Acute infarcts cause focal thinning in remote cortex via degeneration of connecting fiber tracts
Acute infarcts cause focal thinning in remote cortex via degeneration of connecting fiber tracts
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DOI：
10.1212/wnl.0000000000001502
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发表时间：
2015-04-21
期刊：
影响因子：
9.9
通讯作者：
Dichgans, Martin
中科院分区：
文献类型：
--
作者：
Duering, Marco;Righart, Ruthger;Dichgans, Martin
目的：研究远程影响远离急性缺血性梗死通过测量纵向变化的皮质厚度在连接的大脑区域，以及在连接fiber tracts.Methods的微观结构的完整性的变化：32例（平均年龄71岁）进行了标准化的协议，包括多模式MRI和临床评估中风发作和6个月后的事件。从急性病变开始，通过概率扩散张量纤维束成像确定与急性梗死相连的皮质。使用FreeSurfer的纵向流测量皮质厚度的变化。通过平均扩散率的变化评估了白色物质束的微结构损伤。结果：我们发现了与急性梗死相关区域的局灶性皮质变薄（p < 0.001）。变薄在显示与梗死连通性高的可能性的区域更明显。连接急性梗死和远端皮质的白色物质束的显微结构损伤与该区域的厚度变化显著相关（=-0.39，p = 0.028）。有没有迹象表明，在皮层和白色matters.Conclusions观察到的变化的空化状态或梗死病因的影响：这些研究结果确定继发性变性的连接白色物质束和远程皮质急性缺血性梗死的关键特征。我们的观察结果可能对理解中风后的结构和功能重组有影响。
Objective:To study remote effects distant from acute ischemic infarcts by measuring longitudinal changes of cortical thickness in connected brain regions as well as changes in microstructural integrity in connecting fiber tracts.Methods:Thirty-two patients (mean age 71 years) underwent a standardized protocol including multimodal MRI and clinical assessment both at stroke onset and 6 months after the event. Cortex connected to acute infarcts was identified by probabilistic diffusion tensor tractography starting from the acute lesion. Changes of cortical thickness were measured using the longitudinal stream of FreeSurfer. Microstructural damage in white matter tracts was assessed by changes of mean diffusivity.Results:We found focal cortical thinning specifically in areas connected to acute infarcts (p < 0.001). Thinning was more pronounced in regions showing a high probability of connectivity to infarcts. Microstructural damage in white matter tracts connecting acute infarcts with distant cortex significantly correlated with thickness changes in that region ( = -0.39, p = 0.028). There was no indication of an influence of cavitation status or infarct etiology on the observed changes in cortex and white matter.Conclusions:These findings identify secondary degeneration of connected white matter tracts and remote cortex as key features of acute ischemic infarcts. Our observations may have implications for the understanding of structural and functional reorganization after stroke.