Diffusion Tensor Imaging Biomarkers to Predict Motor Outcomes in Stroke: A Narrative Review

Frontiers in Neurology

Joselisa P. Q. de Paiva¹  Adriana B. Conforto¹  Edson Amaro²  Claudia da C. Leite²  Maria C. G. Otaduy²  Rafael Luccas³  Luciana M. Moura³  Alexander Leemans⁴ 

[1] Hospital Israelita Albert Einstein, São Paulo, Brazil;Lim 44, Department of Radiology and Oncology, Faculdade de Medicina, Hospital das Clínicas/São Paulo University, São Paulo, Brazil;Neurostimulation Laboratory, Neurology Department, Hospital das Clínicas/São Paulo University, São Paulo, Brazil;PROVIDI Lab, Image Sciences Institute, UMC Utrecht, Utrecht, Netherlands;

关键词: diffusion MRI (dMRI);    diffusion tensor imaging (DTI);    corticospinal tract (CST);    motor stroke;    stroke recovery;    white matter (WM);   

DOI  :  10.3389/fneur.2019.00445

来源: DOAJ

【 摘 要 】

Stroke is a leading cause of disability worldwide. Motor impairments occur in most of the patients with stroke in the acute phase and contribute substantially to disability. Diffusion tensor imaging (DTI) biomarkers such as fractional anisotropy (FA) measured at an early phase after stroke have emerged as potential predictors of motor recovery. In this narrative review, we: (1) review key concepts of diffusion MRI (dMRI); (2) present an overview of state-of-art methodological aspects of data collection, analysis and reporting; and (3) critically review challenges of DTI in stroke as well as results of studies that investigated the correlation between DTI metrics within the corticospinal tract and motor outcomes at different stages after stroke. We reviewed studies published between January, 2008 and December, 2018, that reported correlations between DTI metrics collected within the first 24 h (hyperacute), 2–7 days (acute), and >7–90 days (early subacute) after stroke. Nineteen studies were included. Our review shows that there is no consensus about gold standards for DTI data collection or processing. We found great methodological differences across studies that evaluated DTI metrics within the corticospinal tract. Despite heterogeneity in stroke lesions and analysis approaches, the majority of studies reported significant correlations between DTI biomarkers and motor impairments. It remains to be determined whether DTI results could enhance the predictive value of motor disability models based on clinical and neurophysiological variables.

【 授权许可】

Unknown