title: Axial Diffusivity of the Corona Radiata at 24 Hours Post-Stroke: A New Biomarker for Motor and Global Outcome.
abstract: Fractional anisotropy (FA) is an effective marker of motor outcome at the chronic stage of stroke yet proves to be less efficient at early time points. This study aims to determine which diffusion metric in which location is the best marker of long-term stroke outcome after thrombolysis with diffusion tensor imaging (DTI) at 24 hours post-stroke. Twenty-eight thrombolyzed patients underwent DTI at 24 hours post-stroke onset. Ipsilesional and contralesional FA, mean (MD), axial (AD), and radial (RD) diffusivities values were calculated in different Regions-of-Interest (ROIs): (1) the white matter underlying the precentral gyrus (M1), (2) the corona radiata (CoRad), (3) the posterior limb of the internal capsule (PLIC) and (4) the cerebral peduncles (CP). NIHSS scores were acquired at admission, day 1, and day 7; modified Rankin Scores (mRS) at 3 months. Significant decreases were found in FA, MD, and AD of the ipsilesional CoRad and M1. MD and AD were also significantly lower in the PLIC. The ratio of ipsi and contralesional AD of the CoRad (CoRad-rAD) was the strongest diffusion parameter correlated with motor NIHSS scores on day 7 and with the mRS at 3 months. A Receiver-Operator Curve analysis yielded a model for the CoRad-rAD to predict good outcome based on upper limb NIHSS motor scores and mRS with high specificity and sensitivity. FA values were not correlated with clinical outcome. In conclusion, axial diffusivity of the CoRad from clinical DTI at 24 hours post-stroke is the most appropriate diffusion metric for quantifying stroke damage to predict outcome, suggesting the importance of early axonal damage.
authors.affiliation: Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France.|UPMC Paris 6, Inserm, U1127, CNRS, UMR 7225, Paris, France.|CONAM, UPMC Paris 6, Inserm, U1127, CNRS, UMR 7225, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Moulton
authors.affiliation: AP-HP, Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Mélika
authors.initials: M
authors.lastname: Amor-Sahli
authors.affiliation: INSERM U1146, CNRS UMR7371, laboratoire d'imagerie biomédicale, Sorbonne université, UPMC université, Paris 60 UMCR2, Hôpital de la Pitié-Salpêtrière, Paris, France.|IHU-A-ICM, Bioinformatics/Biostatistics Plateform, Paris, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Perlbarg
authors.affiliation: APHP, Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Pires
authors.affiliation: APHP, Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Paris, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Crozier
authors.affiliation: Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France.|UPMC Paris 6, Inserm, U1127, CNRS, UMR 7225, Paris, France.|AP-HP, Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.|COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Galanaud
authors.affiliation: Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France.|UPMC Paris 6, Inserm, U1127, CNRS, UMR 7225, Paris, France.|COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France.|Centre de Neuro-Imagerie de Recherche, http://cenir.org, Hôpital Pitié-Salpêtrière, Paris, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Valabregue
authors.affiliation: APHP, Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Paris, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Yger
authors.affiliation: APHP, Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Paris, France.
authors.forename: Flore
authors.initials: F
authors.lastname: Baronnet-Chauvet
authors.affiliation: Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France.|UPMC Paris 6, Inserm, U1127, CNRS, UMR 7225, Paris, France.|APHP, Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Paris, France.|COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Samson
authors.affiliation: Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France.|UPMC Paris 6, Inserm, U1127, CNRS, UMR 7225, Paris, France.|AP-HP, Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.|COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Dormont
authors.affiliation: Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France.|UPMC Paris 6, Inserm, U1127, CNRS, UMR 7225, Paris, France.|CONAM, UPMC Paris 6, Inserm, U1127, CNRS, UMR 7225, Paris, France.|APHP, Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Paris, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Rosso
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D006801:Humans; D020772:Internal Capsule / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D020521:Stroke / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy*; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D066127:White Matter / Q000473:pathology* / Q000503:physiopathology