Global changes in diffusion tensor imaging during acute ischemic stroke and post-stroke cognitive performance.
Kyle C KernClinton B WrightRichard LeighPublished in: Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism (2022)
Post-stroke cognitive impairment is related to the effects of the acute stroke and pre-stroke brain health. We tested whether diffusion tensor imaging (DTI) can detect acute, global effects of stroke and predict post-stroke cognitive performance. Patients with stroke or TIA enrolled in a prospective cohort study were included if they had 1) at least one DTI acquisition at acute presentation, 24 hours, 5 days, or 30 days, and 2) follow-up testing with the telephone Montreal Cognitive Assessment (T-MoCA) at 30 and/or 90 days. A whole brain, white-matter skeleton excluding the infarct was used to derive mean global DTI measures for mean diffusivity (MD), fractional anisotropy (FA), free water (FW), FW-corrected MD (MD tissue ), and FW-corrected FA (FA tissue ). In 74 patients with ischemic stroke or TIA, there was a transient 4.2% increase in mean global FW between acute presentation and 24 hours (p = 0.024) that returned to initial values by 30 days (p = 0.03). Each acute global DTI measure was associated with 30-day T-MoCA score (n = 61, p = 0.0011-0.0076). Acute global FW, MD, FA and FA tissue were also associated with 90-day T-MoCA (n = 56, p = 0.0034-0.049). Transient global FW elevation likely reflects stroke-related interstitial edema, whereas other global DTI measures are more representative of pre-stroke brain health.
Keyphrases
- white matter
- liver failure
- atrial fibrillation
- cerebral ischemia
- respiratory failure
- drug induced
- multiple sclerosis
- healthcare
- acute ischemic stroke
- public health
- aortic dissection
- molecular dynamics
- mental health
- heart failure
- coronary artery disease
- subarachnoid hemorrhage
- hepatitis b virus
- resting state
- intensive care unit
- brain injury
- extracorporeal membrane oxygenation
- risk assessment
- social media
- mechanical ventilation
- acute respiratory distress syndrome