Changes in subcortical white matter in the unaffected hemisphere following unilateral spontaneous intracerebral hemorrhage: a tract-based spatial statistics study.

Abstract

We investigated changes in the subcortical white matter in the unaffected hemisphere in patients with unilateral intracerebral hemorrhage (ICH) by applying tract-based spatial statistics (TBSS) analysis. Twenty-four patients with ICH and 17 healthy control subjects were recruited for this study. Diffusion tensor imaging (DTI) data were obtained at least four weeks after ICH onset. TBSS analysis was performed using fractional anisotropy (FA) DTI data. We calculated mean FA values across the tract skeleton and within 27 regions of interest (ROIs) based on the observed intersections between the FA skeleton and the probabilistic Johns Hopkins University white matter atlases. The FA values of 27 ROIs in the unaffected hemisphere in the patient group were significantly lower than those of the control group (p < 0.05). In terms of a causal relationship between possible confounding factors (sex, age, lateralization [right], lesion volume), a negative correlation coefficient was observed in five ROIs (the tapetum, sagittal stratum, column and body of the fornix, posterior corona radiate, inferior cerebellar peduncle, superior cerebellar peduncle) in the regression analysis (p < 0.05). In the patient group, moderate negative correlations were detected between ICH volume and the FA values of two ROIs: the sagittal stratum, r = -0.479, p < 0.05; the tapetum, r = -0.414, p < 0.05. We detected extensive neural injury of the subcortical white matter in the unaffected hemisphere in patients with unilateral ICH. In addition, injury severities of neural structures located around the mid-sagittal line or periventricular areas were correlated with ICH volume.