Diffusion tensor imaging detects early Wallerian degeneration of the pyramidal tract after ischemic stroke

Thomalla, Götz; Glauche, Volkmar; Koch, Martin; Beaulieu, Christian; Weiller, Cornelius; Röther, Joachim

doi:10.1016/j.neuroimage.2004.03.041

Cited by 385 publications

(376 citation statements)

References 40 publications

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“…Previously, similar studies have been performed by using ROIbased analysis of DTI data to show a high correlation between the FA values and the overall muscle strength of the affected extremities (by using the total score of Manual Muscle Testing or Motricity Index) 2,42 and the hand function 6,7 in patients with subacute or chronic ischemic stroke. Using the TS analysis, we have successfully demonstrated that the fiber integrity of the affected CST corresponding to the lower extremity motor control originating from the M1 is strongly correlated with the motor function of the affected lower extremity (r Ͼ 0.75).…”

Section: Discussionmentioning

confidence: 92%

“…1,2 It has been reported that FA, which is a quantitative index of the directional anisotropy of water molecular diffusion derived from the diffusion tensor, is an effective measure of fiber integrity. 3 Decreases in FA have been found in the affected tracts at infarct regions and regions with wallerian degeneration.…”

mentioning

confidence: 99%

“…2,6,7 Using ROI-based analysis, researchers manually select certain white matter regions with the aid of anatomic landmarks. This approach depends on raters' familiarity with the brain anatomy and is thus subject to poor interrater and intrarater reproducibility.…”

mentioning

confidence: 99%

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Tract-Specific and Region of Interest Analysis of Corticospinal Tract Integrity in Subcortical Ischemic Stroke: Reliability and Correlation with Motor Function of Affected Lower Extremity

Tang

Ko²,

Luo³

et al. 2010

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 92%

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confidence: 99%

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Tract-Specific and Region of Interest Analysis of Corticospinal Tract Integrity in Subcortical Ischemic Stroke: Reliability and Correlation with Motor Function of Affected Lower Extremity

Tang

Ko²,

Luo³

et al. 2010

AJNR Am J Neuroradiol

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“…Moreover, the early decrease of FA correlates positively with motor deficits, and the more pronounced the degeneration of the pyramidal tract, the higher the motor deficit. 13,14 A strong correlation between degeneration in the cerebral peduncle and functional outcome of the upper limbs has been detected in patients with chronic stage stroke. 1 In addition, longitudinal studies have demonstrated that a progressive decrease of FA occurs along the pyramidal tract in the cerebral peduncle below the primary lesion.…”

Section: Discussionmentioning

confidence: 99%

Secondary Degeneration Detected by Combining Voxel-Based Morphometry and Tract-Based Spatial Statistics in Subcortical Strokes with Different Outcomes in Hand Function

Yin

Fan

et al. 2013

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Secondary degeneration of the pyramidal tract after focal motor pathway stroke has been observed by diffusion tensor imaging. However, the relationships between outcomes in hand function and secondary degeneration in widespread regions are not well understood. For the first time, we investigated the differences of secondary degeneration across the whole brain between subgroups of patients with stroke.

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“…Changes in water diffusion following this process of Wallerian degeneration can be visualized with DTI (13). Previous studies have shown that asymmetries in FA of the CST after PVHI and arterial stroke at TEA indicate CST injury that is associated with the development of USCP (14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

Neonatal DTI early after birth predicts motor outcome in preterm infants with periventricular hemorrhagic infarction

et al. 2015

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Background:To determine the association between early neonatal diffusion tensor imaging (DTI) and the development of unilateral spastic cerebral palsy (USCP) in preterm infants with periventricular hemorrhagic infarction (PVHI). Methods: Preterm infants with PVHI were assessed with early (≤4 wk after birth) and term-equivalent age MRI-DTI. Involvement of corticospinal tracts was assessed by visual assessment of the posterior limb of the internal capsule (PLIC) on DTI (classified asymmetrical, equivocal, or symmetrical) and by an atlas-based approach calculating fractional anisotropy asymmetry index in the PLIC. Motor outcome was assessed at ≥15 mo corrected age. results: Seven out of 23 infants with PVHI developed USCP. Their PLIC was visually scored as asymmetrical in 6 and equivocal in 1 on the early DTI. Thirteen out of 16 infants with a symmetrical motor development had a symmetrical PLIC on early DTI, the remaining 3 were equivocal. All infants with USCP had a fractional anisotropy asymmetry index of >0.05 (optimal cut-off value) on early DTI. In infants with a symmetrical motor development (n = 16), 14 had an asymmetry index ≤0.05 while 2 had an index >0.05. conclusion: DTI in preterm infants with PVHI within a few weeks after birth is associated with later motor development. P eriventricular hemorrhagic infarction (PVHI) is a serioustype of brain injury that occurs in around 1-3% of preterm infants with a gestational age below 37 wk (1-3). It is a complication of a germinal matrix hemorrhage that develops due to impaired venous drainage of the medullary veins in the periventricular white matter and may have an adverse effect on corticospinal tract (CST) development (4). PVHI leads in about 50-85% of infants to, mainly unilateral, spastic cerebral palsy (USCP) (2,3,5). The diagnosis is made with cranial ultrasound (cUS) and prediction of cerebral palsy is possible in most but not all infants taken the site and size of the lesion into account (5).MRI studies performed at term-equivalent age (TEA) will reliably predict motor outcome with asymmetry in myelination of the posterior limb of the internal capsule (PLIC) due to Wallerian degeneration being almost invariably associated with the development of USCP (6).Diffusion tensor imaging (DTI) allows the study of microstructural properties of the white matter (7). To the best of our knowledge, it has not yet been studied whether early disturbances in CST integrity shortly after the onset of PVHI relate to later development of USCP. In addition, the prognostic value of DTI for early prediction of USCP in infants with PVHI is still unknown.The aim of this study was to determine the association between MRI-DTI within 4 wk after birth and the development of USCP in preterm infants with PVHI. RESULTS PatientsThe clinical characteristics and motor outcome of the study group (n = 23) are summarized in Table 1. The infants who developed cerebral palsy (n = 7, 30%) all had USCP. Cranial Ultrasound FindingsIn 16 infants with a normal motor development, the cUS on which t...

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Diffusion tensor imaging detects early Wallerian degeneration of the pyramidal tract after ischemic stroke

Cited by 385 publications

References 40 publications

Tract-Specific and Region of Interest Analysis of Corticospinal Tract Integrity in Subcortical Ischemic Stroke: Reliability and Correlation with Motor Function of Affected Lower Extremity

Tract-Specific and Region of Interest Analysis of Corticospinal Tract Integrity in Subcortical Ischemic Stroke: Reliability and Correlation with Motor Function of Affected Lower Extremity

Secondary Degeneration Detected by Combining Voxel-Based Morphometry and Tract-Based Spatial Statistics in Subcortical Strokes with Different Outcomes in Hand Function

Neonatal DTI early after birth predicts motor outcome in preterm infants with periventricular hemorrhagic infarction

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