Acute infarcts cause focal thinning in remote cortex via degeneration of connecting fiber tracts
Autor: | Benno Gesierich, Marco Duering, Ruthger Righart, Martin Dichgans, Vera Zietemann, Frank A. Wollenweber |
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Rok vydání: | 2015 |
Předmět: |
Brain Infarction
Male Pathology medicine.medical_specialty pathology [Nerve Net] Fiber tract Degeneration (medical) Nerve Fibers Myelinated Article White matter Lesion Cortex (anatomy) medicine Humans ddc:610 Stroke Aged Cerebral Cortex Aged 80 and over pathology [Nerve Fibers Myelinated] business.industry pathology [Brain Infarction] Anatomy Middle Aged medicine.disease Diffusion Tensor Imaging medicine.anatomical_structure Cerebral cortex pathology [Cerebral Cortex] Female sense organs Neurology (clinical) Nerve Net medicine.symptom business Follow-Up Studies Diffusion MRI |
Zdroj: | Neurology 84(16), 1685-1692 (2015). doi:10.1212/WNL.0000000000001502 |
ISSN: | 1526-632X 0028-3878 |
DOI: | 10.1212/wnl.0000000000001502 |
Popis: | To study remote effects distant from acute ischemic infarcts by measuring longitudinal changes of cortical thickness in connected brain regions as well as changes in microstructural integrity in connecting fiber tracts.Thirty-two patients (mean age 71 years) underwent a standardized protocol including multimodal MRI and clinical assessment both at stroke onset and 6 months after the event. Cortex connected to acute infarcts was identified by probabilistic diffusion tensor tractography starting from the acute lesion. Changes of cortical thickness were measured using the longitudinal stream of FreeSurfer. Microstructural damage in white matter tracts was assessed by changes of mean diffusivity.We found focal cortical thinning specifically in areas connected to acute infarcts (p0.001). Thinning was more pronounced in regions showing a high probability of connectivity to infarcts. Microstructural damage in white matter tracts connecting acute infarcts with distant cortex significantly correlated with thickness changes in that region (ρ = -0.39, p = 0.028). There was no indication of an influence of cavitation status or infarct etiology on the observed changes in cortex and white matter.These findings identify secondary degeneration of connected white matter tracts and remote cortex as key features of acute ischemic infarcts. Our observations may have implications for the understanding of structural and functional reorganization after stroke. |
Databáze: | OpenAIRE |
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