Cerebral perfusion of the left reading network predicts recovery of reading in subacute to chronic stroke

Boukrina, Olga; Barrett, Anna M.; Graves, William W.

doi:10.1002/hbm.24773

Cited by 17 publications

(47 citation statements)

References 86 publications

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“…However, hypoperfusion in the peri-infarct area can remain for weeks after stroke 22 . In line with the results of the present study, the effects of stroke can also affect remote functional networks 26 , likely due to diaschisis (electrical, metabolic, or blood flow dysfunction in functionally connected areas remote from the lesion 55 ) or due to other signals leading to a widespread disconnection of brain networks 54 . In adult patients after stroke, hypoperfusion of anatomically intact areas can be seen up to a year after stroke 56 .…”

Section: Discussionsupporting

confidence: 90%

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Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery

Steiner

Federspiel

Jaros

et al. 2021

Sci Rep

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Adaptive recovery of cerebral perfusion after pediatric arterial ischemic stroke (AIS) is sought to be crucial for sustainable rehabilitation of cognitive functions. We therefore examined cerebral blood flow (CBF) in the chronic stage after stroke and its association with cognitive outcome in patients after pediatric AIS. This cross-sectional study investigated CBF and cognitive functions in 14 patients (age 13.5 ± 4.4 years) after pediatric AIS in the middle cerebral artery (time since AIS was at least 2 years prior to assessment) when compared with 36 healthy controls (aged 13.8 ± 4.3 years). Cognitive functions were assessed with neuropsychological tests, CBF was measured with arterial spin labeled imaging in the anterior, middle, and posterior cerebral artery (ACA, MCA, PCA). Patients had significantly lower IQ scores and poorer cognitive functions compared to healthy controls (p < 0.026) but mean performance was within the normal range in all cognitive domains. Arterial spin labeled imaging revealed significantly lower CBF in the ipsilesional MCA and PCA in patients compared to healthy controls. Further, we found significantly higher interhemispheric perfusion imbalance in the MCA in patients compared to controls. Higher interhemispheric perfusion imbalance in the MCA was significantly associated with lower working memory performance. Our findings revealed that even years after a pediatric stroke in the MCA, reduced ipsilesional cerebral blood flow occurs in the MCA and PCA and that interhemispheric imbalance is associated with cognitive performance. Thus, our data suggest that cerebral hypoperfusion might underlie some of the variability observed in long-term outcome after pediatric stroke.

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Section: Discussionsupporting

confidence: 90%

“…However, case studies of patients in the chronic phase after stroke report hypoperfusion in the lesioned hemisphere 22 , 24 , 25 and relate it to functional deficits, i.e. language problems 22 , reading deficits 24 , 26 , and phonological competence 26 .…”

Section: Introductionmentioning

confidence: 99%

Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery

Steiner

Federspiel

Jaros

et al. 2021

Sci Rep

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“…In the absence of treatment, the results for all three perilesional rings revealed that perfusion in the damaged left hemisphere was lower than in the undamaged right hemisphere, consistent with previous findings (Boukrina et al, 2019;Brumm et al, 2010;Richardson et al, 2011;Thompson et al, 2017). Within the left hemisphere as well, tissue closer to the lesion was reduced in perfusion relative to more distant areas -for the 0-6mm ring compared to the 6-12mm ring, and for 6-12mm vs. 12-18mm.…”

Section: Discussionsupporting

confidence: 91%

“…Perfusion in perilesional rings is also consistently found to be abnormally low relative to undamaged homolog regions in the contralesional hemisphere (Brumm et al, 2010;Richardson et al, 2011;Thompson et al, 2017), though only marginally so in one study (Boukrina et al, 2019).…”

Section: Despite Variable Definitions Of How Far Perilesional Tissue ...mentioning

confidence: 87%

Perilesional Perfusion in Chronic Stroke-Induced Aphasia and Its Response to Behavioral Treatment Interventions

Walenski

Chen

Litcofsky

et al. 2022

Neurobiology of Language

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Stroke-induced alterations in cerebral blood flow (perfusion) may contribute to functional language impairments in chronic aphasia, particularly in perilesional tissue. Abnormal perfusion in this region may also serve as a biomarker for predicting functional improvements with behavioral treatment interventions. Using pseudo-continuous arterial spin labeling (pCASL) in MRI, we examined perfusion in chronic aphasia, in perilesional rings in the left hemisphere and their right hemisphere homologues. In the left hemisphere we found a gradient pattern of decreasing perfusion closer to the lesion. The opposite pattern was found in the right hemisphere, with significantly increased perfusion close to the lesion homolog. Perfusion was also increased in the right hemisphere lesion homologue region relative to the surrounding tissue. We next examined changes in perfusion in two groups: One group who underwent MRI scanning before and after three months of a behavioral treatment intervention that led to significant language gains, and a second who were scanned twice at a three-month interval without a treatment intervention. For both groups, there was no difference in perfusion over time in either the left or the right hemisphere. Moreover, within the treatment group pre-treatment perfusion scores did not predict treatment response; neither did pre-treatment perfusion predict post-treatment language performance. These results indicate that perfusion is chronically abnormal in both hemispheres, but chronically abnormal perfusion did not change in response to our behavioral treatment interventions, and did not predict responsiveness to language treatment.

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“…Hypoperfusion has previously been suggested to resolve over time in accordance with early behavioral recovery patterns [21][22][23]. However, case studies of patients in the chronic phase after stroke report hypoperfusion in the lesioned hemisphere [22,24,25] and relate it to functional deficits [22,24,26]. In the chronic stage after stroke, reductions of ipsilesional cerebral blood flow was correlated with infarct size in patients after left-hemisphere stroke, indicating sustained hypoperfusion in the affected hemisphere [20].…”

Section: Introductionmentioning

confidence: 95%

Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery

Steiner

Federspiel

Jaros

et al. 2021

Preprint

View full text Add to dashboard Cite

Adaptive recovery of cerebral perfusion after pediatric arterial ischemic stroke (AIS) is sought to be crucial for sustainable rehabilitation of cognitive functions. We therefore examined cerebral blood flow in the chronic stage after stroke and its association with cognitive outcome in patients after pediatric arterial ischemic stroke (AIS). This cross-sectional study investigated cerebral blood flow and cognitive functions in 14 patients (age 13.5 ± 4.4 years) after pediatric AIS in the middle cerebral artery (time since AIS was at least 2 years prior to assessment) when compared with 36 healthy controls (aged 13.8 ± 4.3 years). Cognitive functions were assessed using neuropsychological tests and cerebral blood flow was measured with arterial spin labeled imaging in the area of the anterior, middle, and posterior cerebral artery (ACA, MCA, PCA). Patients had significantly lower IQ scores and poorer cognitive functions compared to healthy controls. Arterial spin labeled imaging revealed significantly lower cerebral blood flow in the ipsilesional MCA and PCA in patients compared to healthy controls. Further, we found significantly higher interhemispheric perfusion imbalance in the MCA in patients compared to controls. Higher interhemispheric perfusion imbalance in the MCA was significantly associated with lower working memory performance. Our findings revealed that even years after pediatric stroke in the MCA, reduced ipsilesional cerebral blood flow occurs in the MCA and PCA and interhemispheric imbalance is associated with cognitive performance. Thus, our data suggest that cerebral hypoperfusion might underlie some of the variability observed in long-term outcome after pediatric stroke.

show abstract

Cerebral perfusion of the left reading network predicts recovery of reading in subacute to chronic stroke

Cited by 17 publications

References 86 publications

Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery

Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery

Perilesional Perfusion in Chronic Stroke-Induced Aphasia and Its Response to Behavioral Treatment Interventions

Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery

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