Predicting Functional Prognosis in Supratentorial Stroke Using [¹⁸F]Fluoro-2-deoxy-D-glucose Positron Emission...

Cerebral metabolic activity following stroke plays a crucial role in neurological recovery. This study aimed to investigate whether decreased cerebral metabolic activity, quantified by the asymmetry index (AI) using [¹⁸F]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET), predicts functional prognosis at 3 and 6 months in patients with supratentorial stroke.

Forty patients with a first-time supratentorial stroke were enrolled. Neurological status was quantified using the National Institutes of Health Stroke Scale (NIHSS) and the Motricity Index (MI) at baseline (time of PET acquisition), and at 3 and 6 months after stroke onset. Using PET imaging, metabolic AI was calculated for both the cerebral and cerebellar hemispheres. Correlations between AI and neurologic outcomes were analyzed according to the timing of PET acquisition, classified as the acute (1-14 days) or subacute (15-60 days) phases.

In the subacute group, cerebral AI showed significant correlations with NIHSS scores at baseline (r=0.511, p<0.01) and with both NIHSS (r=0.589, p<0.01) and MI (r=-0.479, p<0.01) at 3 months. These correlations strengthened at 6 months for both NIHSS (r=0.724, p<0.01) and MI (r=-0.744, p<0.01). However, no significant correlations were found between cerebral AI and neurological outcomes in the acute group. Cerebellar AI did not correlate with functional outcomes at any time point.

Cerebral metabolic asymmetry measured during the subacute phase of supratentorial stroke is a significant predictor of long-term neurological outcomes at 3 and 6 months.