Wallerian Degeneration of the Cerebral Peduncle and Association with Motor Outcome in Childhood Stroke.


Journal

Pediatric neurology
ISSN: 1873-5150
Titre abrégé: Pediatr Neurol
Pays: United States
ID NLM: 8508183

Informations de publication

Date de publication:
01 2020
Historique:
received: 01 06 2019
accepted: 12 07 2019
pubmed: 15 10 2019
medline: 15 12 2020
entrez: 15 10 2019
Statut: ppublish

Résumé

To evaluate the presence of Wallerian degeneration and its relationship with sensorimotor deficits following childhood-onset arterial ischemic stroke (AIS). Children surviving unilateral AIS older than one month of age were assessed for severity of sensorimotor neurological deficit with the Pediatric Stroke Outcome Measure at least one year post stroke (mean follow-up = 2.9 years, S.D. = ±1.6). The area (mm Asymmetry was compared in 52 children with stroke (cases) and 20 controls (normal brain MRIs). The AI was greater in patients with stroke (mean = 6.8%, S.D. = ±5.9) compared with controls (mean = 3.4%, S.D. = ±3.5, P < 0.02). Patients with poor outcome had an AI of 10% or greater compared with patients with good outcome (mean 10.4 versus 4, P < 0.001), and the AI was moderately correlated with motor deficit severity (r = 0.582, P = 0.001). Asymmetry of the cerebral peduncle is a feasible method of assessing Wallerian degeneration in children with unilateral AIS. The degree of asymmetry in the cerebral peduncles was moderately correlated with neurological outcome severity and reflects the degree of motor deficit in children following stroke.

Sections du résumé

BACKGROUND
To evaluate the presence of Wallerian degeneration and its relationship with sensorimotor deficits following childhood-onset arterial ischemic stroke (AIS).
METHODS
Children surviving unilateral AIS older than one month of age were assessed for severity of sensorimotor neurological deficit with the Pediatric Stroke Outcome Measure at least one year post stroke (mean follow-up = 2.9 years, S.D. = ±1.6). The area (mm
RESULTS
Asymmetry was compared in 52 children with stroke (cases) and 20 controls (normal brain MRIs). The AI was greater in patients with stroke (mean = 6.8%, S.D. = ±5.9) compared with controls (mean = 3.4%, S.D. = ±3.5, P < 0.02). Patients with poor outcome had an AI of 10% or greater compared with patients with good outcome (mean 10.4 versus 4, P < 0.001), and the AI was moderately correlated with motor deficit severity (r = 0.582, P = 0.001).
CONCLUSIONS
Asymmetry of the cerebral peduncle is a feasible method of assessing Wallerian degeneration in children with unilateral AIS. The degree of asymmetry in the cerebral peduncles was moderately correlated with neurological outcome severity and reflects the degree of motor deficit in children following stroke.

Identifiants

pubmed: 31607421
pii: S0887-8994(19)30533-8
doi: 10.1016/j.pediatrneurol.2019.07.004
pii:
doi:

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Pagination

67-73

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Trish Domi (T)

Stroke Imaging Lab for Children, Department of Translational Medicine, The Hospital for Sick Children, Peter Gilgan Centre for Research & Learning, Toronto, Ontario, Canada; Stroke Imaging Lab for Children, Department of Child Health & Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research & Learning, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. Electronic address: trish.domi@sickkids.ca.

Gabrielle deVeber (G)

Pediatrics, University of Toronto, Toronto, Ontario, Canada; Children's Stroke Program, Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada; Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.

David Mikulis (D)

Department of Medical Imaging, Toronto Western Hospital, Toronto, Ontario, Canada; Division of Neuroimaging, University of Toronto, Toronto, Ontario, Canada.

Andrea Kassner (A)

Stroke Imaging Lab for Children, Department of Translational Medicine, The Hospital for Sick Children, Peter Gilgan Centre for Research & Learning, Toronto, Ontario, Canada; Medical Imaging, UofT, Toronto, Ontario, Canada.

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