Cerebral blood flow imbalance is associated with motor outcome after pediatric arterial ischemic stroke.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2019
Historique:
received: 08 04 2019
accepted: 24 09 2019
entrez: 12 10 2019
pubmed: 12 10 2019
medline: 14 3 2020
Statut: epublish

Résumé

Cerebral hemodynamics after arterial ischemic stroke (AIS) in children are largely unknown. This study aims to explore long-term cerebral perfusion balance of vital tissue and its relation to motor outcome after childhood AIS. Patients diagnosed with childhood AIS (≤16 years at diagnosis, time since stroke ≥2 years) and typically developing peers were examined. Hemiparesis was classified according to the Pediatric Stroke Outcome Measure. Manual ability was assessed using the ABILHAND-Kids questionnaire. Cerebral blood flow was measured by arterial spin labeling and analyzed in the following brain regions: the hemispheres, the territory of the anterior cerebral artery (ACA), the middle cerebral artery (MCA), and in subregions of the MCA territory (MCA anterior, middle, posterior). To assess cerebral perfusion balance, laterality indices were calculated using cerebral blood flow in the ipsi- and contralesional hemisphere. Laterality indices were compared between stroke patients with and without hemiparesis, and peers. Twenty participants diagnosed with AIS were included (12 boys, 8 girls; mean age 14.46±4.96 years; time since stroke 8.08±3.62 years); 9 (45%) were diagnosed with hemiparesis. Additionally, 47 typically developing peers (21 boys, 26 girls; mean age 14.24±5.42 years) were studied. Laterality indices were higher in stroke patients and oriented to the contralesional hemisphere in all brain regions except the ACA territory and MCA posterior subregion. This was significantly different from peers, who showed balanced laterality indices. There was a significant correlation between laterality indices and manual ability, except in the ACA territory. AIS is associated with long-term alterations of cerebral blood flow in vital tissue, even in patients without hemiparesis. The degree of imbalance of cerebral perfusion in children after AIS is associated with manual ability.

Identifiants

pubmed: 31603919
doi: 10.1371/journal.pone.0223584
pii: PONE-D-19-09431
pmc: PMC6788710
doi:

Banques de données

Dryad
['10.5061/dryad.g88kb35']

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0223584

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Rebekka Leistner (R)

Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Regula Everts (R)

Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Department of Diabetes, Endocrinology, Clinical Nutrition and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Andrea Federspiel (A)

Psychiatric Neuroimaging Unit, Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland.

Salome Kornfeld (S)

Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Nedelina Slavova (N)

Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Leonie Steiner (L)

Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Roland Wiest (R)

Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Maja Steinlin (M)

Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Sebastian Grunt (S)

Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

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