Ipsilesional volume loss of basal ganglia and thalamus is associated with poor hand function after ischemic perinatal stroke

Abstract Background Perinatal stroke (PS) is the leading cause of hemiparetic cerebral palsy (CP). Involvement of the corticospinal tract on neonatal magnetic resonance imaging (MRI) is predictive of motor outcome in patients with hemiparetic CP. However, early MRI is not available in patients with delayed presentation of PS and prediction of hemiparesis severity remains a challenge. Aims To evaluate the volumes of the basal ganglia, amygdala, thalamus, and hippocampus following perinatal ischemic stroke in relation to hand motor function in children with a history of PS and to compare the volumes of subcortical structures in children with PS and in healthy controls. Methods Term born PS children with arterial ischemic stroke (AIS) (n = 16) and with periventricular venous infarction (PVI) (n = 18) were recruited from the Estonian Pediatric Stroke Database. MRI was accuired during childhood (4-18 years) and the volumes of the basal ganglia, thalamus, amygdala and hippocampus were calculated. The results of stroke patients were compared to the results of 42 age- and sex-matched healthy controls. Affected hand function was evaluated by Assisting Hand Assessment (AHA) and classified by the Manual Ability Classification System (MACS). Results Compared to the control group, children with AIS had smaller volumes of the ipsi- and contralesional thalami, ipsilesional globus pallidus, nucleus accumbens and hippocampus (p < 0.005). Affected hand function in children with AIS was correlated with smaller ipsilesional thalamus, putamen, globus pallidus, hippocampus, amygdala and contralesional amygdala (r > 0.5; p < 0.05) and larger volume of the contralesional putamen and hippocampus (r < − 0.5; p < 0.05). In children with PVI, size of the ipsilesional caudate nucleus, globus pallidus, thalamus (p ≤ 0.001) and hippocampus (p < 0.03) was smaller compared to controls. Smaller volume of the ipsi- and contralesional thalami and ipsilesional caudate nucleus was correlated with affected hand function (r > 0.55; p < 0.05) in children with PVI. Conclusions Smaller volume of ipsilesional thalamus was associated with poor affected hand function regardless of the perinatal stroke subtype. The pattern of correlation between hand function and volume differences in the other subcortical structures varied between children with PVI and AIS. Evaluation of subcortical structures is important in predicting motor outcome following perinatal stroke.

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A Connectome-Based Approach to Assess Motor Outcome after Neonatal Arterial Ischemic Stroke

10.1101/2020.08.24.265173 ◽

2020 ◽

Author(s):

Mariam Al Harrach ◽

Pablo Pretzel ◽

Samuel Groeschel ◽

François Rousseau ◽

Thijs Dhollander ◽

...

Keyword(s):

Ischemic Stroke ◽

Structural Changes ◽

Structural Connectivity ◽

Multiple Linear Regression Model ◽

Brain Regions ◽

Motor Deficit ◽

Healthy Controls ◽

Arterial Ischemic Stroke ◽

Motor Outcome ◽

Motor Areas

AbstractObjectivestudies of motor outcome after Neonatal Arterial Ischemic Stroke (NAIS) often rely on lesion mapping using MRI. However, clinical measurements indicate that motor deficit can be different than what would solely be anticipated by the lesion extent and location. Because this may be explained by the cortical disconnections between motor areas due to necrosis following the stroke, the investigation of the motor network can help in the understanding of visual inspection and outcome discrepancy. In this study, we propose to examine the structural connectivity between motor areas in NAIS patients compared to healthy controls in order to define the cortical and subcortical connections that can reflect the motor outcomeMethods30 healthy controls and 32 NAIS patients with and without Cerebral Palsy (CP) underwent MRI acquisition and manual assessment. The connectome of all participants was obtained from T1-weighted and diffusion-weighted imaging.Resultssignificant disconnections in the lesioned and contra-lesioned hemispheres of patients were found. Furthermore, significant correlations were detected between the structural connectivity metric of specific motor areas and manuality assessed by the Box and Block Test (BBT) scores in patients.Interpretationusing the connectivity measures of these links the BBT score can be estimated using a multiple linear regression model. In addition, the presence or not of CP can also be predicted using the KNN classification algorithm. According to our results, the structural connectome can be an asset in the estimation of gross manual dexterity and can help uncover structural changes between brain regions related to NAIS.

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Susceptibility-weighted MR imaging (SWI) of basal ganglia iron deposition in the early and advanced stages of Parkinson's disease

Neurology neuropsychiatry Psychosomatics ◽

10.14412/2074-2711-2019-2-30-36 ◽

2019 ◽

Vol 11 (2) ◽

pp. 30-36

Author(s):

A. G. Trufanov ◽

A. A. Yurin ◽

A. B. Buriak ◽

S. A. Sandalov ◽

M. M. Odinak ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Basal Ganglia ◽

Substantia Nigra ◽

Caudate Nucleus ◽

Globus Pallidus ◽

Red Nucleus ◽

Regions Of Interest ◽

Iron Deposition ◽

Left Caudate

Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease and the first one among the nosological entities of parkinsonism. Susceptibility-weighted imaging (SWI), magnetic resonance imaging (MRI) pulse sequence, which allows the in vivo estimation of the values of iron deposition in different areas of the brain, is a potential technique for the early diagnosis of PD and for the study of the pathogenesis of its complications.Objective: to compare the values of iron deposition in the basal ganglia in Stages II and III PD and to determine the relationship of clinical findings to the level of iron deposition according to the SWI findings.Patients and methods. Twenty-four patients with Hoehn and Yahr Stages II (n=24) and III (n=12) PD were examined. All the patients underwent brain MRI on a Siemens TrioTim (3T) MRI scanner by using pulse sequences T1, T2, SWI and subsequently quantifying the iron deposition (SPIN software). The accumulation of iron is visualized as an area of reduced signal intensity on SWI, and its estimation in accordance with the SPIN program has accordingly a smaller value. The regions of interest on both sides were the dentate nucleus, substantia nigra, red nucleus, putamen, globus pallidus, and head of the caudate nucleus. The examination protocol also included tests using the following scales: the Unified Parkinson's Disease Rating Scale (UPDRS), the Mini-Mental State Examination (MMSE), Frontal Assessment Batter (FAB), Freezing of Gait (FOG), Gait and Balance Scale (GABS), the Epworth Daytime Sleepiness Scale, the Parkinson's Disease Quality of Life Questionnaire (PDQ), the Beck Depression Inventory, and the Clock-Drawing Test.Results and discussion. The investigators found significant (p<0.05) correlations between the clinical picture and the level of iron deposition in the regions of interest in patients with Stage II PD: FOG – left caudate nucleus (r=-0.94); GABS – left caudate nucleus (r=-0.94); and in patients with stage III of the disease: UPDRS (full) – left red nucleus (r=-0.82), right globus pallidus (r=-0,80), left putamen (r=-0,96); UPDRS (Section 2) – left red nucleus (r=-0.77), left globus pallidus (r=-0.84); UPDRS (Section 3) – right putamen (r=-0,85), right globus pallidus (r=-0.78), left globus pallidus (r=-0,92); FOG – left globus pallidus (r=-0.81); GABS – left red nucleus (r=-0.96), left putamen (r=0.82), right putamen (r=-0.89), left globus pallidus (r=-0.82), right globus pallidus (r=-0.85), left caudate nucleus (r=-0.82), right caudate nucleus (r=-0.89); Beck Depression Inventory – right substantia nigra (r=-0.82).Conclusion. SWI measurement of the values of iron deposition in the structures of the extrapyramidal system in PD provides an additional insight into the pathological processes occurring in them.

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A longitudinal study of the association between basal ganglia volumes and psychomotor symptoms in subjects with late life depression undergoing ECT

Translational Psychiatry ◽

10.1038/s41398-021-01314-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

M. G. A. Van Cauwenberge ◽

F. Bouckaert ◽

K. Vansteelandt ◽

C. Adamson ◽

F. L. De Winter ◽

...

Keyword(s):

Nucleus Accumbens ◽

Basal Ganglia ◽

Caudate Nucleus ◽

Globus Pallidus ◽

Brain Mri ◽

Late Life ◽

Late Life Depression ◽

Core Element ◽

Left Caudate ◽

The Right

AbstractPsychomotor dysfunction (PMD) is a core element and key contributor to disability in late life depression (LLD), which responds well to electroconvulsive therapy (ECT). The neurobiology of PMD and its response to ECT are not well understood. We hypothesized that PMD in LLD is associated with lower striatal volume, and that striatal volume increase following ECT explains PMD improvement. We analyzed data from a two-center prospective cohort study of 110 LLD subjects (>55 years) receiving ECT. Brain MRI and assessment of mood, cognition, and PMD was performed 1 week before, 1 week after, and 6 months after ECT. Volumetry of the caudate nucleus, putamen, globus pallidus, and nucleus accumbens was derived from automatically segmented brain MRIs using Freesurfer®. Linear multiple regression analyses were used to study associations between basal ganglia volume and PMD. Brain MRI was available for 66 patients 1 week post ECT and in 22 patients also six months post ECT. Baseline PMD was associated with a smaller left caudate nucleus. One week after ECT, PMD improved and volume increases were detected bilaterally in the caudate nucleus and putamen, and in the right nucleus accumbens. Improved PMD after ECT did not relate to the significant volume increases in these structures, but was predicted by a nonsignificant volume change in the right globus pallidus. No volume differences were detected 6 months after ECT, compared to baseline. Although PMD is related to lower striatal volume in LLD, ECT-induced increase of striatal volume does not explain PMD improvement.

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MRI in schizophrenia: basal ganglia and white matter T1 times

Psychological Medicine ◽

10.1017/s0033291700022224 ◽

1991 ◽

Vol 21 (3) ◽

pp. 587-598 ◽

Cited By ~ 14

Author(s):

I. Harvey ◽

M. A. Ron ◽

R. Murray ◽

S. Lewis ◽

G. Barker ◽

...

Keyword(s):

Relaxation Time ◽

White Matter ◽

Basal Ganglia ◽

Globus Pallidus ◽

Group Differences ◽

Healthy Controls ◽

Normal Variation ◽

Centrum Semiovale ◽

Schizophrenic Patients ◽

First Time

SYNOPSISThe T1 relaxation time of the basal ganglia (putamen, globus pallidus and head of caudate) and of the frontoparietal centrum semiovale was compared between 49 schizophrenic patients and 36 healthy controls. Previous reports of increased T1 time in the basal ganglia were not confirmed, and group differences were not detected within the white matter. Within patients T1 values could not be related to tardive dyskinesia or other clinical features. Normal variation seen in basal ganglia T1 times is described for the first time: lowest values occur in the globus pallidus and highest in the caudate, and values within the putamen increase rostrally.

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Basal Ganglia

10.1093/med/9780197512166.003.0017 ◽

2021 ◽

pp. 141-146

Author(s):

Farwa Ali ◽

Eduardo E. Benarroch

Keyword(s):

Nucleus Accumbens ◽

Basal Ganglia ◽

Substantia Nigra ◽

Motor Learning ◽

Caudate Nucleus ◽

Globus Pallidus ◽

Subthalamic Nucleus ◽

Motor Program ◽

Pedunculopontine Nucleus ◽

Program Selection

The basal ganglia are a group of nuclei that are involved in motor, cognitive, and behavioral circuits and are especially important in motor program selection and motor learning. The key components of the basal ganglia and their circuitry include the striatum (putamen, caudate nucleus, and nucleus accumbens), globus pallidus (GP), subthalamic nucleus (STN), substantia nigra, pedunculopontine nucleus (PPN), and parts of the thalamus and cortex. The basal ganglia have parallel motor, oculomotor, associative, and limbic circuits. This chapter reviews the anatomy and circuitry of the basal ganglia.

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Inhibitory Control on a Stop Signal Task in Tourette Syndrome before and after Deep Brain Stimulation of the Internal Segment of the Globus Pallidus

Brain Sciences ◽

10.3390/brainsci11040461 ◽

2021 ◽

Vol 11 (4) ◽

pp. 461

Author(s):

Francesca Morreale ◽

Zinovia Kefalopoulou ◽

Ludvic Zrinzo ◽

Patricia Limousin ◽

Eileen Joyce ◽

...

Keyword(s):

Deep Brain Stimulation ◽

Tourette Syndrome ◽

Globus Pallidus ◽

Brain Stimulation ◽

Stop Signal ◽

Stop Signal Task ◽

Healthy Controls ◽

Reactive Inhibition ◽

Double Blind ◽

Deep Brain

As part of the first randomized double-blind trial of deep brain stimulation (DBS) of the globus pallidus (GPi) in Tourette syndrome, we examined the effect of stimulation on response initiation and inhibition. A total of 14 patients with severe Tourette syndrome were recruited and tested on the stop signal task prior to and after GPi-DBS surgery and compared to eight age-matched healthy controls. Tics were significantly improved following GPi-DBS. The main measure of reactive inhibition, the stop signal reaction time did not change from before to after surgery and did not differ from that of healthy controls either before or after GPi-DBS surgery. This suggests that patients with Tourette syndrome have normal reactive inhibition which is not significantly altered by GPi-DBS.

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Morphological Abnormalities in the Basal Ganglia of Dystonia Patients

Stereotactic and Functional Neurosurgery ◽

10.1159/000512599 ◽

2021 ◽

pp. 1-12

Author(s):

Xi Bai ◽

Peter Vajkoczy ◽

Katharina Faust

Keyword(s):

Basal Ganglia ◽

Globus Pallidus ◽

Trajectory Planning ◽

Matched Control ◽

Young Patients ◽

Control Population ◽

Pathogenic Role ◽

Target Region ◽

Morphological Abnormalities ◽

Primary Dystonia

Objective: The pathophysiology of dystonia is poorly understood. As opposed to secondary forms of dystonia, primary dystonia has long been believed to lack any neuroanatomical substrate. During trajectory planning for DBS, however, conspicuous T2-hyperinstensive signal alterations (SA) were registered within the target region, even in young patients, where ischemia is rare. Methods: Fifty MRIs of primary dystonia patients scheduled for DBS were analyzed. Total basal ganglia (BG) volumes, as well as proportionate SA volumes, were measured and compared to 50 age-matched control patients. Results: There was a 10-fold preponderance of percentaged SA within the globus pallidus (GP) in dystonia patients. The greatest disparity was in young patients <25 years. Also, total BG volume differences were observed with larger GP and markedly smaller putamen and caudate in the dystonia group. Conclusions: BG morphology in primary dystonia differed from a control population. Volume reductions of the putamen and caudate may reflect functional degeneration, while volume increases of the GP may indicate overactivity. T2-hyperintensive SA in the GP of young primary dystonia patients, where microvascular lesions are highly unlikely, are striking. Their pathogenic role remains unclear.

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Neurocognitive outcome in a 6-year-old girl with a history of perinatal stroke

European Psychiatry ◽

10.1016/s0924-9338(11)72805-x ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1100-1100

Author(s):

A. Matos-Pires ◽

N. Cardoso-Pereira

Keyword(s):

Working Memory ◽

Ischemic Stroke ◽

Verbal Learning ◽

Arterial Ischemic Stroke ◽

Intellectual Performance ◽

Perinatal Stroke ◽

Intellectual Outcome ◽

History Of ◽

Perinatal Arterial Ischemic Stroke

Perinatal Stroke involves an often poorly understood neurocognitive events affecting the fetus and the new born with a potential for serious intellectual outcome.Our aim is to present a case study on the issue of neurocognitive defects on domains such as intellectual performance, attention and vigilance, executive functioning, visual perception, speed of processing, verbal learning and memory, and working memory on a 6 year old girl with perinatal arterial ischemic stroke.

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Head circumference trajectory in children with perinatal stroke

Journal of Child Neurology ◽

10.1177/0883073821996103 ◽

2021 ◽

pp. 088307382199610

Author(s):

Amanda Leong ◽

Amalia Floer ◽

Adam Kirton ◽

Aleksandra Mineyko

Keyword(s):

Ischemic Stroke ◽

Head Circumference ◽

Developmental Outcomes ◽

Normal Growth ◽

Fisher Exact Test ◽

Arterial Ischemic Stroke ◽

Neurodevelopmental Outcomes ◽

Perinatal Stroke ◽

Head Growth ◽

Poor Outcome

Background: Perinatal stroke is a leading cause of hemiparetic cerebral palsy and lifelong disability. Neurodevelopmental outcomes are difficult to predict and markers of long-term poor outcome continue to be investigated. Deceleration in growth of head circumference has been associated with worse developmental outcomes in neonatal brain injury. We hypothesized that perinatal stroke would result in decreased rates of head growth during childhood that would be associated with worse developmental outcomes. Methods: Patients with magnetic resonance imaging (MRI)–confirmed neonatal arterial ischemic stroke and arterial presumed perinatal ischemic stroke were identified from a population-based research cohort (Alberta Perinatal Stroke Project). Demographics and occipital-frontal circumference data were collected from medical records. Head growth was compared to typically developing control charts using a 2-tailed t test. The Fisher exact test was used to examine associations between Pediatric Stroke Outcome Measures (PSOM) scores and occipital-frontal head circumference. Results: Three hundred fifteen occipital-frontal head circumference measurements were collected from 102 patients (48 female, 54 male), over a median of 3.2 years (standard deviation = 5.18, range = 0-18.3). After 3 months for female patients and 1 year for male patients, occipital-frontal head circumference deviated and remained below normal growth trajectories ( P < .05) with a large effect size (Cohen d >0.8). Poor outcome (PSOM ≥ 1) was associated with smaller occipital-frontal head circumference ( P < .05). Conclusion: Head growth deceleration is observed in children with perinatal arterial ischemic stroke and is associated with poor outcome. Head circumference may be a tool to alert clinicians to the potential of abnormal neurologic outcome.

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Abstract W MP14: Detection of Early Ischemia Varies Extensively with Topography: Concurrent CT versus DWI ASPECTS

Stroke ◽

10.1161/str.46.suppl_1.wmp14 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

David S Liebeskind ◽

Sunil A Sheth ◽

Farhad Mehrkhani ◽

Shahmir Kamalian ◽

Fabien Scalzo ◽

...

Keyword(s):

Ischemic Stroke ◽

Symptom Onset ◽

Regional Variation ◽

Internal Capsule ◽

Kappa Statistic ◽

Subcortical Structures ◽

Subcortical Regions ◽

Cortical Regions ◽

Ct And Mri ◽

Good Agreement

Background: Numerous studies have compared CT with DWI ASPECTS, yet differences in timing between study acquisition may impart error or confound. We analyzed a large cohort of concurrently acquired CT and MRI to discern differences in regional variation in the ability to detect early ischemia. Methods: CT and DWI were acquired within 1 hour of each other during the first 8 hours after symptom onset and pooled from two large academic stroke centers for these analyses. Two raters independently scored CT ASPECTS and DWI ASPECTS at separate reading sessions. Modified DWI-ASPECTS (including only >20% per region) was also scored. Consensus readings were then utilized to compare regional ASPECTS across the 3 ASPECTS scales using the kappa statistic. Results: 136 patients underwent both CT and DWI within 1 hour of each other in the setting of acute ischemic stroke. Regional involvement on DWI included caudate in 57%, lentiform in 73%, insula in 69%, internal capsule in 24%, M1 in 34%, M2 in 49%, M3 in 36%, M4 in 21%, M5 in 57% and M6 in 41%. The agreement between CT and DWI varied by region, from caudate kappa 0.616 (0.484-0.748), to lentiform 0.602 (0.457-0.748), insula 0.690 (0.558-0.822), internal capsule 0.374 (0.189-0.559), M1 0.583 (0.435-0.731), M2 0.515 (0.389-0.641), M3 0.421 (0.275-0.568), M4 0.453 (0.262-0.644), M5 0.388 (0.268-0.507) and M6 0.500 (0.366-0.634). Modified DWI-ASPECTS (>20% per region) and CT demonstrated overall better agreement, yet still markedly varied by region. In general, CT and DWI ASPECTS reveal good agreement in subcortical structures, whereas very limited agreement is noted in several cortical ischemic regions. Modified-DWI ASPECTS improves cortical agreement, yet remains poor in the internal capsule. Conclusions: Detection of early ischemia varies considerably depending on the location or topography depicted with either CT or MRI. Deep subcortical regions are best detected with either modality, whereas cortical regions exhibit marked distinctions. Modified DWI ASPECTS improves agreement with CT ASPECTS in cortical regions.

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