Focal Wallerian degeneration of the corpus callosum in large middle cerebral artery stroke: Serial diffusion tensor imaging

Gupta, Rakesh K.; Saksena, Sona; Hasan, Khader M.; Agarwal, Atul; Haris, Mohammad; Pandey, Chandra M.; Narayana, Ponnada A.

doi:10.1002/jmri.20677

Cited by 83 publications

(77 citation statements)

References 21 publications

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“…Disintegration of the axonal structures and myelin sheath results in reduced anisotropy on DTI [38]. The timing and pattern of abnormal CC diffusion (decreased FA and increased MD, AD and RD) in our participants is consistent with the chronic phase of degeneration observed in cases of TBI [2,60,61,62], stroke [38,63,64] and cerebral palsy [65,66], all presumed to be wallerian degeneration. Similar time-dependent axonal and myelin degradation findings have been reported in patients with epilepsy after corpus callosotomy, and in some cases up to 17 years from anterior resection [67,68].…”

Section: Discussionsupporting

confidence: 59%

Corpus Callosum and Inferior Forebrain White Matter Microstructure Are Related to Functional Outcome from Raised Intracranial Pressure in Child Traumatic Brain Injury

Tasker¹,

Westland²,

White

et al. 2010

Dev Neurosci

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In severe paediatric traumatic brain injury (TBI), a common focus of treatment is raised intracranial pressure (ICP). We have previously reported frontal cerebral vulnerability with executive deficits from raised ICP in paediatric TBI. Now, using diffusion tensor imaging (DTI) in a different population, we have examined fractional anisotropy (FA), and mean, axial and radial diffusivity (MD, AD, RD) in 4 regions of the corpus callosum (CC) and in both inferior frontal regions. Our aim was to examine during the chronic phase of TBI whether the CC cross-sectional area correlated with regional DTI metrics of white matter microstructure, with global outcome ratings of function (Functional Independence Measure and Multiattribute Health Status Classification) and with performance in the Rey-Osterrieth Complex Figure (ROCF) test. We examined 33 paediatric TBI cases who were followed, on average, 4.9 years after severe injury. All cases had received mechanical ventilation during their acute treatment and, a priori, they were assigned to a non-ICP or a raised ICP group. Twenty-two participants had mainly right-sided injury at the time of acute ictus. The findings confirm that severe TBI in childhood, complicated by intracranial hypertension, results in CC vulnerability. In the chronic phase of recovery, it is reduced in the cross-sectional area, it is more compact and thinned, and the anterior region is disproportionately small. Late after raised ICP, we have also found that individuals exhibit regional microstructural abnormality with combined reduced FA and increased MD, AD and RD. Smaller size and such microstructural changes in the anterior CC were associated with similar right-sided (rather than left-sided) frontal microstructural changes in the ICP group. Taken together, this evidence points to an interaction between raised ICP-related brain tissue perturbation and focal frontal extracallosal injury, leading to anterior CC regional vulnerability, most likely wallerian degeneration. At long-term follow-up, this lack of white matter integrity in the anterior CC is correlated with functional outcome, particularly in aspects of social interaction and the copy component of the ROCF test, which suggests that the CC-to-forebrain function warrants further study in chronic TBI.

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Section: Discussionsupporting

confidence: 59%

Corpus Callosum and Inferior Forebrain White Matter Microstructure Are Related to Functional Outcome from Raised Intracranial Pressure in Child Traumatic Brain Injury

Tasker¹,

Westland²,

White

et al. 2010

Dev Neurosci

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“…It therefore stands to reason that it would be a site of structural and functional change after stroke, even when the inciting lesion is in a remote location in the contralateral hemisphere (so called transcallosal or transhemispheric diaschisis ) [35]. The notion of stroke lesions inciting changes in the contralateral hemisphere is further supported by diffusion tensor imaging studies demonstrating callosal degeneration after stroke [36]. …”

Section: Discussionmentioning

confidence: 81%

Contralesional Thalamic Surface Atrophy and Functional Disconnection 3 Months after Ischemic Stroke

et al. 2015

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Background: Remote structural and functional changes have been previously described after stroke and may have an impact on clinical outcome. We aimed to use multimodal MRI to investigate contralesional subcortical structural and functional changes 3 months after anterior circulation ischemic stroke. Methods: Fifteen patients with acute ischemic stroke had multimodal MRI imaging (including high resolution structural T1-MPRAGE and resting state fMRI) within 1 week of onset and at 1 and 3 months. Seven healthy controls of similar age group were also imaged at a single time point. Contralesional subcortical structural volume was assessed using an automated segmentation algorithm in FMRIB's Integrated Registration and Segmentation Tool (FIRST). Functional connectivity changes were assessed using the intrinsic connectivity contrast (ICC), which was calculated using the functional connectivity toolbox for correlated and anticorrelated networks (Conn). Results: Contralesional thalamic volume in the stroke patients was significantly reduced at 3 months compared to baseline (median change -2.1%, interquartile range [IQR] -3.4-0.4, p = 0.047), with the predominant areas demonstrating atrophy geometrically appearing to be the superior and inferior surface. The difference in volume between the contralesional thalamus at baseline (mean 6.41 ml, standard deviation [SD] 0.6 ml) and the mean volume of the 2 thalami in controls (mean 7.22 ml, SD 1.1 ml) was not statistically significant. The degree of longitudinal thalamic atrophy in patients was correlated with baseline stroke severity with more severe strokes being associated with a greater degree of atrophy (Spearman's rho -0.54, p = 0.037). There was no significant difference between baseline contralesional thalamic ICC in patients and control thalamic ICC. However, in patients, there was a significant linear reduction in the mean ICC of the contralesional thalamus over the imaging time points (p = 0.041), indicating reduced connectivity to the remainder of the brain. Conclusions: These findings highlight the importance of remote brain areas, such as the contralesional thalamus, in stroke recovery. Similar methods have the potential to be used in the prediction of stroke outcome or as imaging biomarkers of stroke recovery.

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“…One of the most important factors affecting the FA value is the integrity of axons and their myelin sheaths. Degeneration of neural tracts can therefore be detected by measurement of FA value [Gupta et al, 2006].…”

Section: Introductionmentioning

confidence: 99%

White matter tract integrity in aging and Alzheimer's disease

Damoiseaux

Smith

Witter

et al. 2008

Human Brain Mapping

224

158

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The pattern of degenerative changes in the brain white matter (WM) in aging, mild cognitive impairment (MCI), and Alzheimer's disease (AD) has been under debate. Methods of image analysis are an important factor affecting the outcomes of various studies. Here we used diffusion tensor imaging (DTI) to obtain fractional anisotropy (FA) measures of the WM in healthy young (n = 8), healthy elderly (n = 22), MCI (n = 8), and AD patients (n = 16). We then applied "tract-based spatial statistics" (TBSS) to study the effects of aging, MCI, and AD on WM integrity. Our results show that changes in WM integrity (that is, decreases in FA) are different between healthy aging and AD: in healthy older subjects compared with healthy young subjects decreased FA was primarily observed in frontal, parietal, and subcortical areas whereas in AD, compared with healthy older subjects, decreased FA was only observed in the left anterior temporal lobe. This different pattern of decreased anatomical connectivity in normal aging and AD suggests that AD is not merely accelerated aging.

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Focal Wallerian degeneration of the corpus callosum in large middle cerebral artery stroke: Serial diffusion tensor imaging

Cited by 83 publications

References 21 publications

Corpus Callosum and Inferior Forebrain White Matter Microstructure Are Related to Functional Outcome from Raised Intracranial Pressure in Child Traumatic Brain Injury

Corpus Callosum and Inferior Forebrain White Matter Microstructure Are Related to Functional Outcome from Raised Intracranial Pressure in Child Traumatic Brain Injury

Contralesional Thalamic Surface Atrophy and Functional Disconnection 3 Months after Ischemic Stroke

White matter tract integrity in aging and Alzheimer's disease

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