Wallerian degeneration in lateral cervical spinal cord detected with diffusion tensor imaging in four chronic stroke patients.
OBJECTIVE
wallerian degeneration (WD) in descending motor tracts after stroke is described at the level of the internal capsule and the brainstem. We investigated whether diffusion tensor imaging (DTI) can detect degeneration in the lateral cervical spinal cord after stroke.


METHODS
DTI at 1.5 T of the cervical spinal cord was performed in 4 chronic hemiparetic patients after ischemic stroke. Stroke lesions included the corticospinal tract. DTI was also performed in 12 healthy controls. Diffusion parameters were obtained for left and right (i) half and (ii) lateral spinal cord extending from C2 to C7.


RESULTS
relative fractional anisotropy (FA) in the lateral tracts on the affected side compared with the unaffected side (left/right) was reduced in stroke patients as compared with controls (P= .007). FA was lowest in patients with severe upper limb hemiparesis. Relative apparent diffusion coefficient in the lateral tracts was increased in the patients (P= .03).


CONCLUSIONS
this study provides preliminary evidence that DTI at 1.5 T can be used for identification and quantification of WD in the lateral cervical spinal cord in stroke patients. This may prove useful for prognosis of motor outcome after stroke.
Lindberg
Påvel G
PG
CNRS, UMR 7060, LNRS, Université Paris Descartes (Paris-5), Paris, France. pavel.lindberg@cch.aphp.fr
Bensmail
Djamel
D
Bussel
Bernard
B
Maier
Marc A
MA
Feydy
Antoine
A
D000368:Aged; D016880:Anisotropy; D002574:Cervical Vertebrae; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011712:Pyramidal Tracts / Q000473:pathology*; D013116:Spinal Cord / Q000473:pathology*; D020521:Stroke / Q000150:complications / Q000473:pathology*; D014855:Wallerian Degeneration / Q000209:etiology / Q000473:pathology*