Quantification of white matter injury following neonatal stroke with serial DTI

Aa, Niek E. van der; Northington, Frances J.; Stone, Brian; Groenendaal, Floris; Benders, Manon J. N. L.; Porro, Giorgio L.; Yoshida, Shoko; Mori, Susumu; Vries, Linda S. de; Zhang, Jiangyang

doi:10.1038/pr.2013.45

Cited by 30 publications

(22 citation statements)

References 30 publications

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“…17 A DTI study by van der Aa et al showed that fractional anisotropy values, while not initially lower after injury, do reflect functional pathway disruption at 3 months after perinatal stroke, and this alteration predicts cortical dysfunction in motor and visual pathways. 37 Our data seem to support this supposition, in that only 3 of 11 stroke patients showed normal contralateral sensorimotor activation on fMRI-the same 3 perinatal stroke patients with severe motor decline postoperatively.…”

Section: Predicting Motor Preservation After Hemispherectomysupporting

confidence: 63%

Corticospinal tract atrophy and motor fMRI predict motor preservation after functional cerebral hemispherectomy

Wang¹,

Ibrahim

Poliakov

et al. 2018

Journal of Neurosurgery: Pediatrics

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OBJECTIVEThe potential loss of motor function after cerebral hemispherectomy is a common cause of anguish for patients, their families, and their physicians. The deficits these patients face are individually unique, but as a whole they provide a framework to understand the mechanisms underlying cortical reorganization of motor function. This study investigated whether preoperative functional MRI (fMRI) and diffusion tensor imaging (DTI) could predict the postoperative preservation of hand motor function.METHODSThirteen independent reviewers analyzed sensorimotor fMRI and colored fractional anisotropy (CoFA)–DTI maps in 25 patients undergoing functional hemispherectomy for treatment of intractable seizures. Pre- and postoperative gross hand motor function were categorized and correlated with fMRI and DTI findings, specifically, abnormally located motor activation on fMRI and corticospinal tract atrophy on DTI.RESULTSNormal sensorimotor cortical activation on preoperative fMRI was significantly associated with severe decline in postoperative motor function, demonstrating 92.9% sensitivity (95% CI 0.661–0.998) and 100% specificity (95% CI 0.715–1.00). Bilaterally robust, symmetric corticospinal tracts on CoFA-DTI maps were significantly associated with severe postoperative motor decline, demonstrating 85.7% sensitivity (95% CI 0.572–0.982) and 100% specificity (95% CI 0.715–1.00). Interpreting the fMR images, the reviewers achieved a Fleiss’ kappa coefficient (κ) for interrater agreement of κ = 0.69, indicating good agreement (p < 0.01). When interpreting the CoFA-DTI maps, the reviewers achieved κ = 0.64, again indicating good agreement (p < 0.01).CONCLUSIONSFunctional hemispherectomy offers a high potential for seizure freedom without debilitating functional deficits in certain instances. Patients likely to retain preoperative motor function can be identified prior to hemispherectomy, where fMRI or DTI suggests that cortical reorganization of motor function has occurred prior to the operation.

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Section: Predicting Motor Preservation After Hemispherectomysupporting

confidence: 63%

Corticospinal tract atrophy and motor fMRI predict motor preservation after functional cerebral hemispherectomy

Wang¹,

Ibrahim

Poliakov

et al. 2018

Journal of Neurosurgery: Pediatrics

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“…Substantial efforts has been devoted to establish human normative maturation curves of diffusion indices in specific WM tracts (Dubois et al, 2008a; Geng et al, 2012; Sadeghi et al, 2013) with the hope that deviation of an individual subject data from a normative maturation curve would indicate injury(van der Aa et al, 2013) or developmental abnormalities (Prastawa et al, 2010). Such an approach definitely holds promise during rapid myelination period in the first 1-2 years of infancy when the magnitude of diffusion changes is large (Mukherjee et al, 2001; Sadeghi et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…Such an approach definitely holds promise during rapid myelination period in the first 1-2 years of infancy when the magnitude of diffusion changes is large (Mukherjee et al, 2001; Sadeghi et al, 2013). The link between rapid diffusion indices change and early myelination phase may explain why FA measurements at 3 month infants were found to be a more reliable predictor of neurodevelopmental outcome than in neonates after neonatal stroke (van der Aa et al, 2013). This is probably because of myelination being in rapid dynamic phase at 3 months and at this time, DTI indices are more sensitive to injury.…”

Section: Discussionmentioning

confidence: 99%

“…Fractional anisotropy (FA) and directional diffusivities changes are being increasingly used to diagnose early motor and cognitive abnormalities in neonates and infants (Anjari et al, 2007; Dubois et al, 2014; Rose et al, 2007; van der Aa et al, 2013; van Kooij et al, 2012). WM tracts are substantially anisotropic in diffusion weighted images even in fetuses and neonates long before the onset of myelination (Wimberger, Roberts et al 1995; Neil, Shiran et al 1998; Drobyshevsky, Song et al 2005).…”

Section: Introductionmentioning

confidence: 99%

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Functional correlates of central white matter maturation in perinatal period in rabbits

Drobyshevsky

Derrick

Luo

et al. 2014

Experimental Neurology

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Anisotropy indices derived from diffusion tensor imaging (DTI) are being increasingly used as biomarkers of central WM structural maturation, myelination and even functional development. Our hypothesis was that the rate of functional changes in central WM tracts directly reflects rate of changes in structural development as determined by DTI indexes. We examined structural and functional development of four major central WM tracts with different maturational trajectories, including internal capsule (IC), corpus callosum (CC), fimbria hippocampi (FH) and anterior commissure (AC). Rabbits were chosen due to perinatal brain development being similar to humans, and four time points were studied: P1, P11, P18 and adults. Imaging parameters of structural maturation included fractional anisotropy (FA), mean and directional diffusivities derived from DTI, and T2 relaxation time. Axonal composition and degree of myelination were confirmed on electron microscopy. To assess functional maturation, conduction velocity was measured in myelinated and non-myelinated fibers by electrophysiological recordings of compound action potential in perfused brain slices. Diffusion indices and T2 relaxation time in rabbits followed a sigmoid curve during development similar to that for humans, with active changes even at premyelination stage. The shape of the developmental curve was different between the fiber tracts, with later onset but steeper rapid phase of development in IC and FH than in CC. The structural development was not directly related to myelination or to functional development. Functional properties in projection (IC) and limbic tracts (FH) matured earlier than in associative and commissural tracts (CC and AC). The rapid phase of changes in diffusion anisotropy and T2 relaxation time coincided with development of functional responses and myelination in IC and FH between the second and third week of postnatal development in rabbits. In these two tracts, MRI indices could serve as surrogate markers of the early stage of myelination. However, the discordance between developmental change of diffusion indices, myelination and functional properties in CC and AC cautions against equating DTI indices changes as biomarkers for myelination in all tracts.

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“…In studies drawing subjects from the same longitudinal study [1][2][3], only the most recent data were reported. In studies using the same data [4][5][6], only the most recent and largest studies were reported. (Table 1) There are a wide range of visual abnormalities seen in perinatal stroke survivors (Table 1); 136 children were included.…”

Section: Resultsmentioning

confidence: 99%