Structural plasticity of remote cortical brain regions is determined by connectivity to the primary lesion in subcortical stroke.
Cortical atrophy as demonstrated by measurement of cortical thickness (CT) is a hallmark of various neurodegenerative diseases. In the wake of an acute ischemic stroke, brain architecture undergoes dynamic changes that can be tracked by structural and functional magnetic resonance imaging studies as soon as 3 months after stroke. In this study, we measured changes of CT in cortical areas connected to subcortical stroke lesions in 12 patients with upper extremity paresis combining white-matter tractography and semi-automatic measurement of CT using the Freesurfer software. Three months after stroke, a significant decrease in CT of -2.6% (median, upper/lower boundary of 95% confidence interval -4.1%/-1.1%) was detected in areas connected to ischemic lesions, whereas CT in unconnected cortical areas remained largely unchanged. A cluster of significant cortical thinning was detected in the superior frontal gyrus of the stroke hemisphere using a surface-based general linear model correcting for multiple comparisons. There was no significant correlation of changes in CT with clinical outcome parameters. Our results show a specific impact of subcortical lesions on distant, yet connected cortical areas explainable by secondary neuro-axonal degeneration of distant areas.
Klinik und Poliklinik für Neurologie, Kopf-und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Bastian
B
Cheng
Klinik und Poliklinik für Neurologie, Kopf-und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Robert
R
Schulz
Klinik und Poliklinik für Neurologie, Kopf-und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Marlene
M
Bönstrup
Klinik und Poliklinik für Neurologie, Kopf-und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Friedhelm C
FC
Hummel
Klinik und Poliklinik für Neuroradiologische Diagnostik und Intervention, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Jan
J
Sedlacik
Klinik und Poliklinik für Neuroradiologische Diagnostik und Intervention, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Jens
J
Fiehler
Klinik und Poliklinik für Neurologie, Kopf-und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Christian
C
Gerloff
Klinik und Poliklinik für Neurologie, Kopf-und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Götz
G
Thomalla
D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019636:Neurodegenerative Diseases / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D009473:Neuronal Plasticity; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D011859:Radiography; D020521:Stroke / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology