Mapping remote subcortical ramifications of injury after ischemic strokes.
Mapping remote subcortical ramifications of injury after ischemic strokes.
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DOI：
10.1155/2014/215380
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发表时间：
2014
影响因子：
2.8
通讯作者：
Fridriksson J
中科院分区：
文献类型：
--
作者：
Bonilha L;Nesland T;Rorden C;Fillmore P;Ratnayake RP;Fridriksson J
背景慢性脑卒中患者的脑损伤程度传统上被定义为磁共振成像（MRI）上观察到的坏死组织。然而，患者通常表现出的症状表明，功能障碍可能会影响皮质坏死病变以外的区域，例如，当皮质下损伤后皮质症状接踵而至。这一观察结果表明，断开或神经联系不能可导致远端皮质功能障碍，其功能等同于直接皮质病变。Objective.直接测量脑卒中后皮层下神经切断。方法.我们描述了一个原则性的方法，利用全脑连接体重建的扩散MRI评估减少明显的白色纤维密度的半球相比，受中风影响的备用半球。结果在8例慢性中风患者中，我们观察到皮质下分离延伸超出组织坏死的位置，并影响坏死区域下方的主要白色物质通路。结论.我们认为，这是可能的，以检测和量化以前不受重视的领域皮层下和皮层断开。具体而言，该方法可用于评估病变位置和症状之间的关系，重点是基于连通性的方法。
Background. The extent of brain damage in chronic stroke patients is traditionally defined as the necrotic tissue observed on magnetic resonance image (MRI). However, patients often exhibit symptoms suggesting that functional impairment may affect areas beyond the cortical necrotic lesion, for example, when cortical symptoms ensue after subcortical damage. This observation suggests that disconnection or diaschisis can lead to remote cortical dysfunction that can be functionally equivalent to direct cortical lesions. Objective. To directly measure subcortical disconnection after stroke. Methods. We describe a principled approach utilizing the whole brain connectome reconstructed from diffusion MRI to evaluate the reduction of apparent white matter fiber density in the hemisphere affected by the stroke compared with the spared hemisphere. Results. In eight chronic stroke patients, we observed subcortical disconnection extending beyond the location of tissue necrosis and affecting major white matter pathways underlying the necrotic area. Conclusions. We suggest that it is possible to detect and quantify previously unappreciated areas of subcortical and cortical disconnection. Specifically, this method can be used to evaluate the relationship between lesion location and symptoms, with emphasis on a connectivity-based approach.