Longitudinal microstructural alterations surrounding subcortical ischemic stroke lesions detected by free-water imaging
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Longitudinal microstructural alterations surrounding subcortical ischemic stroke lesions detected by free-water imaging. / Nägele, Felix L; Petersen, Marvin; Mayer, Carola; Bönstrup, Marlene; Schulz, Robert; Gerloff, Christian; Thomalla, Götz; Cheng, Bastian.
In: HUM BRAIN MAPP, Vol. 45, No. 8, 01.06.2024, p. e26722.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Longitudinal microstructural alterations surrounding subcortical ischemic stroke lesions detected by free-water imaging
AU - Nägele, Felix L
AU - Petersen, Marvin
AU - Mayer, Carola
AU - Bönstrup, Marlene
AU - Schulz, Robert
AU - Gerloff, Christian
AU - Thomalla, Götz
AU - Cheng, Bastian
N1 - © 2024 The Author(s). Human Brain Mapping published by Wiley Periodicals LLC.
PY - 2024/6/1
Y1 - 2024/6/1
N2 - In this study we explore the spatio-temporal trajectory and clinical relevance of microstructural white matter changes within and beyond subcortical stroke lesions detected by free-water imaging. Twenty-seven patients with subcortical infarct with mean age of 66.73 (SD 11.57) and median initial NIHSS score of 4 (IQR 3-7) received diffusion MRI 3-5 days, 1 month, 3 months, and 12 months after symptom-onset. Extracellular free-water and fractional anisotropy of the tissue (FAT) were averaged within stroke lesions and the surrounding tissue. Linear models showed increased free-water and decreased FAT in the white matter of patients with subcortical stroke (lesion [free-water/FAT, mean relative difference in %, ipsilesional vs. contralesional hemisphere at 3-5 days, 1 month, 3 months, and 12 months after symptom-onset]: +41/-34, +111/-37, +208/-26, +251/-18; perilesional tissue [range in %]: +[5-24]/-[0.2-7], +[2-20]/-[3-16], +[5-43]/-[2-16], +[10-110]/-[2-12]). Microstructural changes were most prominent within the lesion and gradually became less pronounced with increasing distance from the lesion. While free-water elevations continuously increased over time and peaked after 12 months, FAT decreases were most evident 1 month post-stroke, gradually returning to baseline values thereafter. Higher perilesional free-water and higher lesional FAT at baseline were correlated with greater reductions in lesion size (rho = -0.51, p = .03) in unadjusted analyses only, while there were no associations with clinical measures. In summary, we find a characteristic spatio-temporal pattern of extracellular and cellular alterations beyond subcortical stroke lesions, indicating a dynamic parenchymal response to ischemia characterized by vasogenic edema, cellular damage, and white matter atrophy.
AB - In this study we explore the spatio-temporal trajectory and clinical relevance of microstructural white matter changes within and beyond subcortical stroke lesions detected by free-water imaging. Twenty-seven patients with subcortical infarct with mean age of 66.73 (SD 11.57) and median initial NIHSS score of 4 (IQR 3-7) received diffusion MRI 3-5 days, 1 month, 3 months, and 12 months after symptom-onset. Extracellular free-water and fractional anisotropy of the tissue (FAT) were averaged within stroke lesions and the surrounding tissue. Linear models showed increased free-water and decreased FAT in the white matter of patients with subcortical stroke (lesion [free-water/FAT, mean relative difference in %, ipsilesional vs. contralesional hemisphere at 3-5 days, 1 month, 3 months, and 12 months after symptom-onset]: +41/-34, +111/-37, +208/-26, +251/-18; perilesional tissue [range in %]: +[5-24]/-[0.2-7], +[2-20]/-[3-16], +[5-43]/-[2-16], +[10-110]/-[2-12]). Microstructural changes were most prominent within the lesion and gradually became less pronounced with increasing distance from the lesion. While free-water elevations continuously increased over time and peaked after 12 months, FAT decreases were most evident 1 month post-stroke, gradually returning to baseline values thereafter. Higher perilesional free-water and higher lesional FAT at baseline were correlated with greater reductions in lesion size (rho = -0.51, p = .03) in unadjusted analyses only, while there were no associations with clinical measures. In summary, we find a characteristic spatio-temporal pattern of extracellular and cellular alterations beyond subcortical stroke lesions, indicating a dynamic parenchymal response to ischemia characterized by vasogenic edema, cellular damage, and white matter atrophy.
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Ischemic Stroke/diagnostic imaging
KW - White Matter/diagnostic imaging
KW - Diffusion Magnetic Resonance Imaging/methods
KW - Longitudinal Studies
KW - Water
KW - Brain/diagnostic imaging
KW - Anisotropy
U2 - 10.1002/hbm.26722
DO - 10.1002/hbm.26722
M3 - SCORING: Journal article
C2 - 38780442
VL - 45
SP - e26722
JO - HUM BRAIN MAPP
JF - HUM BRAIN MAPP
SN - 1065-9471
IS - 8
ER -