Pervasive White Matter Fiber Degeneration in Ischemic Stroke

Natalia Egorova; Thijs Dhollander; Mohamed Salah Khlif; Wasim Khan; Emilio Werden; Amy Brodtmann

doi:10.1161/STROKEAHA.119.028143

Pervasive White Matter Fiber Degeneration in Ischemic Stroke

Natalia Egorova^*, Thijs Dhollander, Mohamed Salah Khlif, Wasim Khan, Emilio Werden, Amy Brodtmann

^*Corresponding author for this work

NIHR Maudsley Biomedical Research Centre (BRC)

Research output: Contribution to journal › Article › peer-review

59 Citations (Scopus)

Abstract

Background and Purpose-We examined if ischemic stroke is associated with white matter degeneration predominantly confined to the ipsi-lesional tracts or with widespread bilateral axonal loss independent of lesion laterality. Methods-We applied a novel fixel-based analysis, sensitive to fiber tract-specific differences within a voxel, to assess axonal loss in stroke (N=104, 32 women) compared to control participants (N=40, 15 women) across the whole brain. We studied microstructural differences in fiber density and macrostructural (morphological) changes in fiber cross-section. Results-In participants with stroke, we observed significantly lower fiber density and cross-section in areas adjacent, or connected, to the lesions (eg, ipsi-lesional corticospinal tract). In addition, the changes extended beyond directly connected tracts, independent of the lesion laterality (eg, corpus callosum, bilateral inferior fronto-occipital fasciculus, right superior longitudinal fasciculus). Conclusions-We conclude that ischemic stroke is associated with extensive neurodegeneration that significantly affects white matter integrity across the whole brain. These findings expand our understanding of the mechanisms of brain volume loss and delayed cognitive decline in stroke.

Original language	English
Pages (from-to)	1507-1513
Number of pages	7
Journal	Stroke
DOIs	https://doi.org/10.1161/STROKEAHA.119.028143
Publication status	Accepted/In press - 1 Jan 2020

Keywords

brain ischemia
cognitive dysfunction
diffusion
stroke
white matter

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10.1161/STROKEAHA.119.028143

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title = "Pervasive White Matter Fiber Degeneration in Ischemic Stroke",

abstract = "Background and Purpose-We examined if ischemic stroke is associated with white matter degeneration predominantly confined to the ipsi-lesional tracts or with widespread bilateral axonal loss independent of lesion laterality. Methods-We applied a novel fixel-based analysis, sensitive to fiber tract-specific differences within a voxel, to assess axonal loss in stroke (N=104, 32 women) compared to control participants (N=40, 15 women) across the whole brain. We studied microstructural differences in fiber density and macrostructural (morphological) changes in fiber cross-section. Results-In participants with stroke, we observed significantly lower fiber density and cross-section in areas adjacent, or connected, to the lesions (eg, ipsi-lesional corticospinal tract). In addition, the changes extended beyond directly connected tracts, independent of the lesion laterality (eg, corpus callosum, bilateral inferior fronto-occipital fasciculus, right superior longitudinal fasciculus). Conclusions-We conclude that ischemic stroke is associated with extensive neurodegeneration that significantly affects white matter integrity across the whole brain. These findings expand our understanding of the mechanisms of brain volume loss and delayed cognitive decline in stroke.",

keywords = "brain ischemia, cognitive dysfunction, diffusion, stroke, white matter",

author = "Natalia Egorova and Thijs Dhollander and Khlif, {Mohamed Salah} and Wasim Khan and Emilio Werden and Amy Brodtmann",

year = "2020",

month = jan,

day = "1",

doi = "10.1161/STROKEAHA.119.028143",

language = "English",

pages = "1507--1513",

journal = "Stroke",

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publisher = "American Heart Association",

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T1 - Pervasive White Matter Fiber Degeneration in Ischemic Stroke

AU - Egorova, Natalia

AU - Dhollander, Thijs

AU - Khlif, Mohamed Salah

AU - Khan, Wasim

AU - Werden, Emilio

AU - Brodtmann, Amy

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Background and Purpose-We examined if ischemic stroke is associated with white matter degeneration predominantly confined to the ipsi-lesional tracts or with widespread bilateral axonal loss independent of lesion laterality. Methods-We applied a novel fixel-based analysis, sensitive to fiber tract-specific differences within a voxel, to assess axonal loss in stroke (N=104, 32 women) compared to control participants (N=40, 15 women) across the whole brain. We studied microstructural differences in fiber density and macrostructural (morphological) changes in fiber cross-section. Results-In participants with stroke, we observed significantly lower fiber density and cross-section in areas adjacent, or connected, to the lesions (eg, ipsi-lesional corticospinal tract). In addition, the changes extended beyond directly connected tracts, independent of the lesion laterality (eg, corpus callosum, bilateral inferior fronto-occipital fasciculus, right superior longitudinal fasciculus). Conclusions-We conclude that ischemic stroke is associated with extensive neurodegeneration that significantly affects white matter integrity across the whole brain. These findings expand our understanding of the mechanisms of brain volume loss and delayed cognitive decline in stroke.

AB - Background and Purpose-We examined if ischemic stroke is associated with white matter degeneration predominantly confined to the ipsi-lesional tracts or with widespread bilateral axonal loss independent of lesion laterality. Methods-We applied a novel fixel-based analysis, sensitive to fiber tract-specific differences within a voxel, to assess axonal loss in stroke (N=104, 32 women) compared to control participants (N=40, 15 women) across the whole brain. We studied microstructural differences in fiber density and macrostructural (morphological) changes in fiber cross-section. Results-In participants with stroke, we observed significantly lower fiber density and cross-section in areas adjacent, or connected, to the lesions (eg, ipsi-lesional corticospinal tract). In addition, the changes extended beyond directly connected tracts, independent of the lesion laterality (eg, corpus callosum, bilateral inferior fronto-occipital fasciculus, right superior longitudinal fasciculus). Conclusions-We conclude that ischemic stroke is associated with extensive neurodegeneration that significantly affects white matter integrity across the whole brain. These findings expand our understanding of the mechanisms of brain volume loss and delayed cognitive decline in stroke.

KW - brain ischemia

KW - cognitive dysfunction

KW - diffusion

KW - stroke

KW - white matter

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U2 - 10.1161/STROKEAHA.119.028143

DO - 10.1161/STROKEAHA.119.028143

M3 - Article

C2 - 32295506

AN - SCOPUS:85084167161

SN - 0039-2499

SP - 1507

EP - 1513

JO - Stroke

JF - Stroke

ER -

Pervasive White Matter Fiber Degeneration in Ischemic Stroke

Abstract

Keywords

UN SDGs

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