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J Neurol Neurosurg Psychiatry 2007;78:581-586 doi:10.1136/jnnp.2006.099077
  • Paper

A prospective study of secondary degeneration following subcortical infarction using diffusion tensor imaging

  1. Zhijian Liang1,
  2. Jinsheng Zeng1,
  3. Sirun Liu2,
  4. Xueying Ling2,
  5. Anding Xu3,
  6. Jian Yu1,
  7. Li Ling1
  1. 1Department of Neurology and Stroke Centre, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
  2. 2Medical Imaging Centre, The First Affiliated Hospital, Jinan University, Guangzhou, China
  3. 3Department of Neurology, The First Affiliated Hospital, Jinan University, Guangzhou, China
  1. Correspondence to:
 Professor Jinsheng Zeng
 Department of Neurology and Stroke Centre, The First Affiliated Hospital, Sun Yat-Sen University, No 58 Zhongshan Road II, Guangzhou, 510080, PR China; zengjs{at}pub.guangzhou.gd.cn
  • Received 1 June 2006
  • Accepted 5 January 2007
  • Revised 4 January 2007
  • Published Online First 19 January 2007

Abstract

Background: Secondary degeneration of the pyramidal tract distal to the primary lesion after a stroke has been detected by some studies using diffusion tensor imaging (DTI) but its potential clinical significance and the degeneration of the fibre tract proximal to the primary lesion have received little attention.

Methods: Twelve patients underwent DTI on the 1st, 4th and 12th week following a subcortical infarct involving the posterior limb of the internal capsule, and 12 age and sex matched controls underwent DTI once. The DTI parameters mean diffusivity and fractional anisotropy (FA), and the clinical scores before DTI examination, including the National Institutes of Health Stroke Scale (NIHSS), the Fugl–Meyer (FM) scale and the Barthel index (BI), were assessed. The relations between the per cent changes in DTI parameters and clinical scores were analysed.

Results: From the 1st to the 12th week after stroke onset, FA values decreased (p<0.01, respectively) in the fibre tract above and below the internal capsule, and the NIHSS decreased (p<0.01) but the FM scale and BI increased (p<0.01, respectively) progressively. The per cent reductions in FA value in the fibre tract above and below the internal capsule were negatively correlated with the per cent changes in NIHSS and FM scale (p<0.05, respectively).

Conclusions: Secondary degeneration of the fibre tract proximal and distal to a primary lesion can be detected by DTI clearly and quantitatively and deteriorates with time progressively, which may hamper functional recovery after a subcortical cerebral infarct.

Footnotes

  • Published Online First 23 January 2007

  • The funding sources were not involved in the study design, collection, analysis or interpretation of data, writing of the report or the decision to submit the paper for publication.

  • Competing interests: None.

This Article

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