To analyze potential of different MRI methods in the quantitative assessment of brain lesions after ischemic stroke, 19 patients (mean age 38.9±6.2 years) with hemiparesis of various severity resulted from supratentorial ischemic stroke (6–12 months prior the examination) were studied. A relationship was established between such parameters as fractional anisotropy (FA), apparent diffusion coefficient (ADC), size of the brain lesion, and severity of motor deficit. The FA and ADC values obtained in the corticospinal tract (CST) projection allow them to be considered as indicators of the degree of the CST post-ischemic damage predicting motor deficit. FA was found to be the most reproducible indicator of the CST structural integrity. FA threshold values (index, %) for unfavorable outcome of the motor function restoration were determined as follows: 50% for posterior limb of internal capsule, 42% for cerebral peduncle, and 65% for pons varolii. High sensitivity and specificity of the obtained parameters provides ground for their use in identifying patients with poor prognosis for the motor function restoration.
MRI in the assessment of motor function restoration in patients with chronic supratentorial infarction
- Authors: Dobrynina L.A.1, Konovalov R.N.1, Kremneva Е.I.1, Kadykov A.S.1
-
Affiliations:
- Research Center of Neurology
- Issue: Vol 6, No 2 (2012)
- Pages: 4-10
- Section: Original articles
- Submitted: 02.02.2017
- Published: 10.02.2017
- URL: https://annaly-nevrologii.com/journal/pathID/article/view/277
- DOI: https://doi.org/10.17816/psaic277
- ID: 277
Cite item
Full Text
Abstract
About the authors
Larisa A. Dobrynina
Research Center of Neurology
Author for correspondence.
Email: dobrla@mail.ru
ORCID iD: 0000-0001-9929-2725
D. Sci. (Med.), Head, 3rd Neurology department
Россия, MoscowRodion N. Konovalov
Research Center of Neurology
Email: dobrla@mail.ru
ORCID iD: 0000-0001-5539-245X
Cand. Sci. (Med.), senior researcher, Neuroradiology department
Россия, 125367 Moscow, Volokolamskoye shosse, 80Еlena I. Kremneva
Research Center of Neurology
Email: dobrla@mail.ru
Россия, Moscow
Albert S. Kadykov
Research Center of Neurology
Email: dobrla@mail.ru
ORCID iD: 0000-0001-7491-7215
D. Sci. (Med.), Professor, senior researcher, 3rd Neurological department
Россия, MoscowReferences
- Кадыков А.С. Реабилитация после инсульта. М.: Миклош, 2003.
- Столярова Л.Г., Кадыков А.С., Вавилов С.Б. Особенности восстановления нарушенных двигательных функций у больных с ишемическим инсультом в зависимости от локализации и размеров очага поражения. Журн. невропатол. и психиатрии им. С.С. Корсакова 1985; 8: 1134–1138.
- Столярова Л.Г., Кадыков А.С., Ткачева Г.Р. Система оценок состояния двигательных функций у больных с постинсультными парезами. Журн. невропатол. и психиатрии им. С.С. Корсакова 1982; 9: 15–18.
- Суслина З.А., Пирадов М.А., Кротенкова М.В. и др. Диффузионно- и перфузионно-взвешенная магнитно-резонансная томография при ишемическом инсульте. Медицинская визуализация 2005; 5: 90–98.
- Baird A.E., Lövblad K.O., Dashe J.F. et al. Clinical correlations of diffusion and perfusion lesion volumes in acute ischemic stroke. Cerebrovasc. Dis. 2000; 10: 441–448.
- Basser P.J., Mattiello J., Le Bihan D. MR diffusion tensor spectroscopy and imaging. Biophys. 1994; 66: 259–267.
- Basser P.J., Pierpaoli C. Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI. J. Magn. Reson. 1996; 111: 209–219.
- Dunсan P.W., Goldstеin L.B., Маtсhаr D. et al. Меasurement of motor recovery аftеr stгoke: outcome assessment and samplе sizе requirmеnts. Stroke l992; 23: l084–1089.
- Gerloff C., Bushara K., Sailer A. et al. Multimodal imaging of brain reorganization in motor areas of the contralesional hemisphere of well recovered patients after capsular stroke. Brain 2006; 129: 791–808.
- Inoue Y., Matsumura Y., Fukuda T. et al. MR imaging of Wallerian degeneration in the brainstem: temporal relationships. Am. J. Neuroradiol. 1990; 11: 897–902.
- Jang S.H., Cho S.H., Kim Y.H. et al. Diffusion anisotrophy in the early stages of stroke can predict motor outcome. Restor. Neurol. Neurosci. 2005; 23: 11–17.
- Konishi J., Yamada K., Kizu O. et al. MR tractography for the evaluation of functional recovery from lenticulostriate infarcts. Neurology 2005; 64: 108–113.
- Kuhn M.J., Mikulis D.J., Ayoub D.M. et al. Wallerian degeneration after cerebral infarction: evaluation with sequential MR imaging. Radiology 1989; 172: 179–182.
- Kunimatsu A., Aoki S., Masutani Y. et al. Three-dimensional white matter tractography by diffusion tensor imaging in ischaemic stroke involving the corticospinal tract. Neuroradiology 2003; 45: 532–525. 10 Том 6. № 2 2012 Контактный адрес: Добрынина Лариса Анатольевна – канд. мед. наук, науч. сотр. III неврол. отд. ФГБУ «НЦН» РАМН. 125367 Москва, Волоколамское ш., д. 80. Тел.: +7 (495) 490-24-17; e-mail: dobrla@mail.ru Коновалов Р.Н. – ст. науч. сотр. отд. лучевой диагностики ФГБУ «НЦН» РАМН; Кремнева Е.И. – асп. отд. лучевой диагностики ФГБУ «НЦН» РАМН; Кадыков А.С. – зав. III неврол. отд. ФГБУ «НЦН» РАМН. To analyze potential of different MRI methods in the quantitative assessment of brain lesions after ischemic stroke, 19 patients (mean age 38.9±6.2 years) with hemiparesis of various severity resulted from supratentorial ischemic stroke (6–12 months prior the examination) were studied. A relationship was established between such parameters as fractional anisotropy (FA), apparent diffusion coefficient (ADC), size of the brain lesion, and severity of motor deficit. The FA and ADC values obtained in the corticospinal tract (CST) projection allow them to be considered as indicators of the degree of the CST post-ischemic damage predicting motor deficit. FA was found to be the most reproducible indicator of the CST structural integrity. FA threshold values (index, %) for unfavorable outcome of the motor function restoration were determined as follows: 50% for posterior limb of internal capsule, 42% for cerebral peduncle, and 65% for pons varolii. High sensitivity and specificity of the obtained parameters provides ground for their use in identifying patients with poor prognosis for the motor function restoration. MRI in the assessment of motor function restoration in patients with chronic supratentorial infarction L.A. Dobrynina, R.N. Konovalov, E.I. Kremneva, A.S. Kadykov Research Center of Neurology, Russian Academy of Medical Sciences (Moscow) Key words: ischemic stroke, motor recovery, fractional anisotropy, apparent diffusion coefficient, infarction volume
- Lövblad K.O., Baird A.E., Schlaug G. et al. Ischemic lesion volumes in acute stroke by diffusion-weighted magnetic resonance imaging correlate with clinical outcome. Ann. Neurol. 1997, 42: 164–170.
- Nelles M., Gieseke J., Flacke S. et al. Diffusion tensor pyramidal tractography in patients with anterior choroidal artery infarcts. Am. J. Neuroradiol. 2008; 29: 488–493.
- Rossi M.E., Jason E., Marchesotti S. et al. Diffusion tensor imaging correlates with lesion volume in cerebral hemisphere infarctions. BMC Medical Imaging 2010; 10: 21–33.
- Schaefer P.W., Grant P.E., Gonzalez R.G. Diffusion-weighted MR imaging of the brain. Radiology 2000; 217: 331–345.
- Strick P.L. Anatomical organization of multiple motor areas in the frontal lobe: implications for recovery of function. Adv. Neurol. 1988; 47: 293–312.
- Thomalla G., Glauche V., Koch M.A. Diffusion tensor imaging detects early Wallerian degeneration of the pyramidal tract after ischemic stroke. Neuroimage 2004; 22: 1767–1774.
- Thomalla G., Glauche V., Weiller C., Rother J. Time course of wallerian degeneration after ischaemic stroke revealed by diffusion tensor imaging. J. Neurol. Neurosurg. Psychiatry 2005; 76: 266–268.
- Warach S., Dashe J.F., Edelman R.R. Clinical outcome in ischemic stroke predicted by early diffusion-weighted and perfusion magnetic resonance imaging: a preliminary analysis. J. Cereb. Blood Flow Metab. 1996; 16: 53–59.
- Ward N.S. Future perspectives in functional neuroimaging in stroke recovery. Eura Medicophys 2007; 43: 285–294.
- Ward N.S., Brown M.M., Thompson A.J., Frackowiak R.S. Neural correlates of outcome after stroke: a cross-sectional fMRI study. Brain 2003; 126: 1430–1448.
- Weiller C., Ramsay S.C., Wise R.J. et al. Individual patterns of functional reorganization in the human cerebral cortex after capsular infarction. Ann. Neurol. 1993; 33: 181–189.
- Werring D.J., Toosy A.T., Clark C.A. et al. Diffusion tensor imaging can detect and quantify corticospinal tract degeneration after stroke. J. Neurol. Neurosurg. Psychiatry 2000; 69: 269–272.
- Yamada K, Ito H., Nakamura H. et al. Stroke patients’ evolving symptoms assessed by tractography. J. Magn. Reson. Imaging 2004; 20: 923–929.