Abstract
Neurological deficits after stroke are closely related to white matter microstructure damage. However, secondary changes in white matter microstructure after pontine infarction (PI) in the whole brain remain unclear. This study aimed to investigate the correlation of diffusion kurtosis imaging (DKI)-derived diffusion and kurtosis parameters of abnormal white matter tracts with behavioral function in patients with chronic PI. Overall, 60 patients with unilateral chronic PI (33 patients with left PI and 27 patients with right PI) and 30 normal subjects were recruited and underwent DKI scans. Diffusion parameters derived from diffusion tensor imaging (DTI) and DKI and kurtosis parameters derived from DKI were obtained. Between-group differences in multiple parameters were analyzed to assess the changes in abnormal white matter microstructure. Moreover, we also calculated the sensitivities of different diffusion and kurtosis parameters of DTI and DKI for identifying abnormal white matter tracts. Correlations between the DKI-derived parameters in secondary microstructure changes and behavioral scores in the PI were analyzed. Compared with the NC group, both left PI and right PI groups showed more extensive perilesional and remote white matter microstructure changes. The DKI-derived diffusion parameters showed higher sensitivities than did the DTI-derived parameters. Further, DKI-derived diffusion and kurtosis parameters in abnormal white matter regions were correlated with impaired motor and cognitive function in patients with PI. In conclusion, PI could lead to extensive white matter tracts impairment in perilesional and remote regions. Further, the diffusion and kurtosis parameters could be complementary for identifying comprehensive tissue microstructural damage after PI.
Highlights
Pons is the most common site of the posterior circulation stroke, and pontine infarction (PI) accounts for approximately 7% of all ischemic strokes (Huang et al, 2019)
This study aimed to investigate the correlations between diffusion kurtosis imaging (DKI)-derived diffusion and kurtosis parameters of abnormal white matter tracts and behavioral function in patients with chronic PI
There were no significant differences in demographic data, such as age, sex, and years of education, between the normal control (NC) and PI groups
Summary
Pons is the most common site of the posterior circulation stroke, and pontine infarction (PI) accounts for approximately 7% of all ischemic strokes (Huang et al, 2019). Some patients with chronic PI exhibit behavioral dysfunctions, such as motor and cognition impairment (Maeshima et al, 2012). Previous studies on brain injuries after PI primarily emphasized the pathological alterations of neuronal cells in gray matter and revealed extensive structural and functional changes in gray matter regions, some of which are related to behavioral impairment and recovery (Jiang et al, 2019; Wei et al, 2020a,b). White matter acts as a relay station for the central nervous system and is responsible for the information exchange and communication between different gray matter areas. There have been relatively few studies regarding the effects of PI on white matter microstructure
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