May 29, 2014

Mapping remote subcortical ramifications of injury after ischemic strokes

Behavioural Neurology
Leonardo BonilhaJulius Fridriksson


The extent of brain damage in chronic stroke patients is traditionally defined as the necrotic tissue observed on magnetic resonance image (MRI). However, patients often exhibit symptoms suggesting that functional impairment may affect areas beyond the cortical necrotic lesion, for example, when cortical symptoms ensue after subcortical damage. This observation suggests that disconnection or diaschisis can lead to remote cortical dysfunction that can be functionally equivalent to direct cortical lesions. Objective. To directly measure subcortical disconnection after stroke. We describe a principled approach utilizing the whole brain connectome reconstructed from diffusion MRI to evaluate the reduction of apparent white matter fiber density in the hemisphere affected by the stroke compared with the spared hemisphere. In eight chronic stroke patients, we observed subcortical disconnection extending beyond the location of tissue necrosis and affecting major white matter pathways underlying the necrotic area. We suggest that it is possible to detect and quantify previously unappreciated areas of subcortical and cortical disconnection. Specifically, this method can be used to evaluate the relationship between lesion location and sym...Continue Reading

  • References18
  • Citations14


  • References18
  • Citations14


Mentioned in this Paper

Biochemical Pathway
Diffusion Magnetic Resonance Imaging
Acute Cerebrovascular Accidents
Malformations of Cortical Development
Structure of Cortex of Kidney
Cerebrovascular Accident
Neural Pathways

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