NDLI: Quantitative Longitudinal Evaluation of Diaschisis-Related Cerebellar Perfusion and Diffusion Parameters in Patients with Supratentorial Hemispheric High-Grade Gliomas After Surgery

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Quantitative Longitudinal Evaluation of Diaschisis-Related Cerebellar Perfusion and Diffusion Parameters in Patients with Supratentorial Hemispheric High-Grade Gliomas After Surgery

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Quantitative Longitudinal Evaluation of Diaschisis-Related Cerebellar Perfusion and Diffusion Parameters in Patients with Supratentorial Hemispheric High-Grade Gliomas After Surgery

Content Provider	Springer Nature Link
Author	Patay, Zoltan Parra, Carlos Hawk, Harris George, Arun Li, Yimei Scoggins, Matthew Broniscer, Alberto Ogg, Robert J.
Copyright Year	2014
Abstract	Decreased cerebral blood volume (CBV) in contralateral cerebellar gray matter (cGM) in conjunction with cerebellar white matter (cWM) damage, consistent with crossed cerebro-cerebellar diaschisis (cCCD) develop following supratentorial hemispheric stroke. In this study, we investigated the longitudinal evolution of diaschisis-related cerebellar perfusion and diffusion tensor-imaging (DTI) changes in patients after surgery for supratentorial brain tumors. Eight patients (M:F 5:3, age 8–22 years) who received surgery for supratentorial high-grade gliomas were evaluated. Initial MRI studies were performed 19–54 days postoperatively, with follow-ups at 2- to 3-month intervals. For each study, parametric maps of the cerebellum were generated and coregistered to T1-weighted images that had been previously segmented for cGM and cWM. Aggregate mean values of CBV, cerebral blood flow (CBF), and fractional anisotropy (FA) were obtained separately for cGM and cWM, and asymmetry indices (AIs) were calculated. Hemodynamic changes were more robust in cGM than in cWM. Seven patients showed decreased perfusion within cGM contralateral to the supratentorial lesion on the first postoperative study, and asymmetry was significant for both CBV (p = 0.008) and CBF (p < 0.01). For CBV, follow-up studies showed a significant trend towards recovery (p < 0.02). DTI changes were more pronounced in cWM. FA values suggested a “paradoxical” increase at initial follow-up, but steadily declined thereafter (p = 0.0003), without evidence of subsequent recovery. Diaschisis-related hemodynamic alterations within cGM appear on early postoperative studies, but CBV recovers over time. Conversely, cWM DTI changes are delayed and progressive. Although the clinical correlates of cCCD are yet to be elucidated, better understanding of longitudinal structural and hemodynamic changes within brain remote from the area of primary insult could have implications in research and clinical rehabilitative strategies.
Starting Page	580
Ending Page	587
Page Count	8
File Format	PDF
ISSN	14734222
Journal	The Cerebellum
Volume Number	13
Issue Number	5
e-ISSN	14734230
Language	English
Publisher	Springer US
Publisher Date	2014-06-12
Publisher Place	Boston
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Diaschisis Cerebellar perfusion Diffusion tensor imaging Functional connectivity Magnetic resonance imaging Neurosciences Neurology Neurobiology
Content Type	Text
Resource Type	Article
Subject	Neurology Neurology (clinical)

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