Abstract
Mesenchymal stem cells have potential as a regenerative therapy in ischemic stroke. We sought to determine MR imaging findings after mesenchymal stem cell implantation in chronic middle cerebral artery infarcts and to compare brain volume changes in patients with mesenchymal stem cells with those in age-matched healthy controls and controls with chronic stable MCA infarcts. We retrospectively identified 5 patients receiving surgical mesenchymal stem cell implantation to an MCA infarct from January 1, 2005, to July 1, 2013, with MR imaging immediately and 1 year postimplantation. Images at both time points were evaluated for any postimplantation complications. Structural image evaluation using normalization of atrophy software was used to determine volume changes between time points and compare them with those in healthy and age- and sex-matched controls with chronic, stable MCA infarcts by using Kruskal-Wallis and Mann-Whitney U tests. Susceptibility signal loss and enhancement at the implantation site were seen. No teratoma, tumor, or heterotopia was identified. Volumetric analysis showed a trend toward less overall volume loss after mesenchymal stem cell implantation (0.736; 95% CI, -4.15-5.62) compared with that in age- and sex-matched controls with chronic, stable MCA infarcts (-3.59; 95% CI, -12.3 to -5.21; P = .09), with a significantly greater growth-to-loss ratio in infarcted regions (1.30 and 0.78, respectively, P = .02). A trend toward correlation of growth-to-loss ratio with improvement in physical examination findings was seen (r = 0.856, P = .06). Postoperative changes consistent with stereotactic implantation were seen, but no teratoma, tumor, or heterotopia was identified. Initial findings suggest a trend toward less volume loss after mesenchymal stem cell implantation compared with that in age- and sex-matched controls with chronic, stable MCA infarcts, with a significantly greater growth-to-loss ratio in the infarcted tissue.
Highlights
ObjectivesThe purpose of our study was to determine MR imaging findings after mesenchymal stem cells (MSC) implantation in patients with chronic MCA infarcts and to compare global and regional brain volume changes in patients with MSC implants with age-matched healthy controls and controls with chronic stable MCA infarcts (MCAI controls)
BACKGROUND AND PURPOSEMesenchymal stem cells have potential as a regenerative therapy in ischemic stroke
Volumetric analysis showed a trend toward less overall volume loss after mesenchymal stem cell implantation (0.736; 95% CI, Ϫ4.15–5.62) compared with that in age- and sex-matched controls with chronic, stable MCA infarcts (Ϫ3.59; 95% CI, Ϫ12.3 to Ϫ5.21; P ϭ .09), with a significantly greater growth-to-loss ratio in infarcted regions (1.30 and 0.78, respectively, P ϭ .02)
Summary
The purpose of our study was to determine MR imaging findings after MSC implantation in patients with chronic MCA infarcts and to compare global and regional brain volume changes in patients with MSC implants with age-matched healthy controls and controls with chronic stable MCA infarcts (MCAI controls)
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