title: White matter injury induced by diabetes in acute stroke is clinically relevant: A preliminary study.
abstract: The importance of white matter injury induced by diabetes in stroke severity and prognosis is largely unknown. We aimed to investigate the relationship between diabetes-related white matter injury beyond stroke lesions with acute neurological deficits and clinical outcome after stroke. In total, 36 stroke patients within 3-7 days after onset were enrolled. Neurological deficits on admission were assessed by National Institute of Health Stroke Score, and poor outcome at 3 months was defined as modified Rankin score >2. White matter tracts were compared between patients with diabetic and non-diabetic stroke using fractional anisotropy from diffusion tensor imaging. Regional white matter abnormality with decreased fractional anisotropy was observed in diabetic patients (n = 18) when compared to non-diabetic patients (n = 18). Decreased fractional anisotropy in ipsilesional distal corticospinal tract was independently associated with higher National Institute of Health Stroke Score motor component score (β = -0.444, p = 0.005), and decreased fractional anisotropy in contralesional superior longitudinal fasciculus I was independently related to poor outcome (odds ratio, 0.900; p = 0.033). Our findings suggested that only white matter injury induced by diabetes in specific tracts like corticospinal tract and superior longitudinal fasciculus beyond stroke lesions has clinically relevant, providing insight into the mechanism of stroke recovery under the diabetic condition.
authors.affiliation: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Xinfeng
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Ruirui
authors.initials: R
authors.lastname: Song
authors.affiliation: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Yerfan
authors.initials: Y
authors.lastname: Jiaerken
authors.affiliation: Key Laboratory for Biomedical Engineering of Education Ministry of China, Departments of Biomedical Engineering & Instrument Science Engineering, Zhejiang University, Hangzhou, China.
authors.forename: Lixia
authors.initials: L
authors.lastname: Yuan
authors.affiliation: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Peiyu
authors.initials: P
authors.lastname: Huang
authors.affiliation: Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Min
authors.initials: M
authors.lastname: Lou
authors.affiliation: Department of Neurology, Henry Ford Health System, Detroit, MI, USA.
authors.forename: Quan
authors.initials: Q
authors.lastname: Jiang
authors.affiliation: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China zhangminming@zju.edu.cn.
authors.forename: Minming
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D048909:Diabetes Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D056324:Diffusion Tensor Imaging; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D009460:Neurologic Examination; D016017:Odds Ratio; D011379:Prognosis; D020127:Recovery of Function; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D013997:Time Factors
keywords: Stroke; diabetes mellitus; diffusion weighted imaging; white matter