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Longitudinal diffusion changes in cerebral hemispheres after MCA infarcts
Frédérique Buffon1, Nicolas Molko, Dominique Hervé
1Department of Neurology, CHU Lariboisière, Université Paris VII, Paris, France.
Abstract:
Diffusion tensor imaging can be used in vivo to assess the longitudinal and regional microstructural changes occurring after middle cerebral artery (MCA) infarcts in humans. Nine patients were investigated 1 week (D7), 1 (M1), 3 (M3), and 6 months (M6) after the occurrence of an isolated MCA infarction. First, an overall analysis was performed using histograms of mean diffusivity (MD) and fractional anisotropy (FA) in each hemisphere. Thereafter, the regional pattern of diffusion changes was investigated voxel by voxel with statistical parametric mapping 99. In the hemisphere ipsilateral to the infarction, histogram analysis revealed a significant decrease in FA between D7 and M6 associated with a progressive increase in MD from D7 to M3. Remote from the MCA territory, the voxel by voxel analyses detected a significant increase in MD within the thalamus at M3 and M6 and a reduction in FA along the pyramidal tract at M6. In the contralateral hemisphere, between D7 and M6, a significant hemispheric atrophy was observed in association with a global reduction in anisotropy, in the absence of distinctive regional diffusion changes. These results suggest that micro- and macrostructural tissue modifications can be detected with diffusion tensor imaging in regions remote from the ischemic area in both hemispheres.
Insights
Diffusion tensor imaging reveals microstructural changes in the brain after middle cerebral artery (MCA) infarction. These changes occur both near and far from the infarct, indicating widespread tissue modification over time.
Area of Science:
- Neuroimaging
- Neurology
- Biomedical Engineering
Background:
- Middle cerebral artery (MCA) infarction causes significant brain damage.
- Diffusion tensor imaging (DTI) is a powerful tool for assessing brain microstructure.
- Longitudinal studies are crucial for understanding post-infarction recovery and changes.
Purpose of the Study:
- To investigate longitudinal microstructural changes after MCA infarction using DTI.
- To assess both regional and remote effects of MCA infarction on brain tissue.
- To correlate diffusion changes with infarct progression and brain atrophy.
Main Methods:
- In vivo Diffusion Tensor Imaging (DTI) was performed on nine patients at multiple time points post-MCA infarction (D7, M1, M3, M6).
- Analysis included histogram analysis of mean diffusivity (MD) and fractional anisotropy (FA) and voxel-wise statistical parametric mapping (SPM).
- Hemispheric and regional analyses were conducted to identify specific patterns of microstructural alteration.
Main Results:
- Ipsilateral hemisphere showed decreased FA and increased MD over time.
- Remote regions, including the thalamus and pyramidal tract, exhibited significant MD and FA changes.
- Contralateral hemisphere displayed global atrophy and reduced anisotropy without distinct regional diffusion alterations.
Conclusions:
- DTI can detect longitudinal micro- and macrostructural tissue modifications after MCA infarction.
- Changes are not limited to the infarct core, extending to remote brain regions.
- Findings highlight the utility of DTI in characterizing the complex spatiotemporal evolution of brain injury post-stroke.
