectively. T2WI showed a lesion area of 19.76 ± 5.02 cm 2 . There were no significant differences in the cerebral infarction lesion areas measured using the three methods. MK, MD, and T2WI showed a good correlation. CONCLUSION DKI parameters showed significant difference between the focal and control areas in patients with acute ischemic cerebral infarction. 3DASL can effectively determine the changes in perfusion levels in the lesion area. There was a high correlation between the area of the infarct lesions diagnosed by DKI and T2WI.

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“…Establishing the time of onset of stroke symptoms heavily determines the treatment strategy (thrombolytics vs. thrombectomy). The clinical presentation of a pontine infarct depends on the anatomical/arterial territories involved and are clinically classified as below (Wei, Y. 2020).…”

Section: Figure 3: Anatomy Of Foville Syndrome At the Level Of The Inferomedial Ponsmentioning

confidence: 99%

Foville Syndrome Due to Pontine Hemorrhage and Pontine Infarct: Case Series

Imran

Syahrul

Fajri

2021

bioex

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Foville Syndrome is a rare clinical feature of stroke or brain hemorrhage. Few cases have been reported worldwide particularly in Asian, Indonesia, Aceh. Patient 1: We report the case of a female 64 years old patient, was admitted in the Neurology Department of Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia, for an abrupt onset of right body side weakness two day before admission. That weakness was preceded by acute headaches and rotatory vertigo with vomiting. with hypertension history since 5 years. Physical examination found paralysis of right oculomotor movements with intact response of pupils to light, right trochlear nerve palsy, left ipsilateral facial nerve palsy, and right hemiparesis which constitute of Foville syndrome. The brain CT scan shown in the right pontine hypodensity area is pontine infarct. Etiological investigations done to chronic hypertension. Patient received antiplatelet therapy and control of vascular risk factors for secondary prevention (hypertension theraphy), and physiotherapy as treatment with clinical improvement. And she has been discharge 8 days later. Patient 2: 45-year-old right-handed female, was admitted in the Neurology Department of Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia, for an abrupt onset of right body side weakness two day before admission. That weakness was preceded by acute headaches and rotatory vertigo with vomiting. with hypertension history since 5 years. Physical examination found paralysis of right oculomotor movements with intact response of pupils to light, right trochlear nerve palsy, left ipsilateral facial nerve palsy, and right hemiparesis which constitute of Foville syndrome. The brain CT scan shown spontaneous hemorrhage in the left pontine’s. Etiological investigations done to chronic hypertension. Patient received therapy control of vascular risk factors for secondary prevention (hypertension theraphy), and physiotherapy as treatment with clinical improvement. And she has been discharge 10 days later. The diagnosis and management of brainstem stroke bring a considerable burden to the healthcare system, the patient, the family members, and the society at large. The slow increase in the global burden of stroke has been steadily increasing.

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Disrupted Regional Cerebral Blood Flow and Functional Connectivity in Pontine Infarction: A Longitudinal MRI Study

Cited by 11 publications

References 55 publications

Longitudinal Changes of Sensorimotor Resting-State Functional Connectivity Differentiate between Patients with Thalamic Infarction and Pontine Infarction

Longitudinal Changes of Sensorimotor Resting-State Functional Connectivity Differentiate between Patients with Thalamic Infarction and Pontine Infarction

Three-dimensional arterial spin labeling and diffusion kurtosis imaging in evaluating perfusion and infarct area size in acute cerebral ischemia

Foville Syndrome Due to Pontine Hemorrhage and Pontine Infarct: Case Series

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