Abstract
Following
acute ischemic stroke, isolated subcortical lesions induce gray matter
atrophy in anatomically connected, yet distant cortical brain regions.
We expand on previous studies by analyzing cortical thinning in
contralesional, homologous regions indirectly linked to primary stroke
lesions via ipsilesional cortical areas. For this purpose, stroke
patients were serially studied by magnetic resonance imaging (diffusion
tensor imaging and high-resolution anatomical imaging) in the acute
(days 3–5) and late chronic stage one year after stroke. We analyzed
changes of gray and white matter integrity in 18 stroke patients (median
age 68 years) with subcortical stroke. We applied probabilistic fiber
tractography to identify brain regions connected to stroke lesions and
contralesional homologous areas. Cortical thickness was quantified by
semi-automatic measurements, and fractional anisotropy was analyzed. One
year after stroke, significant decrease of cortical thickness was
detected in areas connected to ischemic lesions (mean −0.15 mm; 95% CI
−0.23 to −0.07 mm) as well as homologous contralateral brain regions
(mean −0.13 mm; 95% CI −0.07 to −0.19 mm). We detected reduced white
matter integrity of inter- and intrahemispheric fiber tracts. There were
no significant associations with clinical recovery. Our results
indicate that impact of subcortical lesions extends to homologous brain
areas via transcallosal diaschisis.
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