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Role of cerebral reserve assessed using diffusion-weighted magnetic resonance imaging in determining the rehabilitation potential of acute ischemic stroke

https://doi.org/10.14412/2074-2711-2019-3-26-34

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Abstract

Fractional anisotropy (FA) estimated using diffusion tensor magnetic resonance imaging (dMRI) is considered as a promising biomarker in ischemic stroke (IS). The basis of this study is the assumption that the assessment of FA indices for different white matter tracts will be able to predict the main aspects of the rehabilitation potential even without determining the structural and functional bases of these influences.

Objective: to study the diagnostic significance of changes in FA indices to assess various aspects of the rehabilitation potential in acute IS.

Patients and methods. Examinations were made in 100 patients with IS and in 10 individuals without stroke and cognitive impairment. All the patients underwent dMRI and assessments of rehabilitation potential indicators on days 3 and 10 of the disease and at discharge.

Results and discussion. The indices of FA of the ipsilateral upper longitudinal and cingulum bundles, FA and the size of an infarct focus, asymmetry of FA of the cingulum bundle (rFA), corticospinal tract (at the level of the knee of the internal capsule and bridge) and the anterior limb of the internal capsule, as well as the FA of the splenium and knee of the internal capsule of the intact hemisphere are of the most value for the functional outcome of acute IS. The microstructure of these zones determines the state of most rehabilitation domains. With respect to global outcome, the integrity of the associative tracts of the affected hemisphere is more valuable than the microstructure of the intact hemisphere and rFA. The tracts of the intact hemisphere are of particular importance for the restoration of complex rehabilitation spheres, such as cognitive status and daily living and social skills, which is necessary to ensure patient independence.

Conclusion. The FA indices of the tracts under study seem to be a clinically acceptable biomarker of various aspects of the rehabilitation potential in acute IS. 

About the Authors

A. A. Kulesh
Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia; City Clinical Hospital Four
Russian Federation

26, Petropavlovskaya St., Perm 614990;

2, Kim St., Perm 614107



V. E. Drobakha
Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia; City Clinical Hospital Four
Russian Federation

26, Petropavlovskaya St., Perm 614990;

2, Kim St., Perm 614107



K. V. Sobyanin
Institute of Continuum Mechanics, Ural Branch, Russian Academy of Sciences
Russian Federation
1, Academician Korolev St., Perm 614013


S. P. Kulikova
Higher School of Economics
Russian Federation
20, Myasnitskaya St., Moscow 101000


A. Yu. Bykova
Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia;City Clinical Hospital Four
Russian Federation

26, Petropavlovskaya St., Perm 614990;

2, Kim St., Perm 614107



N. A. Kaileva
Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia; City Clinical Hospital Four
Russian Federation

26, Petropavlovskaya St., Perm 614990;

2, Kim St., Perm 614107



A. A. Monak
Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia; City Clinical Hospital Four
Russian Federation

26, Petropavlovskaya St., Perm 614990



I. N. Shardakov
Institute of Continuum Mechanics, Ural Branch, Russian Academy of Sciences
Russian Federation
1, Academician Korolev St., Perm 614013


V. V. Shestakov
Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia; City Clinical Hospital Four
Russian Federation
26, Petropavlovskaya St., Perm 614990


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For citation:


Kulesh A.A., Drobakha V.E., Sobyanin K.V., Kulikova S.P., Bykova A.Yu., Kaileva N.A., Monak A.A., Shardakov I.N., Shestakov V.V. Role of cerebral reserve assessed using diffusion-weighted magnetic resonance imaging in determining the rehabilitation potential of acute ischemic stroke. Neurology, Neuropsychiatry, Psychosomatics. 2019;11(3):26-34. https://doi.org/10.14412/2074-2711-2019-3-26-34

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)