TY - JOUR
T1 - Diffusion tensor imaging biomarkers to predict motor outcomes in stroke
T2 - A narrative review
AU - Moura, Luciana M.
AU - Luccas, Rafael
AU - De Paiva, Joselisa P.Q.
AU - Amaro, Edson
AU - Leemans, Alexander
AU - Leite, Claudia da C.
AU - Otaduy, Maria C.G.
AU - Conforto, Adriana B.
N1 - Funding Information:
AC, RL, and LM received scholarship from Grant R01NS076348-01 (National Institutes of Health). Funds for publication fees were paid by this grant. JPP received a scholarship from CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
Copyright © 2019 Moura, Luccas, Paiva, Amaro, Leemans, Leite, Otaduy and Conforto. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
PY - 2019/5/8
Y1 - 2019/5/8
N2 - Stroke is a leading cause of disability worldwide. Motor impairments occur in most of the patients with stroke in the acute phase and contribute substantially to disability. Diffusion tensor imaging (DTI) biomarkers such as fractional anisotropy (FA) measured at an early phase after stroke have emerged as potential predictors of motor recovery. In this narrative review, we: (1) review key concepts of diffusion MRI (dMRI); (2) present an overview of state-of-art methodological aspects of data collection, analysis and reporting; and (3) critically review challenges of DTI in stroke as well as results of studies that investigated the correlation between DTI metrics within the corticospinal tract and motor outcomes at different stages after stroke. We reviewed studies published between January, 2008 and December, 2018, that reported correlations between DTI metrics collected within the first 24 h (hyperacute), 2–7 days (acute), and >7–90 days (early subacute) after stroke. Nineteen studies were included. Our review shows that there is no consensus about gold standards for DTI data collection or processing. We found great methodological differences across studies that evaluated DTI metrics within the corticospinal tract. Despite heterogeneity in stroke lesions and analysis approaches, the majority of studies reported significant correlations between DTI biomarkers and motor impairments. It remains to be determined whether DTI results could enhance the predictive value of motor disability models based on clinical and neurophysiological variables.
AB - Stroke is a leading cause of disability worldwide. Motor impairments occur in most of the patients with stroke in the acute phase and contribute substantially to disability. Diffusion tensor imaging (DTI) biomarkers such as fractional anisotropy (FA) measured at an early phase after stroke have emerged as potential predictors of motor recovery. In this narrative review, we: (1) review key concepts of diffusion MRI (dMRI); (2) present an overview of state-of-art methodological aspects of data collection, analysis and reporting; and (3) critically review challenges of DTI in stroke as well as results of studies that investigated the correlation between DTI metrics within the corticospinal tract and motor outcomes at different stages after stroke. We reviewed studies published between January, 2008 and December, 2018, that reported correlations between DTI metrics collected within the first 24 h (hyperacute), 2–7 days (acute), and >7–90 days (early subacute) after stroke. Nineteen studies were included. Our review shows that there is no consensus about gold standards for DTI data collection or processing. We found great methodological differences across studies that evaluated DTI metrics within the corticospinal tract. Despite heterogeneity in stroke lesions and analysis approaches, the majority of studies reported significant correlations between DTI biomarkers and motor impairments. It remains to be determined whether DTI results could enhance the predictive value of motor disability models based on clinical and neurophysiological variables.
KW - Corticospinal tract (CST)
KW - Diffusion MRI (dMRI)
KW - Diffusion tensor imaging (DTI)
KW - Motor stroke
KW - Stroke recovery
KW - White matter (WM)
UR - http://www.scopus.com/inward/record.url?scp=85068064548&partnerID=8YFLogxK
U2 - 10.3389/fneur.2019.00445
DO - 10.3389/fneur.2019.00445
M3 - Review article
C2 - 31156529
AN - SCOPUS:85068064548
SN - 1664-2295
VL - 10
SP - 445
JO - Frontiers in Neurology
JF - Frontiers in Neurology
IS - MAY
M1 - 445
ER -