Changes in the Corticospinal Tract Beyond the Ischemic Lesion Following Acute Hemispheric Stroke: A Diffusion Kurtosis Imaging Study
Background The degeneration of the corticospinal tract (CST) in chronic stroke has been widely described using diffusion tensor imaging and correlates with the extent of motor deficits. However, only a few studies have reported the early degeneration in the distal CST during the acute stage of strok...
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| Veröffentlicht in: | Journal of magnetic resonance imaging 2020-08, Vol.52 (2), p.512-519 |
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| creator | Yu, Xinfeng Jiaerken, Yeerfan Wang, Shuyue Hong, Hui Jackson, Alan Yuan, Lixia Lou, Min Jiang, Quan Zhang, Minming Huang, Peiyu |
| description | Background
The degeneration of the corticospinal tract (CST) in chronic stroke has been widely described using diffusion tensor imaging and correlates with the extent of motor deficits. However, only a few studies have reported the early degeneration in the distal CST during the acute stage of stroke and pathological changes in the distal CST have not been described.
Purpose
To study the microstructural changes along the CST beyond the ischemic lesion in acute stroke using diffusion kurtosis imaging (DKI).
Study Type
Prospective.
Population
In all, 48 patients (26 males, 22 females; mean age 58.27 ± 12.89 years) with acute ischemic stroke.
Sequence
A DKI sequence with three b‐values (0, 1000, and 2000 s/mm2) at 3.0T MRI.
Assessment
The kurtosis and tensor parameters were derived from DKI and were compared along the length of the CST beyond the ischemic lesion between the affected and unaffected hemispheres using both voxelwise and slicewise analysis. The degree of neurological deficits was evaluated using the National Institute of Health Stroke Score (NIHSS) and the Barthel index and the clinical outcome at 3 months was evaluated using a modified Rankin scale.
Statistical Tests
Paired t‐tests, a linear mixed model, and multivariate linear regression.
Results
Voxelwise analysis demonstrated increased mean kurtosis, increased axial kurtosis, and decreased axial diffusivity in the affected CST, which were seen only at the level of the cerebral peduncle (all corrected P |
| doi_str_mv | 10.1002/jmri.27066 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2345508055</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2424635916</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3576-7251393f58f125999f635cb60fd0ccf34f1a17f7267bbbb6bae435c2de669d813</originalsourceid><addsrcrecordid>eNp90U1v2yAcBnA0rVpftss-wIS0S1XJLS8Gm93S9C1dpklrd7YI_pOQ2iYFW1Xu_eAlSdvDDuMCEj8eEA9CXyk5pYSws2Ub3CkriJQf0AEVjGVMlPJjWhPBM1qSYh8dxrgkhCiVi09on1NV0pyQA_Q8XuhuDhG7DvcLwGMfemd8XLlON_g-aNPjc1j7rt5uT6JZQOsMnkJ0vsNXvmn8k-vmeGSGHvBN2oyrBYRE7vrgH-AHHuELZ-2w9T-H0PvoIp60er45dtcP9foz2rO6ifDldT5Cf68u78c32fT39WQ8mmaGi0JmBROUK25FaSkTSikruTAzSWxNjLE8t1TTwhZMFrM05ExDngCrQUpVl5QfoeNd7ir4xwFiX6XXGmga3YEfYsV4LgQpiRCJfv-HLv0Q0p8klbM8XayoTOpkp0zwMQaw1Sq4Vod1RUm16abadFNtu0n422vkMGuhfqdvZSRAd-DJNbD-T1R1--vPZBf6AkzYmd8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2424635916</pqid></control><display><type>article</type><title>Changes in the Corticospinal Tract Beyond the Ischemic Lesion Following Acute Hemispheric Stroke: A Diffusion Kurtosis Imaging Study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Yu, Xinfeng ; Jiaerken, Yeerfan ; Wang, Shuyue ; Hong, Hui ; Jackson, Alan ; Yuan, Lixia ; Lou, Min ; Jiang, Quan ; Zhang, Minming ; Huang, Peiyu</creator><creatorcontrib>Yu, Xinfeng ; Jiaerken, Yeerfan ; Wang, Shuyue ; Hong, Hui ; Jackson, Alan ; Yuan, Lixia ; Lou, Min ; Jiang, Quan ; Zhang, Minming ; Huang, Peiyu</creatorcontrib><description>Background
The degeneration of the corticospinal tract (CST) in chronic stroke has been widely described using diffusion tensor imaging and correlates with the extent of motor deficits. However, only a few studies have reported the early degeneration in the distal CST during the acute stage of stroke and pathological changes in the distal CST have not been described.
Purpose
To study the microstructural changes along the CST beyond the ischemic lesion in acute stroke using diffusion kurtosis imaging (DKI).
Study Type
Prospective.
Population
In all, 48 patients (26 males, 22 females; mean age 58.27 ± 12.89 years) with acute ischemic stroke.
Sequence
A DKI sequence with three b‐values (0, 1000, and 2000 s/mm2) at 3.0T MRI.
Assessment
The kurtosis and tensor parameters were derived from DKI and were compared along the length of the CST beyond the ischemic lesion between the affected and unaffected hemispheres using both voxelwise and slicewise analysis. The degree of neurological deficits was evaluated using the National Institute of Health Stroke Score (NIHSS) and the Barthel index and the clinical outcome at 3 months was evaluated using a modified Rankin scale.
Statistical Tests
Paired t‐tests, a linear mixed model, and multivariate linear regression.
Results
Voxelwise analysis demonstrated increased mean kurtosis, increased axial kurtosis, and decreased axial diffusivity in the affected CST, which were seen only at the level of the cerebral peduncle (all corrected P < 0.05). Slicewise analysis also demonstrated increased axial kurtosis in the cerebral peduncle of the affected CST (corrected P < 0.05). The axial kurtosis from slicewise analysis independently correlated with the motor component of NIHSS (β = 0.297, P = 0.040).
Data Conclusion
Our findings suggest that early anterograde degeneration occurs along the axon direction in the distal CST in acute stroke, and can be detected using DKI. Moreover, acute axonal degeneration along the CST correlated with motor deficits.
Level of Evidence
2
Technical Efficacy Stage
1 J. Magn. Reson. Imaging 2020;52:512–519.</description><identifier>ISSN: 1053-1807</identifier><identifier>EISSN: 1522-2586</identifier><identifier>DOI: 10.1002/jmri.27066</identifier><identifier>PMID: 31981400</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Aged ; Brain Ischemia - complications ; Brain Ischemia - diagnostic imaging ; Brain slice preparation ; Correlation analysis ; Degeneration ; Diffusion ; Diffusion Magnetic Resonance Imaging ; Diffusion Tensor Imaging ; Evaluation ; Female ; Hemispheres ; Humans ; Ischemia ; Kurtosis ; Lesions ; Magnetic resonance imaging ; Male ; Medical imaging ; Middle Aged ; Neurodegeneration ; Neurological diseases ; Population studies ; Prospective Studies ; Pyramidal tracts ; Pyramidal Tracts - diagnostic imaging ; Regression analysis ; Regression models ; Statistical analysis ; Statistical tests ; Stroke ; Stroke - diagnostic imaging ; Tensors ; white matter</subject><ispartof>Journal of magnetic resonance imaging, 2020-08, Vol.52 (2), p.512-519</ispartof><rights>2020 International Society for Magnetic Resonance in Medicine</rights><rights>2020 International Society for Magnetic Resonance in Medicine.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3576-7251393f58f125999f635cb60fd0ccf34f1a17f7267bbbb6bae435c2de669d813</citedby><cites>FETCH-LOGICAL-c3576-7251393f58f125999f635cb60fd0ccf34f1a17f7267bbbb6bae435c2de669d813</cites><orcidid>0000-0003-4226-9369</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjmri.27066$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjmri.27066$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31981400$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yu, Xinfeng</creatorcontrib><creatorcontrib>Jiaerken, Yeerfan</creatorcontrib><creatorcontrib>Wang, Shuyue</creatorcontrib><creatorcontrib>Hong, Hui</creatorcontrib><creatorcontrib>Jackson, Alan</creatorcontrib><creatorcontrib>Yuan, Lixia</creatorcontrib><creatorcontrib>Lou, Min</creatorcontrib><creatorcontrib>Jiang, Quan</creatorcontrib><creatorcontrib>Zhang, Minming</creatorcontrib><creatorcontrib>Huang, Peiyu</creatorcontrib><title>Changes in the Corticospinal Tract Beyond the Ischemic Lesion Following Acute Hemispheric Stroke: A Diffusion Kurtosis Imaging Study</title><title>Journal of magnetic resonance imaging</title><addtitle>J Magn Reson Imaging</addtitle><description>Background
The degeneration of the corticospinal tract (CST) in chronic stroke has been widely described using diffusion tensor imaging and correlates with the extent of motor deficits. However, only a few studies have reported the early degeneration in the distal CST during the acute stage of stroke and pathological changes in the distal CST have not been described.
Purpose
To study the microstructural changes along the CST beyond the ischemic lesion in acute stroke using diffusion kurtosis imaging (DKI).
Study Type
Prospective.
Population
In all, 48 patients (26 males, 22 females; mean age 58.27 ± 12.89 years) with acute ischemic stroke.
Sequence
A DKI sequence with three b‐values (0, 1000, and 2000 s/mm2) at 3.0T MRI.
Assessment
The kurtosis and tensor parameters were derived from DKI and were compared along the length of the CST beyond the ischemic lesion between the affected and unaffected hemispheres using both voxelwise and slicewise analysis. The degree of neurological deficits was evaluated using the National Institute of Health Stroke Score (NIHSS) and the Barthel index and the clinical outcome at 3 months was evaluated using a modified Rankin scale.
Statistical Tests
Paired t‐tests, a linear mixed model, and multivariate linear regression.
Results
Voxelwise analysis demonstrated increased mean kurtosis, increased axial kurtosis, and decreased axial diffusivity in the affected CST, which were seen only at the level of the cerebral peduncle (all corrected P < 0.05). Slicewise analysis also demonstrated increased axial kurtosis in the cerebral peduncle of the affected CST (corrected P < 0.05). The axial kurtosis from slicewise analysis independently correlated with the motor component of NIHSS (β = 0.297, P = 0.040).
Data Conclusion
Our findings suggest that early anterograde degeneration occurs along the axon direction in the distal CST in acute stroke, and can be detected using DKI. Moreover, acute axonal degeneration along the CST correlated with motor deficits.
Level of Evidence
2
Technical Efficacy Stage
1 J. Magn. Reson. Imaging 2020;52:512–519.</description><subject>Aged</subject><subject>Brain Ischemia - complications</subject><subject>Brain Ischemia - diagnostic imaging</subject><subject>Brain slice preparation</subject><subject>Correlation analysis</subject><subject>Degeneration</subject><subject>Diffusion</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>Diffusion Tensor Imaging</subject><subject>Evaluation</subject><subject>Female</subject><subject>Hemispheres</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Kurtosis</subject><subject>Lesions</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Middle Aged</subject><subject>Neurodegeneration</subject><subject>Neurological diseases</subject><subject>Population studies</subject><subject>Prospective Studies</subject><subject>Pyramidal tracts</subject><subject>Pyramidal Tracts - diagnostic imaging</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Statistical analysis</subject><subject>Statistical tests</subject><subject>Stroke</subject><subject>Stroke - diagnostic imaging</subject><subject>Tensors</subject><subject>white matter</subject><issn>1053-1807</issn><issn>1522-2586</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90U1v2yAcBnA0rVpftss-wIS0S1XJLS8Gm93S9C1dpklrd7YI_pOQ2iYFW1Xu_eAlSdvDDuMCEj8eEA9CXyk5pYSws2Ub3CkriJQf0AEVjGVMlPJjWhPBM1qSYh8dxrgkhCiVi09on1NV0pyQA_Q8XuhuDhG7DvcLwGMfemd8XLlON_g-aNPjc1j7rt5uT6JZQOsMnkJ0vsNXvmn8k-vmeGSGHvBN2oyrBYRE7vrgH-AHHuELZ-2w9T-H0PvoIp60er45dtcP9foz2rO6ifDldT5Cf68u78c32fT39WQ8mmaGi0JmBROUK25FaSkTSikruTAzSWxNjLE8t1TTwhZMFrM05ExDngCrQUpVl5QfoeNd7ir4xwFiX6XXGmga3YEfYsV4LgQpiRCJfv-HLv0Q0p8klbM8XayoTOpkp0zwMQaw1Sq4Vod1RUm16abadFNtu0n422vkMGuhfqdvZSRAd-DJNbD-T1R1--vPZBf6AkzYmd8</recordid><startdate>202008</startdate><enddate>202008</enddate><creator>Yu, Xinfeng</creator><creator>Jiaerken, Yeerfan</creator><creator>Wang, Shuyue</creator><creator>Hong, Hui</creator><creator>Jackson, Alan</creator><creator>Yuan, Lixia</creator><creator>Lou, Min</creator><creator>Jiang, Quan</creator><creator>Zhang, Minming</creator><creator>Huang, Peiyu</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</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>7QO</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4226-9369</orcidid></search><sort><creationdate>202008</creationdate><title>Changes in the Corticospinal Tract Beyond the Ischemic Lesion Following Acute Hemispheric Stroke: A Diffusion Kurtosis Imaging Study</title><author>Yu, Xinfeng ; Jiaerken, Yeerfan ; Wang, Shuyue ; Hong, Hui ; Jackson, Alan ; Yuan, Lixia ; Lou, Min ; Jiang, Quan ; Zhang, Minming ; Huang, Peiyu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3576-7251393f58f125999f635cb60fd0ccf34f1a17f7267bbbb6bae435c2de669d813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Brain Ischemia - complications</topic><topic>Brain Ischemia - diagnostic imaging</topic><topic>Brain slice preparation</topic><topic>Correlation analysis</topic><topic>Degeneration</topic><topic>Diffusion</topic><topic>Diffusion Magnetic Resonance Imaging</topic><topic>Diffusion Tensor Imaging</topic><topic>Evaluation</topic><topic>Female</topic><topic>Hemispheres</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Kurtosis</topic><topic>Lesions</topic><topic>Magnetic resonance imaging</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Middle Aged</topic><topic>Neurodegeneration</topic><topic>Neurological diseases</topic><topic>Population studies</topic><topic>Prospective Studies</topic><topic>Pyramidal tracts</topic><topic>Pyramidal Tracts - diagnostic imaging</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Statistical analysis</topic><topic>Statistical tests</topic><topic>Stroke</topic><topic>Stroke - diagnostic imaging</topic><topic>Tensors</topic><topic>white matter</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yu, Xinfeng</creatorcontrib><creatorcontrib>Jiaerken, Yeerfan</creatorcontrib><creatorcontrib>Wang, Shuyue</creatorcontrib><creatorcontrib>Hong, Hui</creatorcontrib><creatorcontrib>Jackson, Alan</creatorcontrib><creatorcontrib>Yuan, Lixia</creatorcontrib><creatorcontrib>Lou, Min</creatorcontrib><creatorcontrib>Jiang, Quan</creatorcontrib><creatorcontrib>Zhang, Minming</creatorcontrib><creatorcontrib>Huang, Peiyu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of magnetic resonance imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yu, Xinfeng</au><au>Jiaerken, Yeerfan</au><au>Wang, Shuyue</au><au>Hong, Hui</au><au>Jackson, Alan</au><au>Yuan, Lixia</au><au>Lou, Min</au><au>Jiang, Quan</au><au>Zhang, Minming</au><au>Huang, Peiyu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in the Corticospinal Tract Beyond the Ischemic Lesion Following Acute Hemispheric Stroke: A Diffusion Kurtosis Imaging Study</atitle><jtitle>Journal of magnetic resonance imaging</jtitle><addtitle>J Magn Reson Imaging</addtitle><date>2020-08</date><risdate>2020</risdate><volume>52</volume><issue>2</issue><spage>512</spage><epage>519</epage><pages>512-519</pages><issn>1053-1807</issn><eissn>1522-2586</eissn><abstract>Background
The degeneration of the corticospinal tract (CST) in chronic stroke has been widely described using diffusion tensor imaging and correlates with the extent of motor deficits. However, only a few studies have reported the early degeneration in the distal CST during the acute stage of stroke and pathological changes in the distal CST have not been described.
Purpose
To study the microstructural changes along the CST beyond the ischemic lesion in acute stroke using diffusion kurtosis imaging (DKI).
Study Type
Prospective.
Population
In all, 48 patients (26 males, 22 females; mean age 58.27 ± 12.89 years) with acute ischemic stroke.
Sequence
A DKI sequence with three b‐values (0, 1000, and 2000 s/mm2) at 3.0T MRI.
Assessment
The kurtosis and tensor parameters were derived from DKI and were compared along the length of the CST beyond the ischemic lesion between the affected and unaffected hemispheres using both voxelwise and slicewise analysis. The degree of neurological deficits was evaluated using the National Institute of Health Stroke Score (NIHSS) and the Barthel index and the clinical outcome at 3 months was evaluated using a modified Rankin scale.
Statistical Tests
Paired t‐tests, a linear mixed model, and multivariate linear regression.
Results
Voxelwise analysis demonstrated increased mean kurtosis, increased axial kurtosis, and decreased axial diffusivity in the affected CST, which were seen only at the level of the cerebral peduncle (all corrected P < 0.05). Slicewise analysis also demonstrated increased axial kurtosis in the cerebral peduncle of the affected CST (corrected P < 0.05). The axial kurtosis from slicewise analysis independently correlated with the motor component of NIHSS (β = 0.297, P = 0.040).
Data Conclusion
Our findings suggest that early anterograde degeneration occurs along the axon direction in the distal CST in acute stroke, and can be detected using DKI. Moreover, acute axonal degeneration along the CST correlated with motor deficits.
Level of Evidence
2
Technical Efficacy Stage
1 J. Magn. Reson. Imaging 2020;52:512–519.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>31981400</pmid><doi>10.1002/jmri.27066</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4226-9369</orcidid></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Brain Ischemia - complications Brain Ischemia - diagnostic imaging Brain slice preparation Correlation analysis Degeneration Diffusion Diffusion Magnetic Resonance Imaging Diffusion Tensor Imaging Evaluation Female Hemispheres Humans Ischemia Kurtosis Lesions Magnetic resonance imaging Male Medical imaging Middle Aged Neurodegeneration Neurological diseases Population studies Prospective Studies Pyramidal tracts Pyramidal Tracts - diagnostic imaging Regression analysis Regression models Statistical analysis Statistical tests Stroke Stroke - diagnostic imaging Tensors white matter |
| title | Changes in the Corticospinal Tract Beyond the Ischemic Lesion Following Acute Hemispheric Stroke: A Diffusion Kurtosis Imaging Study |
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