Abstract
After stroke, white matter integrity can be affected both locally and distally to the primary lesion location. It has been shown that tract disruption in mirror’s regions of the contralateral hemisphere is associated with degree of functional impairment. Fourteen patients suffering right hemispheric focal stroke (S) and eighteen healthy controls (HC) underwent Diffusion Weighted Imaging (DWI) and neuropsychological assessment. The stroke patient group was divided into poor (SP; n = 8) and good (SG; n = 6) cognitive recovery groups according to their cognitive improvement from the acute phase (72 hours after stroke) to the subacute phase (3 months post-stroke). Whole-brain DWI data analysis was performed by computing Diffusion Tensor Imaging (DTI) followed by Tract Based Spatial Statistics (TBSS). Assessment of effects was obtained computing the correlation of the projections on TBSS skeleton of Fractional Anisotropy (FA) and Radial Diffusivity (RD) with cognitive test results. Significant decrease of FA was found only in right brain anatomical areas for the S group when compared to the HC group. Analyzed separately, stroke patients with poor cognitive recovery showed additional significant FA decrease in several left hemisphere regions; whereas SG patients showed significant decrease only in the left genu of corpus callosum when compared to the HC. For the SG group, whole brain analysis revealed significant correlation between the performance in the Semantic Fluency test and the FA in the right hemisphere as well as between the performance in the Grooved Pegboard Test (GPT) and theTrail Making Test-part A and the FA in the left hemisphere. For the SP group, correlation analysis revealed significant correlation between the performance in the GPT and the FA in the right hemisphere.
Highlights
Stroke and cerebrovascular disease is a major cause of mortality and disability worldwide [1]
A higher frequency of diabetes mellitus was found in the stroke group with poor cognitive recovery compared to the healthy controls (HC) group
All infarcts were in the territory supplied by the right MCA with the exception of 2 infarcts located in the right PCA territory
Summary
Stroke and cerebrovascular disease is a major cause of mortality and disability worldwide [1]. 64% of patients who have experienced stroke have some degree of cognitive impairment and up to a third of them develop dementia [2]. Cytotoxic edema occurrence produces both a decrease in the extracellular volume fraction and changes in membrane permeability [4]. These events reduce white matter (WM) integrity locally, at the primary lesion location, due to tissue damage or remotely as a consequence of anterograde Wallerian (WD) and/or retrograde axonal degeneration [5]. Reduced WM integrity has been found to be associated with cognitive impairment [6,7,8]
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