The new insights into human brain imaging after stroke

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Stroke imaging has evolved significantly over the past 20 years.
• New Magnetic Resonance Imaging (MRI) biomarkers are crucial for acute stroke management and predicting outcomes.
• Perfusion-weighted imaging aids in identifying optimal cerebral perfusion for reperfusion therapy response.

Purpose of the Study:

• To review novel radiological biomarkers developed in the last two decades for stroke.
• To assess their role in predicting functional, motor, and neuropsychological outcomes post-stroke.
• To highlight advancements in neuroimaging for personalized stroke medicine.

Main Methods:

• Review of recent studies on MRI biomarkers in acute ischemic stroke.
• Analysis of perfusion-weighted imaging for reperfusion therapy.
• Voxel-based lesion-symptom mapping to understand stroke location impact.
• Diffusion tensor imaging, magnetization transfer imaging, and spectroscopy for normal-appearing brain parenchyma analysis.

Main Results:

• Perfusion-weighted imaging is key for optimizing reperfusion therapy.
• Pre-stroke brain status (atrophy, white matter integrity, microinfarcts) influences outcome.
• Analysis of normal-appearing brain parenchyma provides new prognostic biomarkers.
• Novel biomarkers improve prediction of functional, motor, and neuropsychological recovery.

Conclusions:

• Advanced neuroimaging biomarkers offer improved prediction of stroke outcomes.
• These developments support the move towards personalized medicine in stroke care.
• Future therapeutic trials can utilize these biomarkers as targets.