Diffusion tensor imaging detects early Wallerian degeneration of the pyramidal tract after ischemic stroke
Abstract
We used diffusion tensor imaging (DTI) to assess Wallerian degeneration of the pyramidal tract within the first 2 weeks after ischemic stroke, and correlated the extent of Wallerian degeneration with the motor deficit. Nine patients with middle cerebral artery stroke were examined 2-16 days after stroke by DTI and T2-weighted MRI. We measured fractional anisotropy (FA), averaged diffusivity (Dav), eigenvalues of the diffusion tensor and T2-weighted signal in the cerebral peduncle and compared these values between the affected and the unaffected side and between patients and six controls. FA was significantly reduced on the affected side compared to the unaffected side and compared to the control group. The largest eigenvalue was reduced, whereas the smallest eigenvalue was elevated on the affected side. There was no significant difference in T2-weighted signal and Dav. The decrease of anisotropy correlated positively with the motor deficit at the time of DTI study and 90 days after stroke. The reduction of anisotropy mirrors the disintegration of axonal structures, as it occurs in the early phase of Wallerian degeneration. DTI detects changes of water diffusion related to beginning pyramidal tract degeneration within the first 2 weeks after stroke that are not yet visible in conventional T2-weighted or orientationally averaged diffusion weighted MRI. We demonstrated for the first time a correlation of early DTI findings of pyramidal tract damage with the motor deficit. DTI can help prognosing recovery of motor function after stroke within the early subacute phase.
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FA changes can reflect one or more microstructural alterations, including Wallerian degeneration or reduced neuronal membrane permeability.
“Changes in FA signal one or many microstructural alterations, such as Wallerian degeneration (Pierpaoli et al., 2001; Thomalla et al., 2004) or decreased neuronal membrane permeability (Jones, KnöSche, & Turner, 2013).”
From Substance abuse and white matter: Findings, limitations, and future of diffusion tensor imaging research (2019) · cites this paper as Thomalla et al., 2004
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“…final sensorimotor performance outcome correlated positively with FA in ipsilesional corticospinal tract regions subacutely, where poor functional outcome was linked to subacutely low FA, in line with DTI studies in human patients (Thomalla et al., 2004; Puig et al., 2010; Radlinska et al., 2010).”
The Biological Basis of Diffusion Anisotropy
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Self-citationEffects of age and gender on white matter integrity
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“It is suggested that in the human brain, age-related increases in RD are due to demyelination(16-19) or a decrease in axonal packing attenuation,(16,19) and age-related decreases in AD are caused by axonal degeneration and the subsequent gliosis that follows an ischemic incident or lesion formation.(17,20,21) Previous…”
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“A few previous studies have delineated the process of WD using DTI (Pierpaoli et al., 2001; Thomalla et al., 2004, 2005).”
MethodInfluentialNetwork analysis detects changes in the contralesional hemisphere following stroke
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“…studies of fractional anisotropy (FA) reveal patterns of anterograde (Wallerian) and retrograde white matter tract degeneration in pathways in the lesioned hemisphere connected to a site of primary damage (Liang et al., 2007; Pierpaoli et al., 2001; Thomalla et al., 2004; Werring et al., 2000).”
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“As indicated by arrows, decreased λ|| was seen at 3 and 14 days in not change at 3 day but decreased RA and increased λ⊥ were observed at the gray matter (Gupta et al., 2006; Khong et al., 2004; Thomalla et al., 2004, 2005), the reduced diffusion anisotropy was also seen in the present study.”
InfluentialFunctional imaging and related techniques: An introduction for rehabilitation researchers
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Upstream Dysfunction of Somatomotor Functional Connectivity After Corticospinal Damage in Stroke
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“Our results show that structural damage to the CST, as determined by a template derived from DTI in healthy controls, was associated with decreased somatomotor interhemispheric rsFC.”
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“This method was applied previously to depict fiber tracts in the central nervous system to detect stroke and other fiber-disrupting pathologies (18, 40, 43).”
MethodWhite matter integrity in small vessel disease is related to cognition
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“Themaskswere visually inspected andmiscellaneous voxels that belonged to other regions, such as the cingulum bundle, were excluded.”
BackgroundZhang, J., Jones, M., DeBoy, C. A., Reich, D. S., Farrell, J. A. D., Hoffman, P. N., Griffin, J. W., Sheikh, K. A., Miller, M. I., Mori, S., et al. (2009) · Journal of Neuroscience · doi:10.1523/jneurosci.3941-08.2009 · Cited by 188 · see citing works
“, fractional anisotropy (FA), are sensitive to axon degeneration in patients (Werring et al., 2000; Pierpaoli et al., 2001; Thomalla et al., 2004; Valsasina et al., 2005; Trip et al., 2006; Agosta et al., 2007).”
BackgroundPuig, J., Pedraza, S., Blasco, G., et al. (2010) · American Journal of Neuroradiology · doi:10.3174/ajnr.a2038 · Cited by 185 · see citing works
“Thomalla et al.(17) found a 13% decrease in FA measured at the cerebral peduncle 2– 6 months and 2–16 days after stroke.”
BackgroundInfluentialRiley, J. D., Franklin, D. L., Choi, V., et al. (2010) · Epilepsia · doi:10.1111/j.1528-1167.2009.02508.x · Cited by 176 · see citing works
“, 2006) and in chronic changes related to ischemic stroke (Thomalla et al., 2004).”
BackgroundNi, H., Kavcic, V., Zhu, T., EKHOLM, S. E., & Zhong, J. (2006) · PubMed Central · Cited by 176 · see citing works
Klöppel, S., Draganski, B., Golding, C. V. P., Chu, C., Nagy, Z., Cook, P. A., Hicks, S. L., Christopher Kennard, C., Alexander, D. C., Parker, G. J. M., et al. (2007) · Brain · doi:10.1093/brain/awm275 · Cited by 171 · see citing works
“the pyramidal tract) are affected by disease (Sach et al., 2004; Thomalla et al., 2004).”
BackgroundEwing‐Cobbs, L., Prasad, M. R., Swank, P. R., Kramer, L. A., Cox, C. S., Fletcher, J. M., Barnes, M. A., Zhang, X., & Hasan, K. M. (2008) · NeuroImage · doi:10.1016/j.neuroimage.2008.06.031 · Cited by 166 · see citing works
“Human (Arfanakis et al., 2002; Concha et al., 2006; Tasker et al., 2005; Thomalla et al., 2004) and animal studies (Boska et al., 2007; Mac Donald et al., 2007) suggest that radial diffusivity assesses change associated with myelin.”
BackgroundThiel, A., Radlinska, B. A., Paquette, C., Sidel, M., Soucy, J., Schirrmacher, R., & Minuk, J. (2010) · Journal of Nuclear Medicine · doi:10.2967/jnumed.110.076612 · Cited by 167 · see citing works
“A decrease in FA distal to the lesion after the first few weeks has been described by some authors (12) and interpreted as a correlate of Wallerian degeneration (38).”
BackgroundKhalil, C., Hancart, C., Thuc, V. L., et al. (2008) · European Radiology · doi:10.1007/s00330-008-0971-4 · Cited by 163 · see citing works
“One might have expected an increase in ADC values in patients suffering from carpal tunnel syndrome, similarly to what has been reported in Wallerian degeneration of the pyramidal tract after ischemic stroke [38, 39].”
ResultKumar, R., Gupta, R. K., Husain, M., Chaudhry, C., Srivastava, A., Saksena, S., & Rathore, R. K. S. (2009) · Brain Injury · doi:10.1080/02699050903014915 · Cited by 162 · see citing works
“They found decreased FA and characteristic changes in the principal eigenvalues reflecting early WD in the cerebral peduncle after ischemic stroke [55, 57].”
BackgroundResultBurzynska, A. Z., Jiao, Y., Knecht, A. M., Fanning, J., Awick, E. A., Chen, T., Gothe, N., Voss, M. W., McAuley, E., & Kramer, A. F. (2017) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2017.00059 · Cited by 150 · see citing works
“This involves an increase in extracellular volume fraction resulting from losses in both axons and myelin (Thomalla et al., 2004; Cosottini et al., 2005; Sen and Basser, 2005; Concha et al., 2006; Lindquist et al., 2007; Sidaros et al., 2008; Sun et al., 2008).”
BackgroundPuig, J., Blasco, G., Gottfried Schlaug, A., Stinear, C. M., Daunis‐i‐Estadella, P., Biarnés, C., Figueras, J., Serena, J. L., Hernández‐Pérez, M., Alberich‐Bayarri, Á., et al. (2017) · Neuroradiology · doi:10.1007/s00234-017-1816-0 · Cited by 152 · see citing works
“creasingly demonstrating greater accuracy in detecting microstructural damage related toWallerian degeneration after acute stroke [15, 16].”
BackgroundSelf-citationPredicting language outcome and recovery after stroke: the PLORAS system
Price, C. J., Seghier, M. L., & Leff, A. P. (2010) · Nature Reviews Neurology · doi:10.1038/nrneurol.2010.15 · Cited by 143 · see citing works
Tuladhar, A. M., van Dijk, E., Zwiers, M. P., van Norden, A. G. W., de Laat, K. F., Shumskaya, E., Norris, D. G., & de Leeuw, F.-E. (2016) · Human Brain Mapping · doi:10.1002/hbm.23032 · Cited by 142 · see citing works
“SVD has a detrimental effect on the multiple white matter tracts by means of direct and indirect damage, which can be ascribed to demyelination, reduction in axonal number, and density and/or gliosis [de Laat et al., 2011; Pantoni and Garcia, 1997; Thomalla et al., 2004].”
BackgroundDiffusion tensor imaging in hydrocephalus: initial experience.
Assaf, Y., Ben‐Sira, L., Constantini, S., Chang, L., & Beni‐Adani, L. (2006) · PubMed Central · Cited by 141 · see citing works
Xu, J., Yang, L., Lin, H., Sinha, R., & Potenza, M. N. (2011) · Human Brain Mapping · doi:10.1002/hbm.21491 · Cited by 138 · see citing works
“This pattern of changes in DTI parameters was observed within days after stroke or corpus callosotomy [Pierpaoli et al., 2001; Song et al., 2003; Thomalla et al., 2004] and was hypothesized to reflect acute axonal degeneration [Bennett et al.”
Wang, L. E., Tittgemeyer, M., Imperati, D., Diekhoff, S., Ameli, M., Fink, G. R., & Grefkes, C. (2011) · Human Brain Mapping · doi:10.1002/hbm.21417 · Cited by 138 · see citing works
“, 2008] and motor performance of the paretic hand [Jang et al., 2008; Lindenberg et al., 2010; Schaechter et al., 2009; Stinear et al., 2007; Thomalla et al., 2004; Yu et al., 2009].”
BackgroundConcha, L. (2013) · Neuroscience · doi:10.1016/j.neuroscience.2013.09.004 · Cited by 129 · see citing works
Lin, Y., Wang, J., Wu, C.-M., Wai, Y., Yu, J., & Ng, S.-H. (2008) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.21464 · Cited by 130 · see citing works
“Previous studies have shown a reduction in FA in disease states, whereas MD was found to increased (20), unchanged (21), or even decreased (22).”
BackgroundSchaechter, J. D., Perdue, K. L., & Wang, R. (2007) · NeuroImage · doi:10.1016/j.neuroimage.2007.09.071 · Cited by 124 · see citing works
“DTI studies in hemiparetic stroke patients have reported early (Thomalla et al., 2004), progressive (Moller et al.”
BackgroundAcute Corticospinal Tract Wallerian Degeneration Is Associated With Stroke Outcome
DeVetten, G., Coutts, S. B., Hill, M. D., Goyal, M., Eesa, M., O'Brien, B., Demchuk, A. M., & Kirton, A. (2010) · Stroke · doi:10.1161/strokeaha.109.573287 · Cited by 122 · see citing works
Structural Plasticity in Adulthood with Motor Learning and Stroke Rehabilitation
Sampaio‐Baptista, C., Sanders, Z., & Johansen‐Berg, H. (2018) · Annual Review of Neuroscience · doi:10.1146/annurev-neuro-080317-062015 · Cited by 122 · see citing works
Compensatory role of the cortico-rubro-spinal tract in motor recovery after stroke
Rüber, T., Schlaug, G., & Lindenberg, R. (2012) · Neurology · doi:10.1212/wnl.0b013e31826356e8 · Cited by 118 · see citing works
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Chen, D.-C., Lin, S., Fan, J.-R., Lin, C.-H., Lee, W., Lin, C.-C., Liu, Y., Tsai, C., Chen, J., Cho, D.-Y., et al. (2014) · Cell Transplantation · doi:10.3727/096368914x678562 · Cited by 119 · see citing works
Effects of home-based telerehabilitation in patients with stroke
Chen, J., Sun, D., Zhang, S., Shi, Y., Qiao, F., Zhou, Y., Liu, J., & Ren, C. (2020) · Neurology · doi:10.1212/wnl.0000000000010821 · Cited by 118 · see citing works
Dynamic changes in corticospinal tracts after stroke detected by fibretracking
Moller, M., Frandsen, J. R., Andersen, G., et al. (2007) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.2006.100248 · Cited by 118 · see citing works
Yoshioka, H., Horikoshi, T., Aoki, S., et al. (2008) · Neurosurgery · doi:10.1227/01.neu.0000311066.03121.b8 · Cited by 116 · see citing works
“MRI sequences and parameters are also reported to affect the results of DT imaging data (15, 17, 23); however, these did not affect our results because all patients in this study were examined with the same MRI protocol.”
BackgroundResultHaller, S., Badoud, S., Nguyen, D. D., Garibotto, V., Lövblad, K., & Burkhard, P. R. (2012) · American Journal of Neuroradiology · doi:10.3174/ajnr.a3126 · Cited by 115 · see citing works
Liang, Z., Zeng, J., Liu, S., Ling, X., Xu, A., Yu, J., & Ling, L. (2007) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.2006.099077 · Cited by 113 · see citing works
Salminen, L. E., & Paul, R. H. (2014) · Reviews in the Neurosciences · doi:10.1515/revneuro-2014-0046 · Cited by 113 · see citing works
“, 2010), although other diffusion patterns have been reported (Thomalla et al., 2004; Acosta-Cabronero et al., 2010; Burzynska et al., 2010).”
BackgroundBacigaluppi, M., Russo, G. L., Peruzzotti‐Jametti, L., Rossi, S., Sandrone, S., Butti, E., Ceglia, R. D., Bergamaschi, A., Motta, C., Gallizioli, M., et al. (2016) · Journal of Neuroscience · doi:10.1523/jneurosci.1643-16.2016 · Cited by 107 · see citing works
“Indeed, axonal degeneration is invariably seen not only within the lesion site but also in remote brain structures that have neuroanatomical links with the ischemic area (Thomalla et al., 2004; Crofts et al., 2011; Sist et al., 2012).”
BackgroundStructural connectivity analyses in motor recovery research after stroke
Koch, P., Schulz, R. J., & Hummel, F. C. (2016) · Annals of Clinical and Translational Neurology · doi:10.1002/acn3.278 · Cited by 107 · see citing works
“These findings highlight one potentially critical point: Various studies have related the integrity indices of the ipsilesional CST to the value of the contralesional tract to account for intersubject variability in premorbid white matter microstructure.(16,35,41,54,55) Despite that gross structural changes are natura…”
BackgroundBrainstem and spinal cord MRI identifies altered sensorimotor pathways post-stroke
Karbasforoushan, H., Cohen‐Adad, J., & Dewald, J. P. A. (2019) · Nature Communications · doi:10.1038/s41467-019-11244-3 · Cited by 108 · see citing works
Haller, S., Nguyen, D., Rodriguez, C., Emch, J., Gold, G., Bartsch, A., Lövblad, K., & Giannakopoulos, P. (2010) · Journal of Alzheimer's Disease · doi:10.3233/jad-2010-100840 · Cited by 113 · see citing works
“Fractional anisotropy (FA) is estimated from DTI [24] and correlates with the integrity of white matter fiber bundles [25].”
BackgroundDiffusion Tensor Imaging and Fiber Tractography in Acute Stroke
Mukherjee, P. (2005) · Neuroimaging Clinics of North America · doi:10.1016/j.nic.2005.08.010 · Cited by 106 · see citing works
“The subacute infarction also is seen as hyperintensity are more sensitive than ADC for wallerian degeneration [47,48].”
BackgroundDiffusion tensor imaging, permanent pyramidal tract damage, and outcome in subcortical stroke
Radlinska, B. A., Ghinani, S. A., Leppert, I. R., Minuk, J., Pike, G. B., & Thiel, A. (2010) · Neurology · doi:10.1212/wnl.0b013e3181f39aa0 · Cited by 104 · see citing works
Deprez, S., Billiet, T., Sunaert, S. G., & Leemans, A. (2013) · Brain Imaging and Behavior · doi:10.1007/s11682-012-9220-1 · Cited by 105 · see citing works
“In particular, an increased RD was found in the case of a decrease in myelin thickness (Song et al. 2002, 2005; Thomalla et al. 2004) and a reduced AD in the case of axonal loss (Song et al.”
BackgroundCorticospinal Tract Diffusion Abnormalities Early After Stroke Predict Motor Outcome
Groisser, B. N., Copen, W. A., Singhal, A. B., et al. (2014) · Neurorehabilitation and neural repair · doi:10.1177/1545968314521896 · Cited by 102 · see citing works
Chen, J. L., & Gottfried Schlaug, A. (2013) · Frontiers in Neurology · doi:10.3389/fneur.2013.00178 · Cited by 102 · see citing works
“These findings are consistent with those from prior studies in chronic (3, 4) and acute (22, 23) stroke, and suggest that the FA decreases may be related to reduced integrity of the myelin sheath (21).”
Diffusion Tensor Imaging in Parkinson's Disease and Parkinsonian Syndrome: A Systematic Review
Zhang, Y., & Burock, M. A. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.531993 · Cited by 99 · see citing works
“Despite these limitations, the decreased FA and increased MD have been found correlated with neuronal degeneration (70) and degeneration caused by dopamine loss (71).”
BackgroundHampton, W. H., Hanik, I. M., & Olson, I. R. (2019) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2019.02.005 · Cited by 95 · see citing works
Fitzsimmons, S., Oostra, E., Postma, T. S., van der Werf, Y. D., & van den Heuvel, O. A. (2023) · Biological Psychiatry · doi:10.1016/j.biopsych.2023.11.016 · Cited by 100 · see citing works
Motor recovery and microstructural change in rubro-spinal tract in subcortical stroke
Takenobu, Y., Hayashi, T., Moriwaki, H., Nagatsuka, K., Naritomi, H., & Fukuyama, H. (2013) · NeuroImage Clinical · doi:10.1016/j.nicl.2013.12.003 · Cited by 92 · see citing works
“…FA decrease found in the ipsi-lesional PT tract, in particular in the CP and CR, provides insight on the progress of Wallerian degeneration (Waller, 1850) and reproduces the findings of previous longitudinal DTI studies in stroke (Liang et al., 2007; Thomalla et al., 2004, 2005; Yu et al., 2009).”
MethodResultMR Relaxation in Multiple Sclerosis
MacKay, A. L., Vavasour, I. M., Rauscher, A., Kolind, S., Mädler, B., Moore, G. R. W., Traboulsee, A. L., Li, D. K. B., & Laule, C. (2008) · Neuroimaging Clinics of North America · doi:10.1016/j.nic.2008.09.007 · Cited by 94 · see citing works
Westerhausen, R., Huster, R. J., Kreuder, F., Wittling, W., & Schweiger, E. (2007) · NeuroImage · doi:10.1016/j.neuroimage.2007.05.047 · Cited by 93 · see citing works
“Finally, clinical studies using modern magnetic resonance imaging (MRI) techniques reported a relationship between the degree of damage of the CST and contralateral upper limb motor impairment in multiple sclerosis (Lee et al., 2000) and stroke (Pendlebury et al., 1999; Thomalla et al., 2004).”
BackgroundRijntjes, M. (2006) · Current Opinion in Neurology · doi:10.1097/01.wco.0000203886.28068.38 · Cited by 94 · see citing works
Circulating neurofilament light in ischemic stroke: temporal profile and outcome prediction
Pedersén, A., Stanne, T. M., Nilsson, S., Klasson, S., Rosengren, L., Holmegaard, L., Jood, K., Blennow, K., Zetterberg, H., & Jern, C. (2019) · Journal of Neurology · doi:10.1007/s00415-019-09477-9 · Cited by 93 · see citing works
MR Diffusion Imaging in Ischemic Stroke
Fung, S. H., Roccatagliata, L., González, R. G., & Schaefer, P. W. (2011) · Neuroimaging Clinics of North America · doi:10.1016/j.nic.2011.03.001 · Cited by 92 · see citing works
Kusano, Y., Seguchi, T., Horiuchi, T., Kakizawa, Y., Kobayashi, T., Tanaka, Y., Seguchi, K., & Hongo, K. (2009) · American Journal of Neuroradiology · doi:10.3174/ajnr.a1639 · Cited by 92 · see citing works
“They reported that the FA in the affected pyramidal tract was reduced 13%–32% during the subacute-to-chronic phase of an ischemic stroke, and the reductions in the FA were more severe at later time points of 2 days to 1 year.(10,11,12,29) Yoshida et at(14) reported that the FA ratio in the affected side decreased 20%…”
BackgroundInfluentialDoughty, C. T., Wang, J., Feng, W., et al. (2016) · Stroke · doi:10.1161/strokeaha.115.012088 · Cited by 92 · see citing works
Akpan, N., Serrano‐Saiz, E., Zacharia, B. E., Otten, M. L., Ducruet, A. F., Snipas, S. J., Liu, W., Velloza, J., Cohen, G., Sosunov, S. A., et al. (2011) · Journal of Neuroscience · doi:10.1523/jneurosci.0698-11.2011 · Cited by 90 · see citing works
“Axon degeneration occurs during stroke with diffusion tensor imaging revealing extensive loss of axonal tracts in the stroke penumbra (Lie et al., 2004; Thomalla et al., 2004).”
BackgroundWidjaja, E., Blaser, S. E., Miller, E., Kassner, A., Shannon, P. T., Chuang, S. H., Snead, O. C., & Raybaud, C. R. (2007) · Epilepsia · doi:10.1111/j.1528-1167.2007.01105.x · Cited by 88 · see citing works
“Changes in λmajor reflect axonal integrity and have been observed in cases of Wallerian degeneration (Thomalla et al., 2004).”
BackgroundAssessing Optic Nerve Pathology with Diffusion MRI: from Mouse to Human
Xu, J.-Q., Sun, S.-W., Naismith, R. T., Snyder, A. Z., Cross, A. H., & Song, S.-K. (2008) · NMR in Biomedicine · doi:10.1002/nbm.1307 · Cited by 99 · see citing works
Lin, F., Yu, C., Jiang, T., Li, K., & Chan, P. (2007) · PubMed Central · Cited by 88 · see citing works
Diffusion properties of major white matter tracts in young, typically developing children
Johnson, R. T., Yeatman, J. D., Wandell, B. A., Buonocore, M. H., Amaral, D. G., & Nordahl, C. W. (2013) · NeuroImage · doi:10.1016/j.neuroimage.2013.11.025 · Cited by 90 · see citing works
“along the long axis of a fascicle of fibers) and has been related to changes in axon integrity such as during axonal degeneration (Kim et al., 2007; Song et al., 2003; Sun et al., 2006; Thomalla et al., 2004).”
BackgroundGupta, R. K., Saksena, S., Hasan, K. M., Agarwal, A. K., Haris, M., Pandey, C. M., & Narayana, P. A. (2006) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.20677 · Cited by 88 · see citing works
“A recent report demonstrated WD of the pyramidal tract within the first two weeks after ischemic stroke using DTI (10).”
BackgroundYu, C., Lin, F., Li, K., Jiang, T., Qin, W., Sun, H., & Chan, P. (2007) · Radiology · doi:10.1148/radiol.2461062075 · Cited by 86 · see citing works
Structural and Resting-State Brain Connectivity of Motor Networks After Stroke
Thiel, A., & Vahdat, S. (2014) · Stroke · doi:10.1161/strokeaha.114.006307 · Cited by 86 · see citing works
“Pyramidal Tract Integrity in Chronic Stroke Decreases in FA have traditionally been interpreted as a correlate of Wallerian degeneration of fiber tracts after stroke.(3) Wallerian degeneration is the anterograde degeneration of axons and their myelin sheaths after proximal axonal injury and most studies traditionally…”
BackgroundBrain-Mapping Techniques for Evaluating Poststroke Recovery and Rehabilitation: A Review
Eliassen, J. C., Boespflug, E. L., Lamy, M., Allendorfer, J. B., Chu, W., & Szaflarski, J. P. (2008) · Topics in Stroke Rehabilitation · doi:10.1310/tsr1505-427 · Cited by 85 · see citing works
“months post stroke, indicating that the degree of FA reduction may be predictive of motor function outcome.(38,41,44,45,49) Thalamic hypometabolism and cortico-spinal tract integrity also are associated with poststroke motor recovery.”
BackgroundSaindane, A. M., Law, M., Ge, Y., Johnson, G., Babb, J. S., & Grossman, R. I. (2007) · PubMed Central · Cited by 83 · see citing works
Hong, X., Lu, Z. K., Teh, I., Nasrallah, F. A., Teo, W., Ang, K. K., Phua, K. S., Guan, C., Chew, E., & Chuang, K. (2017) · Scientific Reports · doi:10.1038/s41598-017-08928-5 · Cited by 85 · see citing works
Neurofilament changes in serum and cerebrospinal fluid after acute ischemic stroke
Pujol-Calderón, F., Portelius, E., Zetterberg, H., Blennow, K., Rosengren, L., & Höglund, K. (2018) · Neuroscience Letters · doi:10.1016/j.neulet.2018.12.042 · Cited by 83 · see citing works
“Neurofilaments are abundant in large myelinated axons susceptible to Wallerian post-stroke degeneration and the time profile of immunohistochemical as well as radiological findings after stroke showing a delayed and longstanding degenerative process fit the release pattern of the neurofilament proteins in this study […”
BackgroundBigourdan, A., Munsch, F., Pierrick Coupé, A., Guttmann, C. R. G., Sagnier, S., Renou, P., Debruxelles, S., Poli, M., Dousset, V., Sibon, I., et al. (2016) · Stroke · doi:10.1161/strokeaha.115.011576 · Cited by 82 · see citing works
“Measurement of CST integrity with diffusion tensor imaging (DTI)(11) has been proposed both by assessment of decreases in FA distal to the stroke area and by the quantification of a decrease in the number of CST fibers, as an index of fiber degeneration (Wallerian degeneration).(12,13) In most previous work, including…”
BackgroundMethodInfluentialArbeláez, A. M., Semenkovich, K. A., & Hershey, T. G. (2013) · Pediatric Diabetes · doi:10.1111/pedi.12088 · Cited by 79 · see citing works
- Authors
- Thomalla, G., Glauche, V., Koch, M. A., Beaulieu, C., Weiller, C., & Röther, J.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- University of Alberta (CA)
- Corresponding author
- Thomalla, Götz
- ORCID
- Venue
- NeuroImage
- Publisher
- Elsevier BV
- Published
- 2004-08
- Volume
- 22
- Issue
- 4
- Pages
- 1767-1774
- ISSN
- 1053-8119 (ISSN-L)
- OpenAlex
- W2059177186
- Cited by
- 438
- References
- 46
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 13 · 2023: 15 · 2022: 12 · 2021: 24 · 2020: 15 · 2019: 17 · 2018: 15 · 2017: 16 · 2016: 23 · 2015: 18 · 2014: 33 · 2013: 25 · 2012: 21
- FWCI
- 18.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- NeuroImage (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Keywords
- Wallerian degeneration, corticospinal tract, ischemic stroke, middle cerebral artery stroke, diffusion tensor imaging, fractional anisotropy, motor impairment, cerebral peduncle
- MeSH terms
- Aged, Axons, Dominance, Cerebral, Female, Humans, Image Processing, Computer-Assisted, Male, Middle Aged, Movement Disorders, Neurologic Examination, Prognosis, Pyramidal Tracts, Reference Values, Statistics as Topic, Wallerian Degeneration, Anisotropy, Infarction, Middle Cerebral Artery, Diffusion Magnetic Resonance Imaging
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