Cerebral blood flow imbalance is associated with motor outcome after pediatric arterial ischemic stroke
Cerebral hemodynamics after arterial ischemic stroke (AIS) in children are largely unknown. This study aims to explore long-term cerebral perfusion balance of vital tissue and its relation to motor outcome after childhood AIS. Patients diagnosed with childhood AIS (≤16 years at diagnosis, time since...
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| creator | Leistner, Rebekka Everts, Regula Federspiel, Andrea Kornfeld, Salome Slavova, Nedelina Steiner, Leonie Wiest, Roland Steinlin, Maja Grunt, Sebastian |
| description | Cerebral hemodynamics after arterial ischemic stroke (AIS) in children are largely unknown. This study aims to explore long-term cerebral perfusion balance of vital tissue and its relation to motor outcome after childhood AIS. Patients diagnosed with childhood AIS (≤16 years at diagnosis, time since stroke ≥2 years) and typically developing peers were examined. Hemiparesis was classified according to the Pediatric Stroke Outcome Measure. Manual ability was assessed using the ABILHAND-Kids questionnaire. Cerebral blood flow was measured by arterial spin labeling and analyzed in the following brain regions: the hemispheres, the territory of the anterior cerebral artery (ACA), the middle cerebral artery (MCA), and in subregions of the MCA territory (MCA anterior, middle, posterior). To assess cerebral perfusion balance, laterality indices were calculated using cerebral blood flow in the ipsi- and contralesional hemisphere. Laterality indices were compared between stroke patients with and without hemiparesis, and peers. Twenty participants diagnosed with AIS were included (12 boys, 8 girls; mean age 14.46±4.96 years; time since stroke 8.08±3.62 years); 9 (45%) were diagnosed with hemiparesis. Additionally, 47 typically developing peers (21 boys, 26 girls; mean age 14.24±5.42 years) were studied. Laterality indices were higher in stroke patients and oriented to the contralesional hemisphere in all brain regions except the ACA territory and MCA posterior subregion. This was significantly different from peers, who showed balanced laterality indices. There was a significant correlation between laterality indices and manual ability, except in the ACA territory. AIS is associated with long-term alterations of cerebral blood flow in vital tissue, even in patients without hemiparesis. The degree of imbalance of cerebral perfusion in children after AIS is associated with manual ability. |
| doi_str_mv | 10.1371/journal.pone.0223584 |
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This study aims to explore long-term cerebral perfusion balance of vital tissue and its relation to motor outcome after childhood AIS. Patients diagnosed with childhood AIS (≤16 years at diagnosis, time since stroke ≥2 years) and typically developing peers were examined. Hemiparesis was classified according to the Pediatric Stroke Outcome Measure. Manual ability was assessed using the ABILHAND-Kids questionnaire. Cerebral blood flow was measured by arterial spin labeling and analyzed in the following brain regions: the hemispheres, the territory of the anterior cerebral artery (ACA), the middle cerebral artery (MCA), and in subregions of the MCA territory (MCA anterior, middle, posterior). To assess cerebral perfusion balance, laterality indices were calculated using cerebral blood flow in the ipsi- and contralesional hemisphere. Laterality indices were compared between stroke patients with and without hemiparesis, and peers. Twenty participants diagnosed with AIS were included (12 boys, 8 girls; mean age 14.46±4.96 years; time since stroke 8.08±3.62 years); 9 (45%) were diagnosed with hemiparesis. Additionally, 47 typically developing peers (21 boys, 26 girls; mean age 14.24±5.42 years) were studied. Laterality indices were higher in stroke patients and oriented to the contralesional hemisphere in all brain regions except the ACA territory and MCA posterior subregion. This was significantly different from peers, who showed balanced laterality indices. There was a significant correlation between laterality indices and manual ability, except in the ACA territory. AIS is associated with long-term alterations of cerebral blood flow in vital tissue, even in patients without hemiparesis. The degree of imbalance of cerebral perfusion in children after AIS is associated with manual ability.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0223584</identifier><identifier>PMID: 31603919</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Age ; Biology and Life Sciences ; Blood ; Blood flow ; Brain ; Brain Ischemia - diagnostic imaging ; Brain Ischemia - physiopathology ; Cerebral Arteries - diagnostic imaging ; Cerebral Arteries - physiopathology ; Cerebral blood flow ; Cerebral circulation ; Cerebral hemispheres ; Cerebrovascular Circulation - physiology ; Child ; Childhood ; Children ; Complications and side effects ; Diagnosis ; Female ; Functional Laterality ; Girls ; Handbooks ; Hemiplegia ; Hemodynamics ; Humans ; Internet ; Ischemia ; Magnetic Resonance Imaging ; Male ; Medical imaging ; Medicine and Health Sciences ; Motor Activity ; Motor skills ; NMR ; Nuclear magnetic resonance ; Paresis ; Paresis - physiopathology ; Pediatrics ; Peer Group ; Perfusion ; Rehabilitation ; Research and Analysis Methods ; Spin labeling ; Stroke ; Stroke - diagnostic imaging ; Stroke - physiopathology ; Stroke patients ; Territory</subject><ispartof>PloS one, 2019-10, Vol.14 (10), p.e0223584-e0223584</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Leistner et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Leistner et al 2019 Leistner et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c585t-5b740c32d32f3fb204a4dcd83df93bf8c3b6e7140322a61cf54619d2a71bba073</citedby><cites>FETCH-LOGICAL-c585t-5b740c32d32f3fb204a4dcd83df93bf8c3b6e7140322a61cf54619d2a71bba073</cites><orcidid>0000-0001-6556-3419</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788710/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788710/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79569,79570</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31603919$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leistner, Rebekka</creatorcontrib><creatorcontrib>Everts, Regula</creatorcontrib><creatorcontrib>Federspiel, Andrea</creatorcontrib><creatorcontrib>Kornfeld, Salome</creatorcontrib><creatorcontrib>Slavova, Nedelina</creatorcontrib><creatorcontrib>Steiner, Leonie</creatorcontrib><creatorcontrib>Wiest, Roland</creatorcontrib><creatorcontrib>Steinlin, Maja</creatorcontrib><creatorcontrib>Grunt, Sebastian</creatorcontrib><title>Cerebral blood flow imbalance is associated with motor outcome after pediatric arterial ischemic stroke</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Cerebral hemodynamics after arterial ischemic stroke (AIS) in children are largely unknown. This study aims to explore long-term cerebral perfusion balance of vital tissue and its relation to motor outcome after childhood AIS. Patients diagnosed with childhood AIS (≤16 years at diagnosis, time since stroke ≥2 years) and typically developing peers were examined. Hemiparesis was classified according to the Pediatric Stroke Outcome Measure. Manual ability was assessed using the ABILHAND-Kids questionnaire. Cerebral blood flow was measured by arterial spin labeling and analyzed in the following brain regions: the hemispheres, the territory of the anterior cerebral artery (ACA), the middle cerebral artery (MCA), and in subregions of the MCA territory (MCA anterior, middle, posterior). To assess cerebral perfusion balance, laterality indices were calculated using cerebral blood flow in the ipsi- and contralesional hemisphere. Laterality indices were compared between stroke patients with and without hemiparesis, and peers. Twenty participants diagnosed with AIS were included (12 boys, 8 girls; mean age 14.46±4.96 years; time since stroke 8.08±3.62 years); 9 (45%) were diagnosed with hemiparesis. Additionally, 47 typically developing peers (21 boys, 26 girls; mean age 14.24±5.42 years) were studied. Laterality indices were higher in stroke patients and oriented to the contralesional hemisphere in all brain regions except the ACA territory and MCA posterior subregion. This was significantly different from peers, who showed balanced laterality indices. There was a significant correlation between laterality indices and manual ability, except in the ACA territory. AIS is associated with long-term alterations of cerebral blood flow in vital tissue, even in patients without hemiparesis. The degree of imbalance of cerebral perfusion in children after AIS is associated with manual ability.</description><subject>Adolescent</subject><subject>Age</subject><subject>Biology and Life Sciences</subject><subject>Blood</subject><subject>Blood flow</subject><subject>Brain</subject><subject>Brain Ischemia - diagnostic imaging</subject><subject>Brain Ischemia - physiopathology</subject><subject>Cerebral Arteries - diagnostic imaging</subject><subject>Cerebral Arteries - physiopathology</subject><subject>Cerebral blood flow</subject><subject>Cerebral circulation</subject><subject>Cerebral hemispheres</subject><subject>Cerebrovascular Circulation - physiology</subject><subject>Child</subject><subject>Childhood</subject><subject>Children</subject><subject>Complications and side effects</subject><subject>Diagnosis</subject><subject>Female</subject><subject>Functional Laterality</subject><subject>Girls</subject><subject>Handbooks</subject><subject>Hemiplegia</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Internet</subject><subject>Ischemia</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medicine and Health Sciences</subject><subject>Motor Activity</subject><subject>Motor skills</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Paresis</subject><subject>Paresis - physiopathology</subject><subject>Pediatrics</subject><subject>Peer Group</subject><subject>Perfusion</subject><subject>Rehabilitation</subject><subject>Research and Analysis Methods</subject><subject>Spin labeling</subject><subject>Stroke</subject><subject>Stroke - diagnostic imaging</subject><subject>Stroke - physiopathology</subject><subject>Stroke patients</subject><subject>Territory</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNptUl2LEzEUHURx19V_IDogiC-t-ZpJ5mVhKX4sLPiizyEfN21qZlKTGRf_vWk7u7TiU5Kbc8-553Cr6jVGS0w5_riNUxpUWO7iAEtECG0Ee1Jd4o6SRUsQfXpyv6he5LxFqKGibZ9XFxS3iHa4u6zWK0igkwq1DjHa2oV4X_teq6AGA7XPtco5Gq9GsPW9Hzd1H8eY6jiNJvZQKzdCqndgCyJ5U6tU3r7Q-Ww20JdKHlP8CS-rZ06FDK_m86r68fnT99XXxd23L7erm7uFaUQzLhrNGTKUWEocdZogppg1VlDrOqqdMFS3wDFDlBDVYuMa1uLOEsWx1gpxelW9PfLuQsxyzihLQhHDiLcHxO0RYaPayl3yvUp_ZFReHgoxrWUx4U0A6bBuAKjDAjPGgQtneQlRN5ZwDh0uXNez2qR7sAaGsUR5Rnr-M_iNXMffsuVCcIwKwYeZIMVfE-RR9iU4CCV9iNNh7gYxwQ5a7_6B_t_djFqrYsAPLhZdsyeVNy0ijAgs9rLvT1AbUGHc5Bim0cchnwPZEWhSzDmBe_SGkdyv4cMQcr-Gcl7D0vbmNJfHpoe9o38BeSPahg</recordid><startdate>20191011</startdate><enddate>20191011</enddate><creator>Leistner, Rebekka</creator><creator>Everts, Regula</creator><creator>Federspiel, Andrea</creator><creator>Kornfeld, Salome</creator><creator>Slavova, Nedelina</creator><creator>Steiner, Leonie</creator><creator>Wiest, Roland</creator><creator>Steinlin, Maja</creator><creator>Grunt, Sebastian</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PIMPY</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQGLB</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-6556-3419</orcidid></search><sort><creationdate>20191011</creationdate><title>Cerebral blood flow imbalance is associated with motor outcome after pediatric arterial ischemic stroke</title><author>Leistner, Rebekka ; Everts, Regula ; Federspiel, Andrea ; Kornfeld, Salome ; Slavova, Nedelina ; Steiner, Leonie ; Wiest, Roland ; Steinlin, Maja ; Grunt, Sebastian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c585t-5b740c32d32f3fb204a4dcd83df93bf8c3b6e7140322a61cf54619d2a71bba073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Age</topic><topic>Biology and Life Sciences</topic><topic>Blood</topic><topic>Blood flow</topic><topic>Brain</topic><topic>Brain Ischemia - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leistner, Rebekka</au><au>Everts, Regula</au><au>Federspiel, Andrea</au><au>Kornfeld, Salome</au><au>Slavova, Nedelina</au><au>Steiner, Leonie</au><au>Wiest, Roland</au><au>Steinlin, Maja</au><au>Grunt, Sebastian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cerebral blood flow imbalance is associated with motor outcome after pediatric arterial ischemic stroke</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-10-11</date><risdate>2019</risdate><volume>14</volume><issue>10</issue><spage>e0223584</spage><epage>e0223584</epage><pages>e0223584-e0223584</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Cerebral hemodynamics after arterial ischemic stroke (AIS) in children are largely unknown. This study aims to explore long-term cerebral perfusion balance of vital tissue and its relation to motor outcome after childhood AIS. Patients diagnosed with childhood AIS (≤16 years at diagnosis, time since stroke ≥2 years) and typically developing peers were examined. Hemiparesis was classified according to the Pediatric Stroke Outcome Measure. Manual ability was assessed using the ABILHAND-Kids questionnaire. Cerebral blood flow was measured by arterial spin labeling and analyzed in the following brain regions: the hemispheres, the territory of the anterior cerebral artery (ACA), the middle cerebral artery (MCA), and in subregions of the MCA territory (MCA anterior, middle, posterior). To assess cerebral perfusion balance, laterality indices were calculated using cerebral blood flow in the ipsi- and contralesional hemisphere. Laterality indices were compared between stroke patients with and without hemiparesis, and peers. Twenty participants diagnosed with AIS were included (12 boys, 8 girls; mean age 14.46±4.96 years; time since stroke 8.08±3.62 years); 9 (45%) were diagnosed with hemiparesis. Additionally, 47 typically developing peers (21 boys, 26 girls; mean age 14.24±5.42 years) were studied. Laterality indices were higher in stroke patients and oriented to the contralesional hemisphere in all brain regions except the ACA territory and MCA posterior subregion. This was significantly different from peers, who showed balanced laterality indices. There was a significant correlation between laterality indices and manual ability, except in the ACA territory. AIS is associated with long-term alterations of cerebral blood flow in vital tissue, even in patients without hemiparesis. The degree of imbalance of cerebral perfusion in children after AIS is associated with manual ability.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31603919</pmid><doi>10.1371/journal.pone.0223584</doi><orcidid>https://orcid.org/0000-0001-6556-3419</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adolescent Age Biology and Life Sciences Blood Blood flow Brain Brain Ischemia - diagnostic imaging Brain Ischemia - physiopathology Cerebral Arteries - diagnostic imaging Cerebral Arteries - physiopathology Cerebral blood flow Cerebral circulation Cerebral hemispheres Cerebrovascular Circulation - physiology Child Childhood Children Complications and side effects Diagnosis Female Functional Laterality Girls Handbooks Hemiplegia Hemodynamics Humans Internet Ischemia Magnetic Resonance Imaging Male Medical imaging Medicine and Health Sciences Motor Activity Motor skills NMR Nuclear magnetic resonance Paresis Paresis - physiopathology Pediatrics Peer Group Perfusion Rehabilitation Research and Analysis Methods Spin labeling Stroke Stroke - diagnostic imaging Stroke - physiopathology Stroke patients Territory |
| title | Cerebral blood flow imbalance is associated with motor outcome after pediatric arterial ischemic stroke |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-21T21%3A50%3A17IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cerebral%20blood%20flow%20imbalance%20is%20associated%20with%20motor%20outcome%20after%20pediatric%20arterial%20ischemic%20stroke&rft.jtitle=PloS%20one&rft.au=Leistner,%20Rebekka&rft.date=2019-10-11&rft.volume=14&rft.issue=10&rft.spage=e0223584&rft.epage=e0223584&rft.pages=e0223584-e0223584&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0223584&rft_dat=%3Cgale_plos_%3EA602428180%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2304107607&rft_id=info:pmid/31603919&rft_galeid=A602428180&rft_doaj_id=oai_doaj_org_article_f1b5ee3f181447e78fd7005b5d277e91&rfr_iscdi=true |