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Altered DTI-ALPS index in Acute Pontine Stroke: Associations with Infarct Size and Cognition
Liqing Dong1, Liqiang Sun2, Pengchao Wang2
1Hebei General Hospital, Department of Ultrasound, Shijiazhuang, China, 050051.
European Journal of Radiology
|June 8, 2026
Summary
Acute pontine stroke impairs remote brain diffusion, measured by DTI-ALPS. This diffusion tensor imaging analysis along the perivascular space index correlates with stroke severity and cognitive function, offering insights into infratentorial lesion effects.
Area of Science:
- Neuroimaging
- Stroke Research
- Diffusion Tensor Imaging
Background:
- The pons is a crucial relay for white matter tracts, but its effect on distant brain diffusion is unknown.
- Investigating remote effects of pontine lesions is vital for understanding stroke consequences.
Purpose of the Study:
- To examine alterations in the diffusion tensor image analysis along the perivascular space (DTI-ALPS) index in patients with acute pontine stroke.
- To assess the association between DTI-ALPS, infarct size, and cognitive function in pontine stroke patients.
Main Methods:
- 103 acute unilateral pontine stroke (PS) patients and 60 healthy controls (HCs) underwent diffusion tensor imaging (DTI).
- DTI-ALPS indices and diffusion parameters were compared between groups.
- Correlations with NIHSS, MoCA, and infarct ratio (RPS) were analyzed.
Main Results:
- Pontine stroke patients exhibited significantly reduced bilateral DTI-ALPS indices compared to controls (P < 0.01).
- In PS patients, DTI-ALPS negatively correlated with infarct burden (RPS; ρ = -0.19, P = 0.048) and positively with MoCA scores (ρ = 0.64, P < 0.001).
- Infarct burden (RPS) correlated positively with NIHSS (ρ = 0.36, P < 0.001) and negatively with MoCA (ρ = -0.69, P < 0.001).
Conclusions:
- Acute pontine stroke is linked to impaired perivascular diffusion in remote cerebral hemispheres.
- The DTI-ALPS index serves as a potential biomarker for infarct burden and cognitive deficits.
- This study highlights a novel approach to understanding remote supratentorial changes from infratentorial pontine lesions.
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