Structural plasticity of remote cortical brain regions is determined by connectivity to the primary lesion in subcortical stroke
Structural plasticity of remote cortical brain regions is determined by connectivity to the primary lesion in subcortical stroke
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DOI：
10.1038/jcbfm.2015.74
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发表时间：
2015-09-01
影响因子：
6.3
通讯作者：
Thomalla, Goetz
中科院分区：
文献类型：
--
作者：
Cheng, Bastian;Schulz, Robert;Thomalla, Goetz
皮质萎缩是各种神经退行性疾病的标志，可以通过皮质厚度测量（CT）来证明。急性缺血性中风后，大脑结构发生动态变化，可以在中风后3个月通过结构和功能磁共振成像研究来追踪。在本研究中，我们使用Freesurfer软件结合白质束造影和半自动CT测量，测量了12例上肢轻瘫患者皮质下脑卒中病变连接区域的CT变化。脑卒中后3个月，缺血性病变连接区域的CT显著下降-2.6%（中位数，95%置信区间上/下边界-4.1%/-1.1%），而未连接皮质区域的CT基本保持不变。使用基于表面的一般线性模型校正多重比较，在中风半球的额上回检测到一组显著的皮质变薄。CT变化与临床预后参数无明显相关性。我们的研究结果表明，皮层下病变对远端皮层区域的特定影响，但可以通过远端区域的继发性神经轴突变性来解释。
Cortical atrophy as demonstrated by measurement of cortical thickness (CT) is a hallmark of various neurodegenerative diseases. In the wake of an acute ischemic stroke, brain architecture undergoes dynamic changes that can be tracked by structural and functional magnetic resonance imaging studies as soon as 3 months after stroke. In this study, we measured changes of CT in cortical areas connected to subcortical stroke lesions in 12 patients with upper extremity paresis combining white-matter tractography and semi-automatic measurement of CT using the Freesurfer software. Three months after stroke, a significant decrease in CT of -2.6% (median, upper/lower boundary of 95% confidence interval -4.1%/-1.1%) was detected in areas connected to ischemic lesions, whereas CT in unconnected cortical areas remained largely unchanged. A cluster of significant cortical thinning was detected in the superior frontal gyrus of the stroke hemisphere using a surface-based general linear model correcting for multiple comparisons. There was no significant correlation of changes in CT with clinical outcome parameters. Our results show a specific impact of subcortical lesions on distant, yet connected cortical areas explainable by secondary neuro-axonal degeneration of distant areas.