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Updated: Oct 9, 2026
Modeling Mitochondrial Disease Using Brain Organoids: A Focus on Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like Episodes
Published on: October 10, 2025
Diffusion-weighted MR imaging in a case of mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike
K Yonemura1, Y Hasegawa, K Kimura
1Department of Medicine, National Cardiovascular Center, Suita, Osaka, Japan.
Abstract:
In a patient with mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes (MELAS), both T2- and diffusion-weighted MR imaging revealed lesions as hyperintense areas in the occipital lobes early after strokelike episodes. In these lesions, no significant reduction in apparent diffusion coefficient was noted. Apparent diffusion coefficient mapping may help to differentiate strokelike episodes in MELAS from acute ischemic stroke. The strokelike episodes may be related to vasogenic edema and hyperperfusion, which were suggested by our single-photon emission CT and MR imaging studies.
Insights
Diffusion-weighted MRI can help distinguish strokelike episodes in mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes (MELAS) from acute ischemic stroke. This finding aids in understanding MELAS-related brain changes.
Area of Science:
- Neurology
- Radiology
- Mitochondrial Diseases
Background:
- Mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes (MELAS) is a rare genetic disorder.
- Strokelike episodes in MELAS can mimic acute ischemic stroke on neuroimaging.
- Accurate differentiation is crucial for appropriate patient management.
Observation:
- T2- and diffusion-weighted MRI in a MELAS patient showed occipital lobe hyperintensities post-strokelike episodes.
- No significant reduction in apparent diffusion coefficient (ADC) was observed in these lesions.
- Single-photon emission CT (SPECT) suggested vasogenic edema and hyperperfusion.
Findings:
- Apparent diffusion coefficient (ADC) mapping may differentiate MELAS strokelike episodes from acute ischemic stroke.
- The observed MRI findings suggest vasogenic edema and hyperperfusion in MELAS strokelike episodes.
- Early post-episode imaging is key for identifying characteristic MELAS changes.
Implications:
- ADC mapping offers a potential tool for non-invasive diagnosis of MELAS-related events.
- Understanding the pathophysiology of MELAS strokelike episodes can guide future therapeutic strategies.
- Improved diagnostic accuracy can lead to better patient outcomes and prognostication.
