Structural Alterations in Chronic Capsular versus Pontine Stroke

Abstract

Purpose To investigate whether patients with capsular stroke (CS) and patients with pontine stroke (PS) involving the motor pathway have different types of structural damage and reorganization. Materials and Methods With institutional review board approval and after obtaining written informed consent, structural magnetic resonance imaging data were prospectively acquired in 115 patients with CS, 47 patients with PS, and 116 control subjects by using four imagers from three hospitals. Patients with stroke lesions in the left and right hemispheres were analyzed (timing of follow-up imaging: mean, 597 days; range, 180-2070 days). The gray matter volume (GMV) of each voxel was compared among the three groups while controlling for the effects of age, sex, and imager. Multiple comparisons were corrected by using a false discovery rate method for voxel-wise comparisons and by using the Bonferroni method for post hoc comparisons. Results Both patients with CS and patients with PS exhibited a GMV reduction (6.18%-8.23%) in the ipsilesional anterior insular cortex and a GMV increase (5.11%-11.73%) in the supplementary motor area relative to control subjects (P < .0013). Moreover, a GMV reduction was observed in the ipsilesional sensorimotor cortex in all patients with CS (9.73%-10.41%) and in the cerebellum in all patients with PS (10.58%-15.81%). Additionally, a GMV increase was found in the precuneus in patients with PS with left lesions (17.23%) and in the middle frontal gyrus in patients with CS with right lesions (10.95%). Conclusion The different patterns of structural damage and reorganization in patients with CS versus those with PS may provide useful information in designing individualized rehabilitative strategies for these patients. RSNA, 2017 Online supplemental material is available for this article.

Ischemic Stroke in Pontine and Corona Radiata: Location Specific Impairment of Neural Network Investigated With Resting State fMRI

“…They are the most common sites of IS that involve the subcortical motor pathway. It is well-known that focal IS leads to extensive structural and functional remodeling (10, 11). However, it remains unclear whether pontine stroke (PS) and corona radiata stroke (CRS) differ in the patterns of the functional remodeling.…”

Differential involvement of rubral branches in chronic capsular and pontine stroke

“…However, it remains unknown whether the rubral branches are differentially involved in the stroke, which is important for understanding the roles of each rubral branch in stroke-induced disability and recovery. Early studies have also shown that the lesion locations of stroke were closely associated with the types and severity of dysfunction and recovery potentials (Cheng et al., 2014); moreover, different infarction location can induce differential types of structural damage and reorganization of brain gray matter, even in brain regions outside of the lesion (Jiang et al., 2017). Thus, it also interesting to elucidate whether the patterns of damage/reorganization of the rubral branches are also lesion-location dependent.…”

Homotopic Connectivity in Early Pontine Infarction Predicts Late Motor Recovery

“…Unlike other subcortical lesions normally reported in previous studies (mostly located in the internal capsule and neighboring regions), the pontine region is a subtentorial structure remote from the cerebral cortex. A recent study has demonstrated different patterns of whole-brain structural damage in patients with pontine stroke and capsular stroke ( 19 ). Therefore, we suppose patients with pontine infarction would present different patterns of functional impairment compared with other infarcts.…”