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Diffusional Kurtosis Imaging and Motor Outcome in Acute Ischemic Stroke.

Publication ,  Journal Article
Spampinato, MV; Chan, C; Jensen, JH; Helpern, JA; Bonilha, L; Kautz, SA; Nietert, PJ; Feng, W
Published in: AJNR Am J Neuroradiol
July 2017

BACKGROUND AND PURPOSE: Motor impairment is the most common deficit after stroke. Our aim was to evaluate whether diffusional kurtosis imaging can detect corticospinal tract microstructural changes in the acute phase for patients with first-ever ischemic stroke and motor impairment and to assess the correlations between diffusional kurtosis imaging-derived diffusion metrics for the corticospinal tract and motor impairment 3 months poststroke. MATERIALS AND METHODS: We evaluated 17 patients with stroke who underwent brain MR imaging including diffusional kurtosis imaging within 4 days after the onset of symptoms. Neurologic evaluation included the Fugl-Meyer Upper Extremity Motor scale in the acute phase and 3 months poststroke. For the corticospinal tract in the lesioned and contralateral hemispheres, we estimated with diffusional kurtosis imaging both pure diffusion metrics, such as the mean diffusivity and mean kurtosis, and model-dependent quantities, such as the axonal water fraction. We evaluated the correlations between corticospinal tract diffusion metrics and the Fugl-Meyer Upper Extremity Motor scale at 3 months. RESULTS: Among all the diffusion metrics, the largest percentage signal changes of the lesioned hemisphere corticospinal tract were observed with axial kurtosis, with an average 12% increase compared with the contralateral corticospinal tract. The strongest associations between the 3-month Fugl-Meyer Upper Extremity Motor scale score and diffusion metrics were found for the lesioned/contralateral hemisphere corticospinal tract mean kurtosis (ρ = -0.85) and axial kurtosis (ρ = -0.78) ratios. CONCLUSIONS: This study was designed to be one of hypothesis generation. Diffusion metrics related to kurtosis were found to be more sensitive than conventional diffusivity metrics to early poststroke corticospinal tract microstructural changes and may have potential value in the prediction of motor impairment at 3 months.

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Published In

AJNR Am J Neuroradiol

DOI

EISSN

1936-959X

Publication Date

July 2017

Volume

38

Issue

7

Start / End Page

1328 / 1334

Location

United States

Related Subject Headings

  • Upper Extremity
  • Treatment Outcome
  • Stroke
  • Pyramidal Tracts
  • Prospective Studies
  • Predictive Value of Tests
  • Nuclear Medicine & Medical Imaging
  • Movement Disorders
  • Middle Aged
  • Male
 

Citation

APA
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ICMJE
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Spampinato, M. V., Chan, C., Jensen, J. H., Helpern, J. A., Bonilha, L., Kautz, S. A., … Feng, W. (2017). Diffusional Kurtosis Imaging and Motor Outcome in Acute Ischemic Stroke. AJNR Am J Neuroradiol, 38(7), 1328–1334. https://doi.org/10.3174/ajnr.A5180
Spampinato, M. V., C. Chan, J. H. Jensen, J. A. Helpern, L. Bonilha, S. A. Kautz, P. J. Nietert, and W. Feng. “Diffusional Kurtosis Imaging and Motor Outcome in Acute Ischemic Stroke.AJNR Am J Neuroradiol 38, no. 7 (July 2017): 1328–34. https://doi.org/10.3174/ajnr.A5180.
Spampinato MV, Chan C, Jensen JH, Helpern JA, Bonilha L, Kautz SA, et al. Diffusional Kurtosis Imaging and Motor Outcome in Acute Ischemic Stroke. AJNR Am J Neuroradiol. 2017 Jul;38(7):1328–34.
Spampinato, M. V., et al. “Diffusional Kurtosis Imaging and Motor Outcome in Acute Ischemic Stroke.AJNR Am J Neuroradiol, vol. 38, no. 7, July 2017, pp. 1328–34. Pubmed, doi:10.3174/ajnr.A5180.
Spampinato MV, Chan C, Jensen JH, Helpern JA, Bonilha L, Kautz SA, Nietert PJ, Feng W. Diffusional Kurtosis Imaging and Motor Outcome in Acute Ischemic Stroke. AJNR Am J Neuroradiol. 2017 Jul;38(7):1328–1334.

Published In

AJNR Am J Neuroradiol

DOI

EISSN

1936-959X

Publication Date

July 2017

Volume

38

Issue

7

Start / End Page

1328 / 1334

Location

United States

Related Subject Headings

  • Upper Extremity
  • Treatment Outcome
  • Stroke
  • Pyramidal Tracts
  • Prospective Studies
  • Predictive Value of Tests
  • Nuclear Medicine & Medical Imaging
  • Movement Disorders
  • Middle Aged
  • Male