Diaschisis revisited: quantitative evaluation of thalamic hypoperfusion in anterior circulation stroke

Reidler, Paul; Mueller, Franziska; Stueckelschweiger, Lena; Feil, Katharina; Kellert, Lars; Fabritius, Matthias P.; Liebig, Thomas; Tiedt, Steffen; Puhr‐Westerheide, Daniel; Kunz, Wolfgang G.

doi:10.1016/j.nicl.2020.102329

Cited by 6 publications

(8 citation statements)

References 30 publications

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“…Recently, the 2 largest studies from Reidler report no independent impact of thalamic hypoperfusion on clinical outcome in hyperacute 2 and acute stroke. 3 However, Kuchcinski et al 30 showed a delayed deposition of iron in the thalamus as a marker of neurodegeneration is independently associated with clinical outcomes 1 year after the acute event.…”

Section: Discussionmentioning

confidence: 99%

“…to 85%. [2][3][4][5] It has been well established in ischemia experimental models that acute diaschisis may be attributed to excitotoxicity and deafferentiation, 6 whereas chronic diaschisis is probably caused by transneuronal degeneration and may result in long-term structural changes, such as ipsilateral thalamic atrophy. 7 Although diaschisis initially describes a reversible functional phenomenon, accumulating evidence has shown that morphological changes also occur in remote but connected brain regions.…”

Section: Clinical and Population Sciencesmentioning

confidence: 99%

“…10,11 Furthermore, the secondary thalamic alterations were found to be independently associated with clinical outcome. 7 Nevertheless, quantitative analysis of ITD in hyperacute stroke has been used in a recent publication, 2 little is knowing concerning regional quantification of the secondary dynamic changes of thalamic perfusion and diffusion and the exact relationship between ITD and underlying microstructural changes across the time span of stroke.…”

Section: Clinical and Population Sciencesmentioning

confidence: 99%

“…ITD has been observed in hyperacute, acute, subacute, and chronic phases of stroke with a considerable frequency of 20% to 85%. 2–5 It has been well established in ischemia experimental models that acute diaschisis may be attributed to excitotoxicity and deafferentiation, 6 whereas chronic diaschisis is probably caused by transneuronal degeneration and may result in long-term structural changes, such as ipsilateral thalamic atrophy. 7…”

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confidence: 99%

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Characterizing Diaschisis-Related Thalamic Perfusion and Diffusion After Middle Cerebral Artery Infarction

Xia

Zhou

et al. 2021

Stroke

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Background and Purpose: Ipsilateral thalamic diaschisis (ITD) initially describes functional depression of the thalamus ipsilateral to a supratentorial lesion, but accumulating evidence has shown morphological changes also occur. Therefore, we aimed to characterize thalamic perfusion and diffusion related to ITD over time and their inter-relationships after middle cerebral artery infarction. Methods: Eighty-five patients with middle cerebral artery infarction who underwent diffusion kurtosis imaging and arterial spin labeling were retrospectively included. ITD was diagnosed as ipsilateral thalamic hypoperfusion present on ≥2 cerebral blood flow maps. The thalamic asymmetrical index was calculated as (ipsilateral value−contralateral value)/contralateral value×100%. Finally, the inter-relationships of thalamic perfusion and diffusion were analyzed. Results: ITD was present in 56/85 patients (65.9%, ITD+). In ITD+ patients, larger abnormal perfusion volume, higher perfusion-infarct mismatch and lower rates of focal hyperperfusion were observed than ITD− patients. Infarction affecting the corona radiata were more frequent among ITD+ patients. Mean kurtosis were slightly but significantly increased within the ipsilateral thalamus compared with the contralateral one in ITD+ patients of subacute and chronic groups, while fractional anisotropy was significantly increased in subacute group but decreased in chronic group for both ITD+ and ITD− patients. Mean diffusivity was significantly increased in ITD+ patients of chronic group. Furthermore, the AI CBF was negatively and significantly correlated with AI MK and AI FA in ITD+ patients in subacute group, and AI MD , even after adjustment for abnormal perfusion volume and days from symptoms onset, in chronic group. ITD+ patients had significantly higher National Institutes of Health Stroke Scale and modified Rankin Scale scores at admission and discharge and also showed a trend to independent association with clinical outcome at discharge. Conclusions: The combination of arterial spin labeling and diffusion kurtosis imaging can reveal early, time-specific thalamic perfusion and diffusion changes after middle cerebral artery infarction. ITD-related hypoperfusion was significantly correlated with underlying microstructural alterations.

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Section: Discussionmentioning

confidence: 99%

Section: Clinical and Population Sciencesmentioning

confidence: 99%

Section: Clinical and Population Sciencesmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Characterizing Diaschisis-Related Thalamic Perfusion and Diffusion After Middle Cerebral Artery Infarction

Xia

Zhou

et al. 2021

Stroke

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“…Moreover, an insufficient perfusion volume of >3.5 ml, as observed on CTP, can be used to identify patient subgroups with poor clinical prognosis and differentiate them from patients with delayed recovery. [ 37 ]…”

Section: Clinical Assessment Of the No-reflow Phenomenonmentioning

confidence: 99%

No-reflow phenomenon following stroke recanalization therapy: Clinical assessment advances: A narrative review

Kan,

Li,

Zhang

et al. 2023

Brain Circulation

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The no-reflow phenomenon (NRP) after successful vascular recanalization in acute ischemic stroke (AIS) has become a major cause of poor clinical prognosis and ineffective recanalization. However, there is currently no clear definition or unified clinical assessment method for the NRP. Therefore, it is urgent to clarify the clinical evaluation criteria for the NRP and develop new no-reflow evaluation techniques so that remedial treatment can be applied to AIS patients suffering from the NRP. In this brief review, a variety of NRP assessment methods and defining criteria for clinical practice are presented.

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Perilesional and contralesional brain activations related to associative encoding of unfamiliar face-names pairs in adults with left chronic stroke with or without ischemic infarct on left inferior frontal gyrus

Batista

Bazán

Martin

et al. 2023

Cortex

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Diaschisis revisited: quantitative evaluation of thalamic hypoperfusion in anterior circulation stroke

Cited by 6 publications

References 30 publications

Characterizing Diaschisis-Related Thalamic Perfusion and Diffusion After Middle Cerebral Artery Infarction

Characterizing Diaschisis-Related Thalamic Perfusion and Diffusion After Middle Cerebral Artery Infarction

No-reflow phenomenon following stroke recanalization therapy: Clinical assessment advances: A narrative review

Perilesional and contralesional brain activations related to associative encoding of unfamiliar face-names pairs in adults with left chronic stroke with or without ischemic infarct on left inferior frontal gyrus

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