Motor outcome of deep intracerebral haemorrhage in diffusion tensor imaging: comparison of data from different locations along the corticospinal tract

Abstract

Objectives: Although diffusion tensor imaging (DTI) is widely studied to assess the motor outcome after ischaemic stroke, there is paucity of data regarding outcomes of intracerebral haemorrhage (ICH). The aim of this study was to determine the DTI data from different locations along the corticospinal tract (CST) and association to motor outcome. Methods: We prospectively recruited patients with deep ICH admitted to our hospital from November 2010 to July 2012.Diffusion tensor imaging was performed within 14 days after the onset of ICH. Fractional anisotropy (FA) was measured along the CST at corona radiata, perihaematomal oedema, cerebral peduncle and pons. Corticospinal tract integrity was classified into three types by diffusion tensor tractography (DTT): type A with preserved CST, type B with partially interrupted CST and type C with completely interrupted CST. Motor outcome was assessed by Motricity index (MI) at admission, after 1 and 3 months. Results: Forty-eight patients were enrolled with a mean age of 62 years. The median time interval from onset of ICH to DTI study was 7 days. The patients in type C had significantly worse MI at admission (Pv0.001), after 1 month (Pv0.001) and after 3 months (Pv0.001) as compared to those with type A and type B. Lower rFA at the corona radiata was significantly correlated with poorer motor outcome at admission, after 1 month and after 3 months. Discussion: Clinical motor outcome of ICH within 2 weeks can be identified with a statistically significant decrease in rFA at the corona radiata.

Evidence of motor injury due to damaged corticospinal tract following acute hemorrhage in the basal ganglia region

“…In addition, in the current study, the determination of the DTI data from different locations along the corticospinal tract (CST) pathway and association to the motor outcome of flow-up at 6 months reveals that the corona radiata and the posterior limb of the internal capsule might be the primary locations for predicting the long-term motor recovery. This finding is consistent with previous studies 16,20 . But most previous studies have used only several pointed ROIs included corona radiata, perihematomal edema area, cerebral peduncle, and pons, as the ROI for FA measurements to predict motor outcomes.…”

“…Such damage to the whiter matter by acute haemorrhage in the basal ganglia region will change the integrity and spatial direction of axonal membranes and myelin sheath of the fibrous bundle, thereby affecting the water molecular diffusion barrier to increase the free diffusion of water molecules and decrease the diffusion anisotropy of white matter in lesions, ultimately leading to a decrease in the FA value 23 . Studies have also shown that the FA value near the hematoma area is affected by the magnetic susceptibility of hemosiderin deposition or mixed vasogenic and cytotoxic oedema 16,24 . The FA value in the bottom segments (8-20th point) along the CST of the injured side was significantly lower than the uninjured side, such segments close to cerebral peduncle that did not close the lesion position also likely attributed to the significantly lower FA value in our study.…”

White Matter Injury after Intracerebral Hemorrhage: Pathophysiology and Therapeutic Strategies

“…The CST, which consists of the internal capsule, the cerebral peduncle and pyramid tract, is one of the most prominent pathways related to motor functional outcome after ICH (Liang et al, 2013 ; Venkatasubramanian et al, 2013 ; Cheng et al, 2015 ). The application of DTI for detecting CST injury after hemorrhagic stroke has been recently reviewed with a particular focus on the predictive value of DTI in ICH (Chaudhary et al, 2015 ).…”

Structural and Electrophysiological Changes in Sciatic Nerve After Intracerebral Hemorrhage in Rats

“…Інсульт є однією з головних причин інвалідності [1]. Пошкодження мозку позначається на структурі і функції периферичних нервів [2]. Відомо, що нейропатію серединного, литкового або сідничного нерва відмічають з 6-14-го місяця з часу розвитку захворювання [3,4].…”