Diffusional Kurtosis Imaging and Motor Outcome in Acute Ischemic Stroke.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Spampinato, MV; Chan, C; Jensen, JH; Helpern, JA; Bonilha, L; Kautz, SA; Nietert, PJ; Feng, W

Published Date

  • July 2017

Published In

Volume / Issue

  • 38 / 7

Start / End Page

  • 1328 - 1334

PubMed ID

  • 28473339

Pubmed Central ID

  • PMC5509471

Electronic International Standard Serial Number (EISSN)

  • 1936-959X

International Standard Serial Number (ISSN)

  • 0195-6108

Digital Object Identifier (DOI)

  • 10.3174/ajnr.a5180

Language

  • eng