2026/11/15 09:10-10:10 Room 401
- Advances in Stroke Neuroimaging
- Time
- Topic
- Speaker
- Moderator
- 09:30-09:50
- White Matter Structural Changes during Acute Ischemic Stroke
- SPEAKER:
Yi-Chia Wei
魏怡嘉
Taiwan (台灣)
- MODERATOR:
Feng-Chi Chang
張豐基
Taiwan (台灣)
Meng Lee
李孟
Taiwan (台灣)
- Yi-Chia Wei
- MD, PhD
-
Attending physician, Chang Gung Memorial Hospital at Keelung
Clinical assistant professor, Chang Gung University
Lecture Abstract：
Background: Acute ischemic lesions can affect white matter beyond the infarct, but conventional diffusion tensor metrics cannot resolve crossing fibres and may be limited in revealing these changes. Fixel-based analysis (FBA) quantifies fibre density (FD), fibre cross-section (FC), and their products (FDC). We used lesion-corrected FBA to map white matter alterations in acute ischemic stroke and relate them to clinical indices.
Methods: Forty-three healthy controls and 28 patients with unilateral subcortical ischemic stroke (14 left-, 14 right-hemispheric) involving the basal ganglia, internal capsule, and corona radiata underwent 3T multi-shell diffusion MRI (b=1500/3000 s/mm²) in the acute stage. Lesion masks were manually labeled on ADC map/DWI images. Each lesion group was compared with controls, adjusting for age, sex, head motion, and intracranial volume, and FBA indices was correlated with NIHSS, mRS, and MoCA scores (family-wise error-corrected).
Results: Left hemisphere-lesion patients showed reduced FC and FDC, without FD change, in the contralesional (right) corticospinal tract; lower FDC in the cerebral peduncle/pontine segment correlated with higher NIHSS. Right hemisphere-lesion patients showed reduced FD and FDC, without FC change, in the corpus callosum, predominantly the splenium, and reduced FD in the bilateral superior corona radiata. In this group, lower FDC correlated with higher NIHSS in the callosal body and superior corona radiata, with higher mRS in the splenium, forceps major, and tapetum, and with lower MoCA in the splenium, forceps major, and posterior thalamic radiation.
Conclusions: Even at the acute stage, subcortical infarcts were accompanied by remote, lesion-side-dependent white matter alterations: corticospinal changes after left-hemispheric stroke and callosal fibre loss after right-hemispheric stroke, both tracking neurological severity, disability, and cognition. Remote FDC may serve as an early imaging marker of post-stroke disability.
Background: Acute ischemic lesions can affect white matter beyond the infarct, but conventional diffusion tensor metrics cannot resolve crossing fibres and may be limited in revealing these changes. Fixel-based analysis (FBA) quantifies fibre density (FD), fibre cross-section (FC), and their products (FDC). We used lesion-corrected FBA to map white matter alterations in acute ischemic stroke and relate them to clinical indices.
Methods: Forty-three healthy controls and 28 patients with unilateral subcortical ischemic stroke (14 left-, 14 right-hemispheric) involving the basal ganglia, internal capsule, and corona radiata underwent 3T multi-shell diffusion MRI (b=1500/3000 s/mm²) in the acute stage. Lesion masks were manually labeled on ADC map/DWI images. Each lesion group was compared with controls, adjusting for age, sex, head motion, and intracranial volume, and FBA indices was correlated with NIHSS, mRS, and MoCA scores (family-wise error-corrected).
Results: Left hemisphere-lesion patients showed reduced FC and FDC, without FD change, in the contralesional (right) corticospinal tract; lower FDC in the cerebral peduncle/pontine segment correlated with higher NIHSS. Right hemisphere-lesion patients showed reduced FD and FDC, without FC change, in the corpus callosum, predominantly the splenium, and reduced FD in the bilateral superior corona radiata. In this group, lower FDC correlated with higher NIHSS in the callosal body and superior corona radiata, with higher mRS in the splenium, forceps major, and tapetum, and with lower MoCA in the splenium, forceps major, and posterior thalamic radiation.
Conclusions: Even at the acute stage, subcortical infarcts were accompanied by remote, lesion-side-dependent white matter alterations: corticospinal changes after left-hemispheric stroke and callosal fibre loss after right-hemispheric stroke, both tracking neurological severity, disability, and cognition. Remote FDC may serve as an early imaging marker of post-stroke disability.
