NDLI: Acute corticospinal tract Wallerian degeneration is associated with stroke outcome.

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Acute corticospinal tract Wallerian degeneration is associated with stroke outcome.

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Acute corticospinal tract Wallerian degeneration is associated with stroke outcome.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Goyal, Mayank Eesa, Muneer Kirton, Adam DeVetten, Giselle O'Brien, Brian Demchuk, Andrew M. Coutts, Shelagh B. Hill, Michael D.
Description	Country affiliation: Canada Author Affiliation: DeVetten G ( Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services, Alberta, Canada.)
Abstract	BACKGROUND AND PURPOSE: In children with stroke, poor motor outcome is associated with early Wallerian degeneration of the corticospinal tract that is seen on diffusion-weighted MRI. In this study we test the hypothesis that early diffusion changes also occur in the corticospinal tract (CST) of adults after stroke and that these lesions are associated with poor outcome. METHODS: In this retrospective study, we assessed images from a serial MRI study of adults with acute middle cerebral/internal carotid artery stroke. MRI-negative TIA patients served as controls. Custom software measured signal along the CST on different sequences, including the apparent diffusion coefficient (ADC). Visual detection of abnormal signal by blinded neuroradiologists was also evaluated. We then determined associations between CST signal changes and 3-month motor outcome (NIHSS score). RESULTS: Thirty-eight patients (20 stroke/18 control) were included. ADC measures were much more accurate than other MRI sequences for detection of degeneration in the CST. The ADC decreased in a time-dependent fashion in the CST of patients with poor motor outcome but not in those with good outcome. Changes in ADC were maximal at 7 days. Neuroradiologists could visually detect these changes with accuracy comparable to the software method. CONCLUSION: CST ADC decreases after acute stroke in patients with poor motor outcome and may represent early Wallerian degeneration. Recognition of this imaging marker may improve early outcome prediction and patient selection for rehabilitation and neuroprotection trials.
ISSN	00392499
e-ISSN	15244628
Journal	Stroke
Issue Number	4
Volume Number	41
Language	English
Publisher	Lippincott Williams & Wilkins (on behalf of the American Heart Association)
Publisher Date	2010-04-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Pyramidal Tracts Pathology Stroke Wallerian Degeneration Diffusion Magnetic Resonance Imaging Image Processing, Computer-assisted Ischemic Attack, Transient Diagnosis Prognosis Retrospective Studies Discipline Cardiology
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine Neuroscience Advanced and Specialized Nursing Neurology (clinical)

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