scholarly journals Hemispheric Difference of Regional Brain Function Exists in Patients With Acute Stroke in Different Cerebral Hemispheres: A Resting-State fMRI Study

2021 ◽  
Vol 13 ◽  
Author(s):  
Jingchun Gao ◽  
Canhong Yang ◽  
Qixiong Li ◽  
Lanpin Chen ◽  
Yijing Jiang ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Brain Function ◽  
Supplementary Motor Area ◽  
Dominant Hemisphere ◽  
Brain Areas ◽  
Middle Cerebral Artery Infarction ◽  
Acute Infarction ◽  
The Right ◽  
The Brain

ObjectiveTo explore the different compensatory mechanisms of brain function between the patients with brain dysfunction after acute ischemic stroke (AIS) in the dominant hemisphere and the non-dominant hemisphere based on Resting-state Functional Magnetic Resonance Imaging (Rs-fMRI).MethodsIn this trial, 15 healthy subjects (HS) were used as blank controls. In total, 30 hemiplegic patients with middle cerebral artery acute infarction of different dominant hemispheres were divided into the dominant hemisphere group (DH) and the non-dominant hemisphere group (NDH), scanned by a 3.0 T MRI scanner, to obtain the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) and compare the differences.ResultsCompared with the HS, increased ALFF values in the brain areas, such as the bilateral midbrain, were observed in DH. Meanwhile decreased ReHo values in the brain areas, such as the right postcentral gyrus (BA3), were also observed. Enhanced ALFF values in the brain areas, such as the left BA6, and enhanced ReHo values in the brain areas, such as the left precuneus, were observed in the NDH. The ALFF and ReHo values of the right BA9 and precentral gyrus were both increased. Compared with DH, the NDH group showed lower ALFF values in the left supplementary motor area and lower ReHo values in the right BA10.ConclusionAfter acute infarction in the middle cerebral artery of the dominant hemisphere, a compensation mechanism is triggered in brain areas of the ipsilateral cortex regulating motor-related pathways, while some brain areas related to cognition, sensation, and motor in the contralateral cortex are suppressed, and the connection with the peripheral brain regions is weakened. After acute infarction in the middle cerebral artery of the non-dominant hemisphere, compensatory activation appears in motor control-related brain areas of the dominant hemisphere. After acute middle cerebral artery infarction in the dominant hemisphere, compared with the non-dominant hemisphere, functional specificity in the bilateral supplementary motor area weakens. After acute middle cerebral artery infarction in different hemispheres, there are hemispheric differences in the compensatory mechanism of brain function.

scholarly journals Hemispheric difference of regional brain function exists in patients with acute stroke in different cerebral hemispheres：a  resting-state fMRI study

2020 ◽  
Author(s):  
Jingchun Gao ◽  
Canhong Yang ◽  
Qixiong Li ◽  
Lanpin Chen ◽  
Yijing Jiang ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Resting State ◽  
Brain Function ◽  
Supplementary Motor Area ◽  
Dominant Hemisphere ◽  
Brain Areas ◽  
Middle Cerebral Artery Infarction ◽  
Acute Infarction ◽  
The Brain

Abstract Objective: To explore the different compensatory mechanisms of brain function between the patients with brain dysfunction after acute ischemic stroke (AIS) in dominant hemisphere and the non-dominant hemisphere, based on Resting-state Functional Magnetic Resonance Imaging (Rs-fMRI).Methods: In this trial, 15 healthy subjects(HS) were used as blank controls. 30 hemiplegic patients with middle cerebral artery acute infarction of the different dominant hemisphere were divided into the dominant hemisphere group (DH) and the non-dominant hemisphere group (NDH), scanned by a 3.0 T MRI scanner, to obtain the amplitude of low frequency fluctuations (ALFF) and regional homogeneity (ReHo) and compare the differences.Results: Compared with the HS, increased ALFF values in the brain areas such as bilateral midbrain were observed in DH. While decreased ReHo values in the brain areas such as right postcentral gyrus (BA3) were also observed. Enhanced ALFF values in the brain areas such as left BA6, and enhanced ReHo values in the brain areas such as left precuneus were observed in NDH. And the ALFF and ReHo values of right BA9 and precentral gyrus were both increased. Compared with DH, NDH have lower ALFF values in left supplementary motor area and lower ReHo values in right BA10.Conclusion: After acute infarction in the middle cerebral artery of the dominant hemisphere, a compensation mechanism is triggered in brain areas of the ipsilateral cortex regulating motor-related pathways, while some brain areas related to cognition, sensation and motor in the contralateral cortex are suppressed, and the connection with the peripheral brain regions is weakened. After acute infarction in the middle cerebral artery of the non-dominant hemisphere, compensatory activation appears in motor control-related brain areas of the dominant hemisphere. After acute middle cerebral artery infarction in the dominant hemisphere, compared with the non-dominant hemisphere, functional specificity in bilateral supplementary motor area weakens. After acute middle cerebral artery infarction in different hemispheres, there are hemispheric differences in the compensatory mechanism of brain function. Trial registration: Ethics Committee of the China-Japan Union Hospital at Jilin University approval. Trial Registration Number:Chinese Clinical Trial Registry ChiCTR-IOR-15007672. Registered July 18, 2016 (No. 2016ks043).

scholarly journals Scalp Acupuncture Enhances the Functional Connectivity of Visual and Cognitive-Motor Function Network of Patients with Acute Ischemic Stroke

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Huacong Liu ◽  
Lanpin Chen ◽  
Guifeng Zhang ◽  
Yijing Jiang ◽  
Shanshan Qu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Functional Connectivity ◽  
Middle Cerebral Artery ◽  
Scalp Acupuncture ◽  
Seed Region ◽  
Dominant Hemisphere ◽  
Nihss Score ◽  
Routine Treatment ◽  
Acute Infarction ◽  
The Brain

Object. To explore the specific effect of the international standard scalp acupuncture (ISSA) on patients with brain dysfunction after acute ischemic stroke (AIS) based on resting-state functional magnetic resonance imaging (Rs-fMRI). Design. A parallel-group randomized controlled trial. Participants. 30 hemiplegic patients with middle cerebral artery acute infarction of the dominant hemisphere. Interventions. 30 patients were divided into 2 groups randomly. 15 patients in the treatment group (TG) were treated with ISSA, needling at the parietal midline (MS5) and left anterior/posterior parietal-temporal oblique lines (MS6 and MS7), combined with western routine treatment. While another 15 patients in the control group (CG) received routine treatment only. Main Outcome Measures. (1) Functional connectivity (FC): patients received brain scan using 3.0 T MRI after the treatment for 1 week. Based on the Matlab2012a platform, SPM12 software and DPABI software were used to process the scanning data and finally the functional connectivity of the brain was obtained. (2) National Institute of Health Stroke Scale (NIHSS) score. Results. The difference in the NIHSS score between the two groups of patients before and after treatment was statistically significant (tNIHSS = 2.225; PNIHSS = 0.038), indicating that TG had a better effect. Centered to the seed region of the left supplementary motor area (SMA) (−5.32, 4.85, 61.38), FC increased at the left middle cerebellar peduncle, left cerebellum posterior lobe (uvula and declive), vermis, fusiform gyrus, lingual gyrus, inferior occipital gyrus, calcarine, cuneus, precuneus, BA7, BA18 and BA19, etc. Centered to the seed region of the left parahippocampal gyrus (PG) (−21.17, −15.95, −20.70), FC increased at the left precuneus, inside-paracingulate, inferior parietal gyrus, paracentral lobule, BA5, BA6, BA7, and BA40, right median cingulate, precuneus, BA19, BA23, and BA31, etc. Conclusions. It is indicated that ISSA can regulate the brain functional connection in patients with middle cerebral artery acute infarction in the dominant hemisphere and specifically strengthen the connections between visual, cognitive, motor control, and planning-related brain regions, which may be related to the recovery of movement in the mechanism. This trial is registered with ChiCTR-IOR-15007672.

scholarly journals Non-survivor patients with malignant middle cerebral artery infarction showed persistently high serum malondialdehyde levels

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Leonardo Lorente ◽  
María M. Martín ◽  
Pedro Abreu-González ◽  
Rafael Sabatel ◽  
Luis Ramos ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Potential Role ◽  
High Serum ◽  
Mortality Prediction ◽  
Middle Cerebral Artery Infarction ◽  
Acute Infarction ◽  
New Findings

Abstract Objective Previously there have been found higher circulating malondialdehyde levels during the first week of ischemic stroke in patients with worst neurological functional outcome, and at moment of ischemic stroke in non-survivor patients. Thus, the aim of our study was to determine the potential role of serum malondialdehyde levels during the first week of a severe cerebral infarction to mortality prediction. Methods This study was observational, prospective, and multicenter. We included patients with a severe malignant middle cerebral artery infarction (MMCAI) defined as patients with computed tomography showing acute infarction in more than of 50% of the territory and Glasgow Coma Scale (GCS) lower than 9. We determined serum concentrations of malondialdehyde on days 1, 4 and 8 of MMCAI. Results Serum malondialdehyde concentrations at days 1 (p < 0.001), 4 (p < 0.001), and 8 (p = 0.001) of MMCAI in non-survivor patients (n = 34) were higher than in survivor patients (n = 34). ROC curve analyses showed that serum malondialdehyde concentrations at days 1, 4, and 8 of MMCAI had an AUC (95% CI) to predict 30-day mortality of 0.77 (0.65–0.86; p < 0.001), 0.82 (0.69–0.91; p < 0.001) and 0.84 (0.70–0.93; p < 0.001) respectively. Conclusions The new findings of our study were that serum malondialdehyde levels during the first week of MMCAI could be used as biomarkers to mortality prediction.

scholarly journals Certain Forms of Matrix Metalloproteinase-9 Accumulate in the Extracellular Space after Microdialysis Probe Implantation and Middle Cerebral Artery Occlusion/Reperfusion

2002 ◽  
Vol 22 (8) ◽  
pp. 918-925 ◽  
Author(s):  
Anna M. Planas ◽  
Carles Justicia ◽  
Sònia Solé ◽  
Bibiana Friguls ◽  
Álvaro Cervera ◽  
...  
Keyword(s):  
Western Blot ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Blot Analysis ◽  
Extracellular Space ◽  
Western Blot Analysis ◽  
Extracellular Fluid ◽  
Microdialysis Probe ◽  
The Right ◽  
The Brain

Matrix metalloproteinases (MMPs) are activated in focal cerebral ischemia. The activation of MMP-9 is involved in blood—brain barrier breakdown and tissue remodeling. The MMPs are released to the extracellular space, but the form and fate of secreted enzymes in brain are unknown. Using microdialysis in vivo, the authors studied whether ischemia-induced MMP-9 in brain tissue was related to free MMP-9 in the extracellular fluid. A microdialysis probe was placed into the right striatum and microdialysis was initiated 24 hours later in controls (n = 7). One hour prior to microdialysis, a group of rats (n = 7) was subjected to 1-hour occlusion of the right middle cerebral artery, followed by reperfusion. Dialysates were collected at discrete time points up to 24 hours, and subjected to zymography and Western blot analysis. The MMP-9 was released after ischemia and accumulated in the extracellular space at 24 hours ( P < 0.05). Free MMP-9 forms include mainly the 95-kd proform, and, to a lesser extent, dimers and cleaved active forms (70 kd), but not the 88-kd form found in tissue. Probe implantation and microdialysis increased free MMP-9 in the dialysate. This increase was concomitant with neutrophil infiltration after the mechanical lesion, as myeloperoxidase was found by means of Western blot analysis in the brain hemisphere subjected to microdialysis ( P < 0.005), and immunohistochemistry revealed the presence of myeloperoxidase stain surrounding the site of probe implantation. The results suggest that certain forms of MMP-9 are released and accumulate in the extracellular space after brain injury, and that vascular alterations and neutrophil recruitment elicit MMP-9 activation in the brain after focal ischemia and trauma.

scholarly journals Immune Cell Infiltration in Malignant Middle Cerebral Artery Infarction: Comparison with Transient Cerebral Ischemia

2013 ◽  
Vol 34 (3) ◽  
pp. 450-459 ◽  
Author(s):  
Hannah X Chu ◽  
Hyun Ah Kim ◽  
Seyoung Lee ◽  
Jeffrey P Moore ◽  
Christopher T Chan ◽  
...  
Keyword(s):  
T Cells ◽  
Cerebral Ischemia ◽  
Middle Cerebral Artery ◽  
Natural Killer ◽  
Cerebral Artery ◽  
Immune Cell ◽  
Immunohistochemical Analysis ◽  
Lymphoid Cells ◽  
Middle Cerebral Artery Infarction ◽  
The Brain

We tested whether significant leukocyte infiltration occurs in a mouse model of permanent cerebral ischemia. C57BL6/J male mice underwent either permanent (3 or 24 hours) or transient (1 or 2 hours+22- to 23-hour reperfusion) middle cerebral artery occlusion (MCAO). Using flow cytometry, we observed ∼15,000 leukocytes (CD45+high cells) in the ischemic hemisphere as early as 3 hours after permanent MCAO (pMCAO), comprising ∼40% lymphoid cells and ∼60% myeloid cells. Neutrophils were the predominant cell type entering the brain, and were increased to ∼5,000 as early as 3 hours after pMCAO. Several cell types (monocytes, macrophages, B lymphocytes, CD8+ T lymphocytes, and natural killer cells) were also increased at 3 hours to levels sustained for 24 hours, whereas others (CD4+ T cells, natural killer T cells, and dendritic cells) were unchanged at 3 hours, but were increased by 24 hours after pMCAO. Immunohistochemical analysis revealed that leukocytes typically had entered and widely dispersed throughout the parenchyma of the infarct within 3 hours. Moreover, compared with pMCAO, there were ∼50% fewer infiltrating leukocytes at 24 hours after transient MCAO (tMCAO), independent of infarct size. Microglial cell numbers were bilaterally increased in both models. These findings indicate that a profound infiltration of inflammatory cells occurs in the brain early after focal ischemia, especially without reperfusion.

Cerebral Blood Flow Velocity during and after Sustained Isometric Skeletal Muscle Contractions in Man

1998 ◽  
Vol 94 (4) ◽  
pp. 353-358 ◽  
Author(s):  
F. J. Imms ◽  
F. Russo ◽  
V. I. Iyawe ◽  
M. B. Segal
Keyword(s):  
Middle Cerebral Artery ◽  
Flow Velocity ◽  
Cerebral Artery ◽  
Cerebral Blood Flow Velocity ◽  
Volume Flow ◽  
Mean Flow ◽  
Arterial Blood ◽  
End Tidal ◽  
The Right ◽  
The Brain

1. Twenty-seven young subjects used their right hand to perform sustained, isometric contractions at 40% of maximum for 2 min while lying supine. 2. During the last 30 s of exercise, mean arterial blood pressure increased by 38 ± 4 mmHg (mean ± S.E.M.) and heart rate by 27 ± 2 beats/min. 3. Nineteen of the subjects respired eucapnically during exercise, increasing ventilation by 4.1 ± 0.5 litres/min. Eight subjects hyperventilated (7.1–19.6 litres/min) and decreased end-tidal Pco2 by 8.2 to 15.1 mmHg during the last minute of exercise. 4. In the eucapnic subjects mean flow velocity in the right (i.e. contralateral to the activated cortex) middle cerebral artery increased by 11.4 ± 1.0 cm/s, a change of 17%, during the contraction. This represents an increase in volume flow to the territory of this vessel, but an increase in global flow to the brain cannot be inferred. 5. In the eight subjects who hyperventilated during exercise, there was no rise of flow velocity in the middle cerebral artery, and in some subjects there was a fall during the first 2 min of recovery. These findings suggest that if subjects hyperventilate during handgrip exercise there could be a fall in volume flow to many regions of the brain during and after the exercise.

Middle Cerebral Artery Response Following Occlusion with a Surgical Clamp

1975 ◽  
Vol 33 ◽  
pp. 400-401
Author(s):  
Ronald F. Dodson ◽  
Yukio Tagashira ◽  
Lena W.F. Chu ◽  
Ronald W. Scates
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Squirrel Monkeys ◽  
Whole Body ◽  
Morphological Response ◽  
Time Period ◽  
Nerve Bundles ◽  
The Right ◽  
The Brain ◽  
L Segment

One of the most consistently reproducible models for studying experimentally induced cerebral infarction in animals has been through surgical occlusion (clamping) of the middle cerebral artery (MCA). The resultant morphological, hemodynamic, and metabolic changes in brain tissue mimic those which occur in man following stroke. Although numerous reports exist which have incorporated this model in their study of ischemic effects on the brain, a void of information exists as to the morphological response of the vessel and its associated nerve bundles following the application of the clip.Adult squirrel monkeys used in this investigation were subjected to transorbital occlusion at the M-l segment of the right middle cerebral artery for respective periods of either 1/2, 1,2,3 or 4 hrs. At the end of the selected time period, the clip was removed and the animals were subjected to whole body perfusion with 500 ml of 3% glutaraldehyde in 0.1 M phosphate buffer.

scholarly journals Higher Serum Melatonin Levels during the First Week of Malignant Middle Cerebral Artery Infarction in Non-Surviving Patients

2019 ◽  
Vol 9 (12) ◽  
pp. 346 ◽  
Author(s):  
Leonardo Lorente ◽  
María M. Martín ◽  
Pedro Abreu-González ◽  
Rafael Sabatel ◽  
Luis Ramos ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Area Under The Curve ◽  
Secondary Brain Injury ◽  
The Novel ◽  
Middle Cerebral Artery Infarction ◽  
Acute Infarction ◽  
Prediction Of Mortality ◽  
Study Results ◽  
Time Of Admission

Objective: The activation of different physiopathological pathways (neuroinflammation, apoptosis, and oxidation) can lead to secondary brain injury in ischemic stroke, and in animal models the administration of melatonin has reduced that secondary injury. Lower levels of serum melatonin were found at the time of admission of cerebral infarction in surviving patients than in non-surviving patients. Thus, we carried out this prospective and observational study with the aim of exploring serum melatonin levels in the first week of a malignant middle cerebral artery infarction (MMCAI) in surviving and non-surviving patients, and to explore the capacity of those levels to predict mortality. Methods: Patients with severe MMCAI, defined as computed tomography showing acute infarction in more than 50% of the territory and Glasgow Coma Scale (GCS) lower than 9, were included in the study. We measured serum melatonin concentrations at days 1, 4, and 8 of MMCAI. Mortality at 30 days was the endpoint of our study. Results: Non-surviving patients (n = 34) compared to surviving patients (n = 34) showed higher serum melatonin levels at days 1 (p < 0.001), 4 (p < 0.001), and 8 (p = 0.001) of MMCAI. Serum melatonin concentrations at days 1, 4, and 8 of MMCAI had an area under the curve (AUC) (95% confidence interval (CI)) in the prediction of mortality of 0.89 (0.80–0.96; p < 0.001), 0.81 (0.68–0.91; p < 0.001), and 0.82 (0.68–0.92; p < 0.001), respectively. Conclusions: The novel findings of our study were that serum melatonin levels in the first week of MMCAI were higher in non-surviving patients, and were able to predict mortality.

scholarly journals Crossed cerebellar diaschisis in patients with acute middle cerebral artery infarction: Occurrence and perfusion characteristics

2015 ◽  
Vol 36 (4) ◽  
pp. 743-754 ◽  
Author(s):  
Wieland H Sommer ◽  
Christine Bollwein ◽  
Kolja M Thierfelder ◽  
Alena Baumann ◽  
Hendrik Janssen ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Symptom Onset ◽  
Ct Perfusion ◽  
Clinical Factors ◽  
Middle Cerebral Artery Infarction ◽  
Whole Brain ◽  
Crossed Cerebellar Diaschisis ◽  
Brain Ct ◽  
Cerebellar Diaschisis

We aimed to investigate the overall prevalence and possible factors influencing the occurrence of crossed cerebellar diaschisis after acute middle cerebral artery infarction using whole-brain CT perfusion. A total of 156 patients with unilateral hypoperfusion of the middle cerebral artery territory formed the study cohort; 352 patients without hypoperfusion served as controls. We performed blinded reading of different perfusion maps for the presence of crossed cerebellar diaschisis and determined the relative supratentorial and cerebellar perfusion reduction. Moreover, imaging patterns (location and volume of hypoperfusion) and clinical factors (age, sex, time from symptom onset) resulting in crossed cerebellar diaschisis were analysed. Crossed cerebellar diaschisis was detected in 35.3% of the patients with middle cerebral artery infarction. Crossed cerebellar diaschisis was significantly associated with hypoperfusion involving the left hemisphere, the frontal lobe and the thalamus. The degree of the relative supratentorial perfusion reduction was significantly more pronounced in crossed cerebellar diaschisis-positive patients but did not correlate with the relative cerebellar perfusion reduction. Our data suggest that (i) crossed cerebellar diaschisis is a common feature after middle cerebral artery infarction which can robustly be detected using whole-brain CT perfusion, (ii) its occurrence is influenced by location and degree of the supratentorial perfusion reduction rather than infarct volume (iii) other clinical factors (age, sex and time from symptom onset) did not affect the occurrence of crossed cerebellar diaschisis.

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