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Published on: August 18, 2015
Diffusion Tensor Imaging Study After Intraarterial Cell Therapy in Acute Ischemic Stroke: A Substudy of the IBIS
Juan Antonio Cabezas-Rodriguez1, Carles Biarnes2, Marian Martí-Navas2
1Department of Neurology, Stroke Unit (J.A.C.-R., B.P.-G., L.A.-G., P.B.-P., M.M.-R., A.H., D.V., F.M.), Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen Del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.
Intraarterial bone marrow mononuclear cell (BM-MNC) therapy may improve stroke outcomes by preserving white matter tracts. This cell therapy showed better corticospinal tract integrity, correlating with improved clinical results in stroke patients.
Area of Science:
- Neuroscience
- Regenerative Medicine
- Clinical Neurology
Background:
- Intraarterial bone marrow mononuclear cell (BM-MNC) transplantation is a potential therapy for stroke.
- Diffusion tensor imaging (DTI) can assess white matter tract integrity.
Purpose of the Study:
- To determine if BM-MNC therapy alters DTI metrics in major white matter tracts after ischemic stroke.
- To correlate white matter tract integrity with clinical outcomes.
Main Methods:
- The IBIS trial (Phase IIb, randomized, controlled) included 77 patients with acute ischemic stroke.
- 38 patients had DTI data at baseline and 6 months; BM-MNC therapy was administered intraarterially.
- Fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity were analyzed in white matter tracts.
Main Results:
- BM-MNC therapy showed significantly less decrease in fractional anisotropy in the corticospinal tract and corpus callosum compared to controls.
- Greater preservation of the ipsilateral corticospinal tract correlated with better modified Rankin Scale and National Institutes of Health Stroke Scale scores.
Conclusions:
- Intraarterial BM-MNC transplantation within 7 days of stroke onset may modify white matter microstructure.
- This cell therapy appears to mitigate acute stroke damage, particularly in major projection fibers.
- Enhanced corticospinal tract preservation is linked to improved clinical outcomes post-stroke.
