Prediction of Motor Function Outcome after Intracerebral Hemorrhage Using Fractional Anisotropy Calculated from Diffusion Tensor Imaging

Abstract

Background: The efficacy of surgical evacuation in patients with intracerebral hemorrhage (ICH) remains unclear for recovery of motor function. The relationship between improvement of motor function outcome and sequential change of fractional anisotropy (FA) values was investigated in patients with ICH, to explore whether motor function outcome can be predicted in the early phase. Indication of the surgical hematoma evacuation was also considered. Methods: This prospective study included 23 patients with ICH. All patients underwent diffusion tensor imaging to measure the FA value five times: within 3 days, day 14, day 30, day 60, and day 90 after the onset. The regions of interest were determined on the b = 0 step of the echo planar imaging scans in the bilateral cerebral peduncles and were automatically transferred onto the FA images. The FA value was then calculated for each patient. Patients were divided into good and poor recovery groups according to the motor function outcome on day 90. Results: The mean FA value of the poor recovery group gradually decreased until day 90, but remained unchanged in the good recovery group. The mean FA value on day 3 was significantly higher (p < 0.001) in the good recovery group (0.745 ± 0.0073) than in the poor recovery group (0.682 ± 0.0090). Receiver operating characteristic curve analysis showed that the FA value on day 3 could predict motor function outcome with a sensitivity of 100% and a specificity of 77.8% at an FA value of 0.7 on day 3. Conclusion: The main finding of this study was that the FA values of the cerebral peduncle on the pathological side in patients with ICH on day 3 could predict the motor function outcome on day 90.

A selective CB2R agonist (JWH133) restores neuronal circuit after Germinal Matrix Hemorrhage in the preterm via CX3CR1+ microglia

“…In the present study, we used MRI-DTI to detect the effects of CB2R activation on white matter and neuronal circuits. As a novel investigation method, DTI has shown potential in studies of white matter injury and neurological deficits after brain injury (Fan et al, 2013;Kuzu et al, 2012). We acquired visible and qualitative images around the hematomas, although the pictures are not of a high resolution, and a several technical mistakes may have occurred.…”

Diffusion tensor imaging in hemorrhagic stroke

“…This means that some patients with poor motor function in the acute phase would improve in the chronic phase. In addition patients with high MFS of 5 or higher correlates with those patients likely to require surgical intervention to improve functional outcome (71). Thus Ching Ma et al surmise in their article that FA measurements may help to select patients who may benefit from surgical hematoma evacuation in turn enabling physicians with ability to predict motor recovery in advance and also choose effective treatment strategy.…”

Motor outcome of deep intracerebral haemorrhage in diffusion tensor imaging: comparison of data from different locations along the corticospinal tract

“…5 Recent studies using DTI and DTT have shown that reduced FA at cerebral peduncle noted 2-18 days after the putaminal or thalamic haemorrhage could predict poor short-term and long-term motor outcome. [6][7][8][9] The cerebral peduncle is distal to putamen or thalamus and reduced FA at this site is supposed to be attributed to Wallerian degeneration (WD). 10 However, in ischaemic stroke DTI study, both anterograde (WD) and retrograde degeneration occurred and were associated with poor recovery after stroke.…”