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Updated: Aug 29, 2026
Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
Plasmatic level of neuroinflammatory markers predict the extent of diffusion-weighted image lesions in hyperacute
Joan Montaner1, Alex Rovira, Carlos A Molina
1Neurovascular Research Laboratory, Stroke Unit, Vall d'Hebron Hospital, Barcelona, Spain. 31862jmv@comb.es
Abstract:
Sixteen patients with acute middle cerebral artery stroke were studied to correlate neuroinflammatory markers with perfusion- and diffusion-weighted magnetic resonance imaging (MRI) lesion volumes (PWI and DWI). At arrival (less than 6 hours), plasmatic matrix metalloproteinase (MMP)-9, MMP-2, interleukin (IL)-6, IL-8, intercellular adhesion molecule (ICAM)-1, and tumor necrosis factor (TNF)-alpha were serially measured (by ELISA), and MRI was performed. In cerebral ischemia, tissue destruction seems related to matrix metalloproteinases expression because baseline MMP-9 was the only predictor of the infarct volume measured as a DWI lesion (lineal regression: b = 0.50, 0.25-0.74; P < 0.001). Moreover, the extent of hypoperfused brain area (PWI) was associated with a proinflammatory cytokine release in the next hours (TNF-alpha and IL-6).
Insights
Matrix metalloproteinase-9 (MMP-9) levels predict infarct volume in acute middle cerebral artery stroke. Hypoperfused brain areas correlated with increased pro-inflammatory cytokines like tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6).
Area of Science:
- Neuroscience
- Biochemistry
- Radiology
Background:
- Acute stroke involves complex neuroinflammatory processes.
- Accurate prediction of infarct volume is crucial for treatment decisions.
Purpose of the Study:
- To correlate neuroinflammatory markers with MRI-derived lesion volumes in acute middle cerebral artery stroke.
- To identify predictors of infarct size and associated inflammatory responses.
Main Methods:
- Serial measurement of plasmatic neuroinflammatory markers (MMP-9, MMP-2, IL-6, IL-8, ICAM-1, TNF-alpha) using ELISA.
- Perfusion-weighted imaging (PWI) and diffusion-weighted imaging (DWI) MRI performed on 16 acute stroke patients within 6 hours of arrival.
- Linear regression analysis to assess correlations between markers and lesion volumes.
Main Results:
- Baseline matrix metalloproteinase-9 (MMP-9) was the sole significant predictor of diffusion-weighted imaging (DWI) infarct volume (b = 0.50, P < 0.001).
- The extent of hypoperfused brain areas on perfusion-weighted imaging (PWI) correlated with subsequent release of pro-inflammatory cytokines, including tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6).
Conclusions:
- MMP-9 is a key predictor of infarct size in acute middle cerebral artery stroke.
- Cerebral ischemia triggers a pro-inflammatory response, with hypoperfusion linked to cytokine release.
