The fate of subcortical diffusion-weighted imaging (DWI) lesions in stroke patients is highly variable, ranging from complete tissue loss to no visible lesion on follow-up. Little is known about within-lesion heterogeneity and its relevance for stroke outcome. Patients with subcortical stroke and recruited through the prospective DEDEMAS study (NCT01334749) were examined at baseline ( n = 45), six months ( n = 45), and three years ( n = 28) post-stroke. We performed high-resolution structural MRI including DWI. Tissue fate was determined voxel-wise using fully automated tissue segmentation. Within-lesion heterogeneity at baseline was assessed by free water diffusion imaging measures. The majority of DWI lesions (66%) showed cavitation on six months follow-up but the proportion of tissue turning into a cavity was small (9 ± 13.5% of the DWI lesion). On average, 69 ± 25% of the initial lesion resolved without any visually apparent signal abnormality. The extent of cavitation at six months post-stroke was independently associated with clinical outcome, i.e. modified Rankin scale score at six months (OR = 4.71, p = 0.005). DWI lesion size and the free water-corrected tissue mean diffusivity at baseline independently predicted cavitation. In conclusion, the proportion of cavitating tissue is typically small, but relevant for clinical outcome. Within-lesion heterogeneity at baseline on advanced diffusion imaging is predictive of tissue fate.

While some individuals tend to follow norms, others, in the face of tempting but forbidden options, tend to commit rule-breaking when this action is beneficial for themselves. Previous studies have neglected such interindividual differences in rule-breaking. The present study fills this gap by investigating cognitive characteristics of individuals who commit spontaneous deliberative rule-breaking (rule-breakers) versus rule-followers. We developed a computerised task, in which 133 participants were incentivised to sometimes violate set rules which would–if followed–lead to a loss. While 52% of participants tended to break rules to obtain a benefit, 48% tended to follow rules even if this behaviour led to loss. Although rule-breakers experienced significantly more cognitive conflict (measured via response times and mouse movement trajectories) than rule-followers, they also obtained higher payoffs. In rule-breakers, cognitive conflict was more pronounced when violating the rules than when following them, and mainly during action planning. This conflict increased with frequent, recurrent, and early rule-breaking. Our results were in line with the Decision-Implementation-Mandatory switch-Inhibition model and thus extend the application of this model to the interindividual differences in rule-breaking. Furthermore, personality traits such as extroversion, disagreeableness, risk propensity, high impulsiveness seem to play a role in the appreciation of behaviours and cognitive characteristics of rule-followers and rule-breakers. This study opens the path towards the understanding of the cognitive characteristics of the interindividual differences in responses towards rules, and especially in spontaneous deliberative rule-breaking.