Possibilities of diff usion-weighted magnetic resonance imaging in determining the rehabilitation potential of the acute period of ischemic stroke

Abstract

Studies over the past decade demonstrate the high potential of diff usion-weighted MRI (dMRI) as a modern technique for non-invasive quantitative assessment of the microstructural integrity of the white matter of the brain, which allows predicting some aspects of the rehabilitation potential. Purpose of the study: to calculate the threshold values of fractional anisotropy (FA) of some cerebral tracts, which are informative in determining various aspects of the rehabilitation potential in the acute period of ischemic stroke. Patients and methods. We examined 100 patients with ischemic stroke and 10 persons without stroke and cognitive impairment. All patients underwent dMRI and clinical assessment of indicators of rehabilitation potential at discharge. Results. The NIHSS at discharge is associated with the size of infarction, the FA of the anterior, posterior leg and knee of the internal capsule, the superior longitudinal, cingular and inferior fronto-occipital bundles. Similar associations were noted for the Rivermead mobility index and the Rankin scale. The function of the hand according to the Frenchay scale is associated with the size of the lesion, FA of the anterior leg of the internal capsule, superior longitudinal, inferior fronto-occipital and cingular bundles. The MoCA is interrelated only with the size of the infarction and the FA of the anterior leg of the internal capsule, the Berg scale — with the size of the lesion and the FA of the upper longitudinal bundle, the FIM scale — with the FA of the upper longitudinal, inferior fronto-occipital and cingular bundles. The threshold values of FA of the cerebral tracts which are most informative in determining various aspects of the rehabilitation potential in the acute period of ischemic stroke were determined. Conclusion. The quantitative assessment of the FA of the main projection and associative tracts is informative in relation to the determination of the rehabilitation potential in the acute period of ischemic stroke.