Poststroke Cerebral Peduncular Atrophy Correlates with a Measure of Corticospinal Tract Injury in the Cerebral Hemisphere

Abstract

BACKGROUND AND PURPOSE:Methods have not been well developed and tested to predict the extent of remote degeneration in the central nervous system that follows cerebral infarction. We hypothesized that the extent of infarction overlap with the cerebral hemispheric course of the corticospinal tract (CST) on structural MR imaging predicts the extent of ipsilateral cerebral peduncular atrophy in patients with chronic stroke.

Mesencephalic Corticospinal Atrophy Predicts Baseline Deficit but Not Response to Unilateral or Bilateral Arm Training in Chronic Stroke

“…Within this compound brain area (Figure 2A) Warabi et al [14] reported an association between lesion size and location and mesencephalic atrophy in 89 chronic stroke survivors. Mark et al [10], however, did not find infarct size to predict atrophy in their sample of 34 chronic stroke survivors but reported that CST atrophy was related to the degree of overlap CST damage (CST-lesion overlap) as we observed in our sample. Consistent with this observation is the VLSM analysis that identified lesions in the internal capsule, i.e., subcortical lesions strategically affecting the CST, to be specifically prone to produce CST atrophy.…”

“…A recent study showed that the degree of mesencephalic pyramidal tract atrophy is a function of the extent of CST injury in the lesioned hemisphere [10]. Similarly, Warabi et al [14] had observed a positive relationship between descending motor tract injury and the mesencephalic CST atrophy in chronic stroke.…”

“…Atrophy and morphological changes of the cerebral peduncles caused by Wallerian and transsynaptic degeneration of pyramidal tract fibres are often observed in chronic stroke survivors [8][9][10][11][12]. Wallerian degeneration (WD) is characterized by progressive degeneration of the distal portion of the injured axon and consecutively by degeneration of the myelin sheath and removal of myelin debris.…”

Rate of ventricular enlargement in multiple sclerosis: a nine-year magnetic resonance imaging follow-up study

“…It is a well-known pathology associated with many neurological diseases, such as dementia (15), Alzheimer's disease (16), stroke (17), Huntington's disease (18), schizophrenia (19), etc. Moreover, brain volume shrinkage, affecting the whole brain or only a limited part of the brain, is a part of normal aging and is analyzed in a number of publications (20Á22).…”

Quantitative microstructural deficits in chronic phase of stroke with small volume infarcts: A diffusion tensor 3-D tractographic analysis

“…It is particularly essential to understand if these patients are also prone to progressive neuroaxonal degeneration in chronic phase of stroke. However, it is known that wallerian degeneration is proportionate to extent of primary infarct [6]. Therefore, the small volume of infarcted tissue, poses a particular challenge, such that the abnormalities in non-infarct zone may potentially be sub-threshold on conventional imaging techniques such as FLAIR and T2w images.…”