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Correlations between cervical spinal cord magnetic resonance diffusion tensor and diffusion kurtosis imaging metrics and motor performance in patients with chronic ischemic brain lesions of the corticospinal tract

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Abstract

Purpose

To investigate modifications of Magnetic Resonance Diffusion Tensor Imaging (DTI) and Diffusion Kurtosis Imaging (DKI) metrics in lateral white matter (WM) bundles of the cervical spinal cord in patients with previous stroke in the vascular territory of the middle cerebral artery (MCA).

Methods

Twenty consecutive patients with a previous ischemic stroke of the MCA territory and a varying degree of upper motor impairment were enrolled. DKI was centered at the C3C4 and C5C6 intervertebral level.

Results

The fractional anisotropy (FA) values in C3C4 and C5C6 were found to be significantly lower in the lateral WM bundles contralateral to the ischemic lesion and thus, in the WM bundle including the affected corticospinal tract (CST) (p = 0.005 and p = 0.008, respectively), as well as mean kurtosis (MK) and axonal water fraction (AWF) values (p = 0.004 and p = 0.04. respectively). FA values correlated significantly with the Global Motor Index (GMI) both for C3C4 (ρ = 0.61, p = 0.004) and C5C6 (ρ = 0.69, p = 0.002). At C3C4, AWF correlated significantly with GMI (ρ = 0.54, p = 0.03). No correlations were found between lateral WM bundle volumes and GMI.

Conclusion

A reduction of anisotropy and microstructural complexity in the affected lateral WM bundle of the cervical spinal cord was observed in patients with previous ischemic stroke involving the CST. The correlations between these metrics and motor performance were statistically significant.

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Abbreviations

AWF:

Axonal water fraction

CST:

Corticospinal tract

cSC:

Cervical spinal cord

DTI:

Diffusion tensor imaging

DKI:

Diffusion kurtosis imaging

FA:

Fractional anisotropy

MK:

Mean kurtosis

RK:

Radial kurtosis

AK:

Axial kurtosis

GMI:

Global motor index

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Authors and Affiliations

  1. ITAB-Institute of Advanced Biomedical Technologies, University “G. D’Annunzio” Chieti-Pescara, Chieti, Italy

    Valentina Panara, E. Piccirilli, V. Bartoletti & M. Caulo

  2. Department of Neuroscience, Imaging and Clinical Sciences, University “G. D’Annunzio” Chieti-Pescara, Via dei Vestini, 31 66100, Chieti, CH, Italy

    Valentina Panara, R. Navarra, P. A. Mattei, A. Uncini & M. Caulo

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  1. Valentina Panara
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  2. R. Navarra
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Correspondence to Valentina Panara.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Panara, V., Navarra, R., Mattei, P.A. et al. Correlations between cervical spinal cord magnetic resonance diffusion tensor and diffusion kurtosis imaging metrics and motor performance in patients with chronic ischemic brain lesions of the corticospinal tract. Neuroradiology 61, 175–182 (2019). https://doi.org/10.1007/s00234-018-2139-5

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