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Updated: May 13, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Quantification of white matter injury following neonatal stroke with serial DTI
Niek E van der Aa1, Frances J Northington, Brian S Stone
1Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
Insights
Diffusion tensor imaging (DTI) at 3 months post-perinatal arterial ischemic stroke (PAIS) predicts neurodevelopmental outcomes. Early DTI scans may underestimate injury extent, highlighting the importance of later assessments for predicting long-term effects.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Developmental Neuroscience
Background:
- Perinatal arterial ischemic stroke (PAIS) is a significant cause of long-term neurological deficits in children.
- Diffusion tensor imaging (DTI) shows promise in predicting outcomes after PAIS, but longitudinal white matter changes are not well understood.
Purpose of the Study:
- To investigate serial white matter changes using DTI in infants with PAIS.
- To assess the predictive value of fractional anisotropy (FA) measurements at different time points for neurodevelopmental outcomes.
Main Methods:
- Serial DTI scans were performed on infants with PAIS during the neonatal period, at 3 months, and at 24 months.
- Fractional anisotropy (FA) values were measured in key white matter regions and compared between affected infants and controls.
- FA values were correlated with neurodevelopmental assessments and outcomes.
Main Results:
- No significant FA differences were observed in the neonatal period.
- At 3 months, infants who later developed motor deficits showed reduced FA in affected regions.
- Lower FA in the optic radiation correlated with visual field defects, and corpus callosum FA at 3 months correlated with developmental quotients.
Conclusions:
- Neonatal DTI may underestimate the extent of brain injury in PAIS.
- FA measurements at 3 months are more reliable predictors of 24-month neurodevelopmental outcomes.
- Serial DTI provides valuable insights into white matter development and recovery trajectories after PAIS.
Background:
Diffusion tensor imaging (DTI) can be used to predict outcome following perinatal arterial ischemic stroke (PAIS), although little is known about white matter changes over time.
Methods:
Infants with PAIS were serially scanned in the neonatal period (n = 15), at 3 mo (n = 16), and at 24 mo (n = 8). Fractional anisotropy (FA) values in five regions of interest (anterior and posterior limb of the internal capsule, corpus callosum, optic radiation, and posterior thalamic radiation) were obtained and compared with FA values of healthy controls and neurodevelopmental outcome.
Results:
In the neonatal period, no differences in FA values were found. At 3 mo, the six infants who ultimately developed motor deficits showed lower FA values in all affected regions. Four infants developed a visual field defect and showed lower FA values in the affected optic radiation at 3 mo (0.22 vs. 0.29; P = 0.03). Finally, a correlation between FA values of the corpus callosum at 3 mo and the Griffiths developmental quotients was found (r = 0.66; P = 0.03). At 24 mo, a similar pattern was observed.
Conclusion:
Neonatal FA measurements may underestimate the extent of injury following PAIS. FA measurements at 3 mo could be considered a more reliable predictor of neurodevelopmental outcome and correlate with DTI findings at 24 mo.
