BACKGROUND AND PURPOSE: Lacunar infarcts may cause disturbances of the white matter (WM) structure remote from the primary lesion. Here, we used diffusion MRI and tractography to (1) spatially characterize microstructural abnormalities along WM tracts containing a lacunar infarct and (2) relate abnormalities in remote parts of the affected WM tract to cognitive outcome. METHODS: In 17 participants with a lacunar infarct, we reconstructed the affected WM tract using fiber tractography. The corresponding nonlesioned tract in the contralateral hemisphere served as a control tract. Diffusion parameters (fractional anisotropy and mean diffusivity) were plotted along the tract and related to measures of memory, executive functioning and information processing speed. RESULTS: Diffusion abnormalities remote from the lacune were present in the affected tract compared with the control tract up to 2 cm from the lacune (9% to 17% decrease in fractional anisotropy, 11% to 27% increase in mean diffusivity; P<0.05). The severity of these abnormalities attenuated with increasing distance to the primary lesion. Furthermore, the degree of remote WM disturbances was related to worse cognitive functioning on all 3 domains, independent of the size of the lacune (r=0.6-0.8; P<0.05). CONCLUSIONS: Lacunar infarcts are associated with abnormalities in the affected WM tract that extend centimeters beyond the lesion visible on conventional MRI. These secondary WM abnormalities may contribute to the cognitive deficits observed in patients with subcortical infarcts.
BACKGROUND AND PURPOSE:Lacunar infarcts may cause disturbances of the white matter (WM) structure remote from the primary lesion. Here, we used diffusion MRI and tractography to (1) spatially characterize microstructural abnormalities along WM tracts containing a lacunar infarct and (2) relate abnormalities in remote parts of the affected WM tract to cognitive outcome. METHODS: In 17 participants with a lacunar infarct, we reconstructed the affected WM tract using fiber tractography. The corresponding nonlesioned tract in the contralateral hemisphere served as a control tract. Diffusion parameters (fractional anisotropy and mean diffusivity) were plotted along the tract and related to measures of memory, executive functioning and information processing speed. RESULTS: Diffusion abnormalities remote from the lacune were present in the affected tract compared with the control tract up to 2 cm from the lacune (9% to 17% decrease in fractional anisotropy, 11% to 27% increase in mean diffusivity; P<0.05). The severity of these abnormalities attenuated with increasing distance to the primary lesion. Furthermore, the degree of remote WM disturbances was related to worse cognitive functioning on all 3 domains, independent of the size of the lacune (r=0.6-0.8; P<0.05). CONCLUSIONS:Lacunar infarcts are associated with abnormalities in the affected WM tract that extend centimeters beyond the lesion visible on conventional MRI. These secondary WM abnormalities may contribute to the cognitive deficits observed in patients with subcortical infarcts.
Authors: Hee Jin Kim; Kiho Im; Hunki Kwon; Jong-Min Lee; Changsoo Kim; Yeo Jin Kim; Na-Yeon Jung; Hanna Cho; Byoung Seok Ye; Young Noh; Geon Ha Kim; En-Da Ko; Jae Seung Kim; Yearn Seong Choe; Kyung Han Lee; Sung Tae Kim; Jae Hong Lee; Michael Ewers; Michael W Weiner; Duk L Na; Sang Won Seo Journal: Neurology Date: 2015-06-10 Impact factor: 9.910
Authors: Eitan Auriel; Brian L Edlow; Yael D Reijmer; Panagiotis Fotiadis; Sergi Ramirez-Martinez; Jun Ni; Anne K Reed; Anastasia Vashkevich; Kristin Schwab; Jonathan Rosand; Anand Viswanathan; Ona Wu; M Edip Gurol; Steven M Greenberg Journal: Neurology Date: 2014-06-11 Impact factor: 9.910
Authors: J Matthijs Biesbroek; Alexander Leemans; Hanna den Bakker; Marco Duering; Benno Gesierich; Huiberdina L Koek; Esther van den Berg; Albert Postma; Geert Jan Biessels Journal: Dement Geriatr Cogn Disord Date: 2018-01-19 Impact factor: 2.959
Authors: Marco Duering; Ruthger Righart; Frank Arne Wollenweber; Vera Zietemann; Benno Gesierich; Martin Dichgans Journal: Neurology Date: 2015-03-25 Impact factor: 9.910
Authors: J E F Moonen; J C Foster-Dingley; A A van den Berg-Huijsmans; W de Ruijter; A J M de Craen; J van der Grond; R C van der Mast Journal: AJNR Am J Neuroradiol Date: 2016-09-22 Impact factor: 3.825