Clinical significance of blood supply to the internal capsule and basal ganglia

Djulejić, Vuk; Marinković, Slobodan; Georgievski, Biljana; Stijak, Lazar; Aksić, Milan; Puškaš, Laslo; Milić, I

doi:10.1016/j.jocn.2015.04.034

Cited by 31 publications

(29 citation statements)

References 80 publications

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“…The association of the intermediate diffusion component f int with enlarged PVS was stronger for the BG than for CSO, which could be due to a denser vasculature of the BG . Furthermore, it has previously been suggested that different pathophysiological processes might underlie enlarged PVS in the BG and CSO …”

Section: Discussionmentioning

confidence: 88%

“…The association of the intermediate diffusion component f int with enlarged PVS was stronger for the BG than for CSO, which could be due to a denser vasculature of the BG. 35 Furthermore, it has previously been suggested that different pathophysiological processes might underlie enlarged PVS in the BG and CSO. 36 Previously, other models have been proposed to extend the two-compartment approach, including three-compartment models to separate the parenchymal, microvascular perfusion, and an additional component which is suggested to indicate freely diffusing water, 37,38 a model which decomposes the microvascular flow into a fast and slow component 39 and a model that disentangles diffusive and ballistic parts.…”

Section: Discussionmentioning

confidence: 99%

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Spectral Diffusion Analysis of Intravoxel Incoherent Motion MRI in Cerebral Small Vessel Disease

Wong

Backes

Drenthen

et al. 2019

Magnetic Resonance Imaging

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Background Cerebral intravoxel incoherent motion (IVIM) imaging assumes two components. However, more compartments are likely present in pathologic tissue. We hypothesized that spectral analysis using a nonnegative least‐squares (NNLS) approach can detect an additional, intermediate diffusion component, distinct from the parenchymal and microvascular components, in lesion‐prone regions. Purpose To investigate the presence of this intermediate diffusion component and its relation with cerebral small vessel disease (cSVD)‐related lesions. Study Type Prospective cross‐sectional study. Population Patients with cSVD (n = 69, median age 69.8) and controls (n = 39, median age 68.9). Field Strength/Sequence Whole‐brain inversion recovery IVIM acquisition at 3.0T. Assessment Enlarged perivascular spaces (PVS) were rated by three raters. White matter hyperintensities (WMH) were identified on a fluid attenuated inversion recovery (FLAIR) image using a semiautomated algorithm. Statistical Tests Relations between IVIM measures and cSVD‐related lesions were studied using the Spearman's rank order correlation. Results NNLS yielded diffusion spectra from which the intermediate volume fraction fint was apparent between parenchymal diffusion and microvasular pseudodiffusion. WMH volume and the extent of MRI‐visible enlarged PVS in the basal ganglia (BG) and centrum semiovale (CSO) were correlated with fint in the WMHs, BG, and CSO, respectively. fint was 4.2 ± 1.7%, 7.0 ± 4.1% and 13.6 ± 7.7% in BG and 3.9 ± 1.3%, 4.4 ± 1.4% and 4.5 ± 1.2% in CSO for the groups with low, moderate, and high number of enlarged PVS, respectively, and increased with the extent of enlarged PVS (BG: r = 0.49, P < 0.01; CSO: r = 0.23, P = 0.02). fint in the WMHs was 27.1 ± 13.1%, and increased with the WMH volume (r = 0.57, P < 0.01). Data Conclusion We revealed the presence of an intermediate diffusion component in lesion‐prone regions of cSVD and demonstrated its relation with enlarged PVS and WMHs. In tissue with these lesions, tissue degeneration or perivascular edema can lead to more freely diffusing interstitial fluid contributing to fint. Level of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:1170–1180.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Spectral Diffusion Analysis of Intravoxel Incoherent Motion MRI in Cerebral Small Vessel Disease

Wong

Backes

Drenthen

et al. 2019

Magnetic Resonance Imaging

View full text Add to dashboard Cite

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“…The latter has the highest percentage of significant voxels (>70%) with respect to MD values and represents—like the uncinate fasciculus —a WM association tract in the human brain that connects parts of the limbic system (such as the hippocampus and amygdala in the temporal lobe) with parts of the frontal cortex (such as the orbitofrontal cortex ). The finding of high percentage of significant voxels in the right posterior limb and the left retrolenticular part of the internal capsule is reasonable, because these parts of the internal capsule are supplied to a large extent by the lenticulostriate arteries (Djulejik et al, ), which are branches of the middle cerebral artery where the transcranial Doppler (TCD) measurements of cerebral blood flow velocity were made, from which the hemodynamic model that generates the DVR is derived. We also note that the other parts of the internal capsule are supplied by other cerebral arteries (viz.…”

Section: Discussionmentioning

confidence: 97%

Comparing model‐based cerebrovascular physiomarkers with DTI biomarkers in MCI patients

et al. 2019

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Objective To compare the novel model‐based hemodynamic physiomarker of Dynamic Vasomotor Reactivity (DVR) with biomarkers based on Diffusion Tensor Imaging (DTI) and some widely used neurocognitive scores in terms of their ability to delineate patients with amnestic Mild Cognitive Impairment (MCI) from age‐matched cognitively normal controls. Materials & Methods The model‐based DVR and MRI‐based DTI markers were obtained from 36 patients with amnestic MCI and 16 age‐matched controls without cognitive impairment, for whom widely used neurocognitive scores were available. These markers and scores were subsequently compared in terms of statistical delineation between patients and controls. Results It was found that statistically significant delineation between MCI patients and controls was comparable for DVR or DTI markers ( p < 0.01). The performance of both types of markers was consistent with the scores of some (but not all) widely used neurocognitive tests. Conclusion Since DTI offers a measure of cerebral white matter integrity, the results suggest that the model‐based hemodynamic marker of DVR may correlate with cognitive impairment due to white matter lesions. This finding is consistent with the hypothesis that dysregulation of cerebral microcirculation may be an early cause of cognitive impairment, which has been recently corroborated by several studies.

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“…Functional outcome measured by mRS, largely depends on the degree of motor weakness 24. Motor tracts, which pass as compact bundles through the internal capsule,25 could be more frequently damaged in the SM+L group, and this might have caused more severe motor weakness and impeded functional recovery. In patients with large superficial territory infarction, additionally sizable infarctions in the subcortex due to LSA involvement might increase the risk of compressing deep brain structures and brain herniation.…”

Section: Discussionmentioning

confidence: 99%

Lenticulostriate Artery Involvement is Predictive of Poor Outcomes in Superficial Middle Cerebral Artery Territory Infarction

et al. 2017

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PurposePatients with superficial middle cerebral artery (MCA) territory infarction may have concomitant lenticulostriate artery (LSA) territory infarction. We investigated the mechanisms thereof and the outcomes of patients with superficial MCA territory infarction according to the presence or absence of LSA involvement.Materials and MethodsConsecutive patients with first-ever infarction in the unilateral superficial MCA territory were included in this study. They were divided into the superficial MCA only (SM) group and the superficial MCA plus LSA (SM+L) group.ResultsOf the 398 patients, 84 patients (21.1%) had LSA involvement (SM+L group). The SM+L group more frequently had significant stenosis of the proximal MCA or carotid artery and high-risk cardioembolic sources. Stroke severity and outcomes were remarkably different between the groups. The SM+L group showed more severe neurologic deficits (National Institute of Health Stroke Scale score 10.8±7.1 vs. 4.0±5.0, p<0.001) and larger infarct in the superficial MCA territory (40.8±62.6 cm3 vs. 10.8±21.8 cm3, p<0.001) than the SM group. A poor functional outcome (mRS >2) at 3 months was more common in the SM+L group (64.3% vs. 15.9%, p<0.001). During a mean follow-up of 26 months, 67 patients died. All-cause (hazard ratio, 2.246) and stroke (hazard ratio, 9.193) mortalities were higher in the SM+L group than the SM group. In multivariate analyses, LSA involvement was an independent predictor of poor functional outcomes and stroke mortality.ConclusionLSA territory involvement is predictive of poor long-term outcomes in patients with superficial MCA territory infarction.

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Clinical significance of blood supply to the internal capsule and basal ganglia

Cited by 31 publications

References 80 publications

Spectral Diffusion Analysis of Intravoxel Incoherent Motion MRI in Cerebral Small Vessel Disease

Spectral Diffusion Analysis of Intravoxel Incoherent Motion MRI in Cerebral Small Vessel Disease

Comparing model‐based cerebrovascular physiomarkers with DTI biomarkers in MCI patients

Lenticulostriate Artery Involvement is Predictive of Poor Outcomes in Superficial Middle Cerebral Artery Territory Infarction

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