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Basal Ganglia versus Peripheral Infarcts: Predictive Value of Early Fiber Alterations.
M T Berndt1, D Pürner2, C Maegerlein3
1From the Departments of Neuroradiology (M.T.B., C.M., B.F., C.Z., D.S., T.B.-B.) maria.berndt@tum.de.
AJNR. American Journal of Neuroradiology
|December 11, 2020
Summary
Early assessment of corticospinal tract integrity after stroke using diffusion tensor imaging (DTI) can predict motor outcomes. Peripheral infarcts show a stronger correlation between tract integrity and clinical course than basal ganglia infarcts.
Area of Science:
- Neuroscience
- Radiology
- Neurology
Background:
- Impaired corticospinal tract fiber integrity post-ischemic stroke correlates with poor motor function.
- Early detection of tract damage is crucial for predicting stroke recovery.
Purpose of the Study:
- To assess corticospinal tract fiber integrity in the acute phase after ischemic stroke.
- To evaluate the association between tract integrity and clinical outcomes based on infarction patterns (peripheral vs. basal ganglia).
Main Methods:
- Diffusion tensor imaging (DTI) was used to analyze the fractional anisotropy (FA) index of the corticospinal tract in 165 patients post-mechanical recanalization.
- FA index was correlated with clinical parameters (NIHSS, mRS) and analyzed for moderation by stroke subtype.
Main Results:
- Reduced FA index in the acute phase correlated with clinical presentation, particularly in peripheral infarcts (NIHSS motor subscore: r = -0.4, P < .001).
- This correlation was absent in basal ganglia infarcts (r = -0.008, P > .05).
- FA index showed a significant association with 90-day clinical outcome (mRS), moderated by stroke subtype, with effects mainly in peripheral infarcts.
Conclusions:
- Corticospinal tract abnormalities are detectable early post-mechanical recanalization and possess prognostic value.
- Early DTI parameters enhance clinical assessment of stroke prognosis.
- Further longitudinal studies are needed for basal ganglia infarcts due to limited observed effects.
