Proliferation of Bilateral Nerve Fibers Following Thalamic Infarction Contributes to Neurological Function Recovery: A Diffusion Tensor Imaging (DTI) Study

Abstract

BackgroundThe aim of this study was to investigate the reorganization in ipsilesional and contralesional thalamic radiation fibers after unilateral focal thalamic stroke in sensory disturbance patients.Material/MethodsWe recruited 12 patients with acute unilateral thalamic infarction and sensory disturbance and 12 healthy age- and sex-matched controls. All patients underwent diffusion tensor imaging (DTI) and were assessed with National Institutes of Health stroke scale (NIHSS), Barthel index (BI), and paragraph 8 of NIHSS (NIHSS8) at 1 week (W1), 4 weeks (W4), 3 months (M3), and 6 months (M6) after thalamic infraction. The relationship between FA changes and the clinical scores changes were then examined.ResultsNIHSS and NIHSS8 scores decreased while BI scores increased gradually from W1 to M6 in patients, but not in controls. FA values of the patients gradually increased in ipsilesional and contralesional thalamic radiation fibers from W1 to M6. In addition, the FA values in patients were significantly higher at M3 and M6 compared to W1. No significant changes were observed in the controls. Regarding the relationship between FA changes and the clinical scores changes, the FA increases were negatively correlated with NIHSS and NIHSS8 decrease while FA increases were positively correlated with BI increases.ConclusionsOur results indicate that reorganization occurred after unilateral focal thalamic infarct not only in ipsilesional, but also in contralesional thalamic radiation fibers in patients with sensory disturbance. In addition, the results suggested that the reorganization can support and promote stroke restoration.

Diffusion Tensor Imaging as a Prognostic Tool for Recovery in Acute and Hyperacute Stroke

“…One study does did provide information regarding field strength [ 30 ]. With regards to the number of directions, three studies used 6 directions (two in 1.5 T [ 34 , 35 ] and one in 3.0 T [ 36 ]), eight studies used 12 directions (four in 1.5 T [ 37 , 38 , 39 ] and four in 3.0 T [ 40 , 41 , 42 , 43 ]), three studies used 15 directions (two in 1.5 T [ 44 , 45 ] and one in 3.0 T [ 23 ]), three studies used 16 directions (one in 1.5 T [ 46 ] and two in 3.0 T [ 24 , 47 ]), one study in 1.5 T used 20 directions [ 31 ], one study in 3.0 T used 25 directions [ 48 ], eight studies used 30 directions (two in 1.5 T [ 49 , 50 ] and six in 3.0 T [ 18 , 29 , 33 , 51 , 52 , 53 ]), three studies in 1.5 T used 32 directions [ 54 , 55 , 56 ], one study in 3.0 T used 55 directions [ 57 ], and seven studies in 3.0 T used 64 directions [ 25 , 26 , 27 , 32 , 58 , 59 , 60 ]). Six studies did not provide information regarding diffusion directions.…”

Clinical Factors Affecting the Recovery of Sensory Impairment After Cerebral Infarction

“…Clinical data during hospitalization was collected from the Stroke Registry. Hospitalization records include [12][13][14][15][16][17] demographic information, length of stay, past history (hypertension, type 2 diabetes, impaired glucose tolerance, dyslipidemia, hyperhomocysteinemia, hyperfibrinogenemia, cerebrovascular stenosis, and coronary heart disease), smoking history, drinking history and family stroke history, the responsible infarction sites of sensory impairment, and NIHSS scores at admission and discharge. In addition, all patients received brain CT and/or MRI.…”