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Thalamic Volume Loss Is Greater in Children Than in Adults Following Middle Cerebral Artery Territory Arterial
Emily J Mastej1, Michelle H Leppert2, Sharon Poisson2
1Computational Bioscience Program, University of Colorado Anschutz, Aurora, CO, USA.
Insights
Pediatric stroke patients experience greater thalamic volume loss compared to adults. This significant brain change in younger individuals following an acute ischemic stroke may impact long-term functional and cognitive outcomes.
Area of Science:
- Neurology
- Neuroimaging
- Pediatric Stroke
Background:
- Younger stroke patients may face poorer outcomes than older adults.
- The impact of stroke age on remote brain regions, like the thalamus, is not well understood.
- Thalamic volume changes following stroke are a key indicator of potential neurological deficits.
Purpose of the Study:
- To investigate age-related differences in thalamic volume loss after middle cerebral artery territory strokes.
- To quantify thalamic volume changes ipsilateral to the stroke in pediatric and adult populations.
- To establish a correlation between age at stroke onset and the degree of thalamic atrophy.
Main Methods:
- Retrospective cohort study of acute ischemic stroke (AIS) patients across three age groups: <9 years, 9-18 years, and >18 years.
- Acquisition of acute (<72 hours) and chronic (>90 days) magnetic resonance imaging (MRI) scans for all subjects.
- Manual segmentation of the thalamus to measure volume changes on both sides of the brain relative to stroke incidence.
Main Results:
- Both younger (<9 years) and older (9-18 years) pediatric stroke patients exhibited significantly greater ipsilateral thalamic volume loss (48.2% and 40.7%, respectively) compared to adult stroke patients.
- Statistical significance was observed for thalamic volume loss in pediatric groups (P=.022 for <9 years; P=.044 for 9-18 years).
- A consistent trend of decreased thalamic volume was noted across all age groups studied.
Conclusions:
- Thalamic volume reduction post-stroke is a phenomenon observed across all ages but is more pronounced in pediatric patients.
- Greater thalamic atrophy in younger individuals following stroke suggests potential for more severe long-term functional and cognitive impairments.
- These findings highlight the need for further research into the long-term neurological consequences of stroke in pediatric populations.
Abstract:
Background: Younger stroke patients may suffer worse outcomes than older patients; however, the extent to which age at stroke impacts remote areas of the brain remains unclear. The objective of this study was to determine thalamic volume changes ipsilateral to middle cerebral artery territory strokes based on age at acute ischemic stroke onset. Methods: Acute ischemic stroke patients <9 years, 9-18 years, and >18 years old were retrospectively recruited from a large quaternary care system. Each subject underwent an acute (<72 hours from AIS) and chronic (>90 days) magnetic resonance imaging (MRI) scan. Manual thalamic segmentation was performed. Results: Younger and older children had significantly greater stroke-side thalamic volume loss compared to adults (48.2%, P = .022; 40.7%, P = .044, respectively). Conclusions: Stroke-side thalamic volumes decreased across the age spectrum but to a greater degree in pediatric patients. This observation can affect functional and cognitive outcomes post stroke and warrants further research.
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