Efficacy of Intravenous Mesenchymal Stem Cells for Motor Recovery After Ischemic Stroke: A Neuroimaging Study

Stroke ◽  
2021 ◽  
Author(s):  
Jungsoo Lee ◽  
Won Hyuk Chang ◽  
Jong-Won Chung ◽  
Soo-Kyoung Kim ◽  
Jin Soo Lee ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Stem Cell ◽  
Ischemic Stroke ◽  
Corticospinal Tract ◽  
Internal Capsule ◽  
Control Group ◽  
Resonance Imaging ◽  
Posterior Limb ◽  
Cell Based Therapy ◽  
Interhemispheric Connectivity

Background and Purpose: Stem cell–based therapy is a promising approach to repair brain damage after stroke. This study was conducted to investigate changes in neuroimaging measures using stem cell–based therapy in patients with ischemic stroke. Methods: In this prospective, open-label, randomized controlled trial with blinded outcome evaluation, patients with severe middle cerebral artery territory infarct were assigned to the autologous mesenchymal stem cell (MSC) treatment or control group. Of 54 patients who completed the intervention, 31 for the MSC and 13 for the control groups were included in this neuroimaging analysis. Motor function was assessed before the intervention and 90 days after randomization using the Fugl-Meyer assessment scale. Neuroimaging measures included fractional anisotropy values of the corticospinal tract and posterior limb of the internal capsule from diffusion tensor magnetic resonance imaging and strength of connectivity, efficiency, and density of the motor network from resting-state functional magnetic resonance imaging. Results: For motor function, the improvement ratio of the Fugl-Meyer assessment score was significantly higher in the MSC group compared with the control group. In neuroimaging, corticospinal tract and posterior limb of the internal capsule fractional anisotropy did not decrease in the MSC group but significantly decreased at 90 days after randomization in the control group. Interhemispheric connectivity and ipsilesional connectivity significantly increased in the MSC group. Change in interhemispheric connectivity showed a significant group difference. Conclusions: Stem cell–based therapy can protect corticospinal tract against degeneration and enhance positive changes in network reorganization to facilitate motor recovery after stroke. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01716481.

Comparing CST Lesion Metrics as Biomarkers for Recovery of Motor and Proprioceptive Impairments After Stroke

2019 ◽  
Vol 33 (10) ◽  
pp. 848-861 ◽  
Author(s):  
Sonja E. Findlater ◽  
Rachel L. Hawe ◽  
Erin L. Mazerolle ◽  
Abdulaziz S. Al Sultan ◽  
Jessica M. Cassidy ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Diffusion Magnetic Resonance Imaging ◽  
Motor Performance ◽  
Corticospinal Tract ◽  
Region Of Interest ◽  
Internal Capsule ◽  
Stroke Recovery ◽  
Future Research ◽  
Resonance Imaging ◽  
Posterior Limb

Background. Corticospinal tract (CST) damage is considered a biomarker for stroke recovery. Several methods have been used to define CST damage and examine its relationship to motor performance, but which method is most useful remains unclear. Proprioceptive impairment also affects stroke recovery and may be related to CST damage. Methods. Robotic assessment quantified upper-limb motor and proprioceptive performance at 2 weeks and 6 months poststroke (n = 149). Three previously-established CST lesion metrics were calculated using clinical neuroimaging. Diffusion magnetic resonance imaging quantified CST microstructure in a subset of participants (n = 21). Statistical region of interest (sROI) analysis identified lesion locations associated with motor and proprioceptive deficits. Results. CST lesion metrics were moderately correlated with motor scores at 2 weeks and 6 months poststroke. CST fractional anisotropy (FA) was correlated with motor scores at 1 month poststroke, but not at 6 months. The FA ratio of the posterior limb of the internal capsule was not correlated with motor performance. CST lesion metrics were moderately correlated with proprioceptive scores at 2 weeks and 6 months poststroke. sROI analysis confirmed that CST damage was associated with motor and proprioceptive deficits and additionally found that putamen, internal capsule, and corticopontocerebellar tract lesions were associated with poor motor performance. Conclusions. Across all methods used to quantify CST damage, correlations with motor or proprioceptive performance were moderate at best. Future research is needed to identify complementary or alternative biomarkers to address the complexity and heterogeneity of stroke recovery.

scholarly journals Magnetic Resonance Imaging of Myocardial Function Following Intracoronary and Intramyocardial Stem Cell Injection

2017 ◽  
Vol 2 (2) ◽  
pp. 112-116
Author(s):  
András Mester ◽  
Balázs Oltean-Péter ◽  
Ioana Rodean ◽  
Diana Opincariu ◽  
Alexandra Stănescu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Stem Cell ◽  
Magnetic Resonance ◽  
Cell Therapy ◽  
Stem Cell Therapy ◽  
Imaging Method ◽  
Resonance Imaging ◽  
Cell Based Therapy

AbstractStem cell-based therapy is a new therapeutic option that can be used in patients with cardiac diseases caused by myocardial injury. Cardiac magnetic resonance imaging (MRI) is a new noninvasive imaging method with an increasingly widespread indication. The aim of this review was to evaluate the role of cardiac MRI in patients with myocardial infarction undergoing stem cell therapy. We studied the role of MRI in the assessment of myocardial viability, stem cell tracking, assessment of cell survival rate, and monitoring of the long-term effects of stem cell therapy. Based on the current knowledge in this field, this noninvasive, in vivo cardiac imaging technique has a large indication in this group of patients and plays an important role in all stages of stem cell therapy, from the indication to the long-term follow-up of patients.

scholarly journals Magnetic resonance imaging and magnetic resonance venography features in heat stroke: a case report

2019 ◽  
Author(s):  
Lizhi Cao ◽  
Juan Wang ◽  
Yaxuan Gao ◽  
Yumei Liang ◽  
Jinhua Yan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
Heat Stroke ◽  
Internal Capsule ◽  
Subcortical White Matter ◽  
Magnetic Resonance Venography ◽  
Resonance Imaging ◽  
Posterior Limb ◽  
External Capsule

Abstract Background: Heat stroke (HS) is a critical illness that can cause multiple organ dysfunction, including damage to the central nervous system (CNS), which can be life-threatening in severe cases. Brain lesions in patients with HS who present with CNS damage have been rarely reported before, and they usually vary in different cases, hence, patients with such lesions may present a clinical challenge in terms of diagnosis and management. Cerebral venous thrombosis (CVT) is a rare cause of stroke that mostly affects young individuals and children. The pathogenesis of brain damage caused by HS is complex, and CVT may be involved in the pathogenesis of HS with CNS damage. In this manuscript, we have reported a case of a patient with HS having CVT with symmetrical lesions in the bilateral putamen, posterior limb of the internal capsule, external capsule, insular lobe, and subcortical white matter in the brain. Case presentation: We encountered a 48-year-old man who presented with HS in the summer season. During admission, he had a high body temperature and was in coma and shock. Then, he developed rhabdomyolysis syndrome, acute kidney and liver damage, electrolyte imbalance, and acid–base balance disorders, and his D-dimer level was elevated. After several days of anti-shock treatment, the patient’s level of consciousness improved. However, he experienced a decline in vision. Cerebral magnetic resonance imaging (MRI) showed symmetrical lesions in the bilateral posterior limb of the internal capsule, putamen, external capsule, insula, and subcortical white matter, and cerebral magnetic resonance venography (MRV) showed the development of CVT. Therefore, anti-coagulation treatment was provided. After timely clinical intervention, the symptoms of the patient gradually improved. Conclusions: This case showed that HS can cause CVT. Therefore, cerebral MRI findings in HS must be assessed; in addition, early MRV can help in the diagnosis of the disease, which can effectively improve prognosis.

scholarly journals Patients With Acute Ischemic Stroke Who Receive Brain Magnetic Resonance Imaging Demonstrate Favorable In‐Hospital Outcomes

2020 ◽  
Vol 9 (20) ◽  
Author(s):  
Hwan Lee ◽  
Yifeng Yang ◽  
Baoqiong Liu ◽  
Simon A. Castro ◽  
Tiantian Shi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Hospital Stay ◽  
Acute Ischemic Stroke ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Control Group ◽  
Inpatient Mortality ◽  
Resonance Imaging

Background Use of inpatient brain magnetic resonance imaging (MRI) in patients with acute ischemic stroke is highly institution dependent and has been associated with increased length and cost of hospital stay. We examined whether inpatient brain MRI in patients with acute ischemic stroke is associated with improved clinical outcomes to justify its resource requirements. Methods and Results The National Inpatient Sample database was queried retrospectively to find 94 003 patients who were admitted for acute ischemic stroke and then received inpatient brain MRI between 2012 and 2014. Multivariable regression analysis was performed with respect to a control group to assess for differences in the rates of inpatient mortality and complications, as well as the length and cost of hospital stay based on brain MRI use. Inpatient brain MRI was independently associated with lower rates of inpatient mortality (1.67% versus 3.09%; adjusted odds ratio [OR], 0.60; 95% CI, 0.53–0.68; P <0.001), gastrostomy (2.28% versus 2.89%; adjusted OR, 0.82; 95% CI, 0.73–0.93; P <0.001), and mechanical ventilation (1.97% versus 2.82%; adjusted OR, 0.68; 95% CI, 0.60–0.77; P <0.001). Brain MRI was independently associated with ≈0.32 days (8%) and $1131 (11%) increase in the total length ( P <0.001) and cost ( P <0.001) of hospital stay, respectively. Conclusions Inpatient brain MRI in patients with acute ischemic stroke is associated with substantial decrease in the rates of inpatient mortality and complications, at the expense of marginally increased length and cost of hospitalization.

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

2019 ◽  
Vol 11 (3) ◽  
pp. 26-34 ◽  
Author(s):  
A. A. Kulesh ◽  
V. E. Drobakha ◽  
K. V. Sobyanin ◽  
S. P. Kulikova ◽  
A. Yu. Bykova ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Diffusion Tensor ◽  
Internal Capsule ◽  
Cognitive Status ◽  
Resonance Imaging ◽  
Diagnostic Significance ◽  
Cingulum Bundle ◽  
Rehabilitation Potential

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. 

scholarly journals Correlation between early magnetic resonance imaging brain abnormalities in term infants with perinatal asphyxia and neuro developmental outcome at one year

2020 ◽  
Vol 7 (10) ◽  
pp. 1957
Author(s):  
Arun Puliyasserimana Satheesan ◽  
Ashwini R. Chinnappa ◽  
Guruprasad Goudar ◽  
Chaitali Raghoji
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Perinatal Asphyxia ◽  
Internal Capsule ◽  
Resonance Imaging ◽  
Term Infants ◽  
Posterior Limb ◽  
Mri Brain ◽  
One Year

Background: Hypoxic ischemic encephalopathy is an important cause of permanent brain damage in neonates with perinatal asphyxia. Magnetic resonance imaging (MRI) is valuable in predicting prognosis following HIE.Methods: Prospective observational cohort study was conducted in tertiary level referral hospital in term infants born with perinatal asphyxia. MRI brain was done between 5 to 14 days of age. Anthropometry and neurological examinations were recorded at birth, discharge and follow-up. Denver developmental screening test II was performed at follow up.Results: Out of 174 neonates born with PA, enrolled 64 underwent MRI brain. Out of these 14% had stage I, 70% stage II and 16 % stage III HIE as per Sarnat staging. At follow up, abnormalities in tone were noted in 36% infants, which included spastic quadriplegia in 34% and atonic cerebral palsy in 2%. DDST II was normal in 32 and suspect in 18 (36%) infants; with global developmental delay in 14 (28%) and predominantly motor development delay in 4 (8%). Abnormal lesions were seen in the corpus callosum in 34 (68%), posterior limb of internal capsule in 14 (28%), basal ganglia in 11 (22%), watershed region in 6 (12%), thalamus in 4 (8%) and corticospinal tract in 1 (2%) infants were associated with statistical significant poor neurodevelopment outcome p<0.05. Diffusion weighted MRI showed abnormalities in the posterior limb of internal capsule (PLIC) in 27 (54%), BG in 8 (16%) and thalamus in 2 (4%) infants was associated with statistically significant poor neurodevelopmental outcome (NDO) (p<0.05).Conclusions: Lesion in BG, thalamic region and PLIC in conventional MRI and abnormality in DW imaging in PLIC and BG were found to correlate with poor NDO at one year of life.

scholarly journals Magnetic resonance imaging and magnetic resonance venography features in heat stroke: a case report

2019 ◽  
Author(s):  
Lizhi Cao ◽  
Juan Wang ◽  
Yaxuan Gao ◽  
Yumei Liang ◽  
Jinhua Yan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
Heat Stroke ◽  
Internal Capsule ◽  
Subcortical White Matter ◽  
Magnetic Resonance Venography ◽  
Resonance Imaging ◽  
Posterior Limb ◽  
External Capsule

Abstract Background: Heat stroke (HS) is a critical illness that can cause multiple organ dysfunction, including damage to the central nervous system (CNS), which can be life-threatening in severe cases. Brain lesions in patients with HS who present with CNS damage have been rarely reported before, and they usually vary in different cases, hence, patients with such lesions may present a clinical challenge in terms of diagnosis and management. Cerebral venous thrombosis (CVT) is a rare cause of stroke that mostly affects young individuals and children. The pathogenesis of brain damage caused by HS is complex, and CVT may be involved in the pathogenesis of HS with CNS damage. In this manuscript, we have reported a case of a patient with HS having CVT with symmetrical lesions in the bilateral putamen, posterior limb of the internal capsule, external capsule, insular lobe, and subcortical white matter in the brain. Case presentation: We encountered a 48-year-old man who presented with HS in the summer season. During admission, he had a high body temperature and was in coma and shock. Then, he developed rhabdomyolysis syndrome, acute kidney and liver damage, electrolyte imbalance, and acid–base balance disorders, and his D-dimer level was elevated. After several days of anti-shock treatment, the patient’s level of consciousness improved. However, he experienced a decline in vision. Cerebral magnetic resonance imaging (MRI) showed symmetrical lesions in the bilateral posterior limb of the internal capsule, putamen, external capsule, insula, and subcortical white matter, and cerebral magnetic resonance venography (MRV) showed the development of CVT. Therefore, anti-coagulation treatment was provided. After timely clinical intervention, the symptoms of the patient gradually improved. Conclusions: This case showed that HS can cause CVT. Therefore, cerebral MRI findings in HS must be assessed; in addition, early MRV can help in the diagnosis of the disease, which can effectively improve prognosis.

scholarly journals Magnetic Resonance Imaging of the Posterior Limb of the Internal Capsule and Neurodevelopmental Impairment After Hypoxic-Ischaemic Encephalopathy. 35

1997 ◽  
Vol 42 (3) ◽  
pp. 391-391
Author(s):  
Mary Rutherford ◽  
Jackie Pennock ◽  
Serena Counsell ◽  
Frances Cowan ◽  
Lilly Dubowitz ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Internal Capsule ◽  
Resonance Imaging ◽  
Posterior Limb ◽  
Neurodevelopmental Impairment

scholarly journals Magnetic resonance imaging and magnetic resonance venography features in heat stroke: a case report

2019 ◽  
Author(s):  
Lizhi Cao ◽  
Juan Wang ◽  
Yaxuan Gao ◽  
Yumei Liang ◽  
Jinhua Yan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
Heat Stroke ◽  
Internal Capsule ◽  
Subcortical White Matter ◽  
Magnetic Resonance Venography ◽  
Resonance Imaging ◽  
Posterior Limb ◽  
External Capsule

Abstract Background: Heat stroke (HS) is a critical illness that can cause multiple organ dysfunction, including damage to the central nervous system (CNS), which can be life-threatening in severe cases. Brain lesions in patients with HS who present with CNS damage have been rarely reported before, and they usually vary in different cases, hence, patients with such lesions may present a clinical challenge in terms of diagnosis and management. Cerebral venous thrombosis (CVT) is a rare cause of stroke that mostly affects young individuals and children. The pathogenesis of brain damage caused by HS is complex, and CVT may be involved in the pathogenesis of HS with CNS damage. In this manuscript, we have reported a case of a patient with HS having CVT with symmetrical lesions in the bilateral putamen, posterior limb of the internal capsule, external capsule, insular lobe, and subcortical white matter in the brain. Case presentation: We encountered a 48-year-old man who presented with HS in the summer season. During admission, he had a high body temperature and was in coma and shock. Then, he developed rhabdomyolysis syndrome, acute kidney and liver damage, electrolyte imbalance, and acid–base balance disorders, and his D-dimer level was elevated. After several days of anti-shock treatment, the patient’s level of consciousness improved. However, he experienced a decline in vision. Cerebral magnetic resonance imaging (MRI) showed symmetrical lesions in the bilateral posterior limb of the internal capsule, putamen, external capsule, insula, and subcortical white matter, and cerebral magnetic resonance venography (MRV) showed the development of CVT. Therefore, anti-coagulation treatment was provided. After timely clinical intervention, the symptoms of the patient gradually improved. Conclusions: This case showed that HS can cause CVT. Therefore, cerebral MRI findings in HS must be assessed; in addition, early MRV can help in the diagnosis of the disease, which can effectively improve prognosis.

Sign in / Sign up

Export Citation Format

Share Document