Evaluating ischemic stroke with diffusion tensor imaging

Chen, Ziqian; Ni, Ping; Zhang, Jing; Ye, Youqiang; Xiao, Hui; Gennian, Qian; Xu, Sheng; Wang, Jingliang; Yang, Xia; Chen, Jinhua; Zhang, Biyun; Zeng, Yanjun

doi:10.1179/174313208x297968

Cited by 31 publications

(22 citation statements)

References 17 publications

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“…The FA and MD values reported in previous studies [8,18,19] are similar to those we recorded. The elevation in the MD value of the ipsilateral thalamus without a change in the FA value has been previously reported by Hervé et al .…”

Section: Discussionsupporting

confidence: 91%

Diffusion tensor imaging correlates with lesion volume in cerebral hemisphere infarctions

et al. 2010

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BackgroundBoth a large lesion volume and abnormalities in diffusion tensor imaging are independently associated with a poor prognosis after cerebral infarctions. Therefore, we assume that they are associated. This study assessed the associations between lesion volumes and diffusion tensor imaging in patients with a right-sided cerebral infarction.MethodsThe lesion volumes of 33 patients (age 65.9 ± 8.7, 26 males and 7 females) were imaged using computed tomography (CT) in the acute phase (within 3-4 hours) and magnetic resonance imaging (MRI) in the chronic phase (follow-up at 12 months, with a range of 8-27 months). The chronic-phase fractional anisotropy (FA) and mean diffusivity (MD) values were measured at the site of the infarct and selected white matter tracts. Neurological tests in both the acute and chronic phases, and DTI lateralization were assessed with the Wilcoxon signed-rank test. The effects of thrombolytic therapy (n = 10) were assessed with the Mann-Whitney U test. The correlations between the measured parameters were analysed with Spearman's rho correlation. Bonferroni post-hoc correction was used to compensate for the familywise error rate in multiple comparisons.ResultsSeveral MD values in the right hemisphere correlated positively and FA values negatively with the lesion volumes. These correlations included both lesion area and healthy tissue. The results of the mini-mental state examination and the National Institutes of Health Stroke Scale also correlated with the lesion volume.ConclusionsA larger infarct volume is associated with more pronounced tissue modifications in the chronic stage as observed with the MD and FA alterations.

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Section: Discussionsupporting

confidence: 91%

Diffusion tensor imaging correlates with lesion volume in cerebral hemisphere infarctions

et al. 2010

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“…Although we selected an FA threshold of 0.15 in correspondence to past literature (e.g. An FA threshold of 0.18 was used in (Chen et al, 2008)), our results suggested that this threshold was also appropriate for contrasting controls with chronic stroke subjects. Across all voxels in the normalized space, the correlation between VISC and FA threshold was R = − 0.950 ± 0.044, and the correlation between log(VISC) vs. FA threshold was R = − 0.978 ± 0.025.…”

Section: Resultsmentioning

confidence: 99%

White matter structural connectivity is associated with sensorimotor function in stroke survivors

Kalinosky

Schindler-Ivens

Schmit

2013

NeuroImage: Clinical

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PurposeDiffusion tensor imaging (DTI) provides functionally relevant information about white matter structure. Local anatomical connectivity information combined with fractional anisotropy (FA) and mean diffusivity (MD) may predict functional outcomes in stroke survivors. Imaging methods for predicting functional outcomes in stroke survivors are not well established. This work uses DTI to objectively assess the effects of a stroke lesion on white matter structure and sensorimotor function.MethodsA voxel-based approach is introduced to assess a stroke lesion's global impact on motor function. Anatomical T1-weighted and diffusion tensor images of the brain were acquired for nineteen subjects (10 post-stroke and 9 age-matched controls). A manually selected volume of interest was used to alleviate the effects of stroke lesions on image registration. Images from all subjects were registered to the images of the control subject that was anatomically closest to Talairach space. Each subject's transformed image was uniformly seeded for DTI tractography. Each seed was inversely transformed into the individual subject space, where DTI tractography was conducted and then the results were transformed back to the reference space. A voxel-wise connectivity matrix was constructed from the fibers, which was then used to calculate the number of directly and indirectly connected neighbors of each voxel. A novel voxel-wise indirect structural connectivity (VISC) index was computed as the average number of direct connections to a voxel's indirect neighbors. Voxel-based analyses (VBA) were performed to compare VISC, FA, and MD for the detection of lesion-induced changes in sensorimotor function. For each voxel, a t-value was computed from the differences between each stroke brain and the 9 controls. A series of linear regressions was performed between Fugl-Meyer (FM) assessment scores of sensorimotor impairment and each DTI metric's log number of voxels that differed from the control group.ResultsCorrelation between the logarithm of the number of significant voxels in the ipsilesional hemisphere and total Fugl-Meyer score was moderate for MD (R2 = 0.512), and greater for VISC (R2 = 0.796) and FA (R2 = 0.674). The slopes of FA (p = 0.0036), VISC (p = 0.0005), and MD (p = 0.0199) versus the total FM score were significant. However, these correlations were driven by the upper extremity motor component of the FM score (VISC: R2 = 0.879) with little influence of the lower extremity motor component (FA: R2 = 0.177).ConclusionThe results suggest that a voxel-wise metric based on DTI tractography can predict upper extremity sensorimotor function of stroke survivors, and that supraspinal intraconnectivity may have a less dominant role in lower extremity function.

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“…17 A further study showed that the severity of damage to the CST -based on the DTI result -was correlated with the muscle strength of the affected hand, indicating that DTI could be used for investigating stroke-related injury. 19 As in previous studies, 20 -22 a series of ratios (not the exact values) were used in the analyses in the present study, which reduced the errors between individuals. This method relied on the premise that each stroke did not obviously affect the contralesional CST, so the ratios were comparable between individuals, as found in other research; 23 this supports the use of ratios to assess the severity of CST damage in stroke patients.…”

Section: Discussionmentioning

confidence: 99%

Diffusion Tensor Imaging for Predicting Hand Motor Outcome in Chronic Stroke Patients

Song

Zhang

et al. 2012

J Int Med Res

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Evaluating ischemic stroke with diffusion tensor imaging

Abstract: This study shows that DTI can be used to investigate ischemic stroke and assess ischemic stroke-induced damage. The damaged severity of corticospinal tracts is correlated with that of muscle strength.

Cited by 31 publications

References 17 publications

Diffusion tensor imaging correlates with lesion volume in cerebral hemisphere infarctions

Diffusion tensor imaging correlates with lesion volume in cerebral hemisphere infarctions

White matter structural connectivity is associated with sensorimotor function in stroke survivors

Diffusion Tensor Imaging for Predicting Hand Motor Outcome in Chronic Stroke Patients

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