Document Detail

Impaired cerebrovascular reactivity with steal phenomenon is associated with increased diffusion in white matter of patients with Moyamoya disease.
MedLine Citation:
PMID:  20576954     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Reduced cerebrovascular reactivity (CVR) with steal phenomenon is an independent predictor for stroke and may indicate tissue exposed to episodic low-grade ischemia. The apparent diffusion coefficient (ADC) calculated using diffusion-weighted MRI is effective in characterizing focal brain ischemia and subtle structural changes in normal-appearing white matter (WM). We hypothesized that regions of steal phenomenon are associated with increased ADC in normal-appearing WM of patients with Moyamoya disease. METHODS: Twenty-two patients with unilateral CVR impairment secondary to Moyamoya disease and 12 healthy control subjects underwent diffusion-weighted MRI and functional MRI mapping of the cerebrovascular response to hypercapnia. Parametric maps of ADC and CVR were calculated, coregistered, and segmented using automated image processing methods. ADC of normal-appearing WM was compared between hemispheres, and between WM with negative CVR (ie, steal phenomenon) and WM with positive CVR. RESULTS: In patients, ADC of normal-appearing WM was elevated in the hemisphere ipsilateral to the CVR impairment compared with the contralateral hemisphere (P<0.005) and in WM with negative CVR compared with WM with positive CVR (P<0.001). WM in regions of steal phenomenon within the affected hemisphere had higher ADC than homologous contralateral WM (P<0.005). In control subjects, negative CVR in WM was not associated with elevated ADC. CONCLUSIONS: Regions of steal phenomenon are spatially correlated with elevated ADC in normal-appearing WM of patients with Moyamoya disease. This structural abnormality may reflect low-grade ischemic injury after exhaustion of the cerebrovascular reserve capacity.
John Conklin; Jorn Fierstra; Adrian P Crawley; Jay S Han; Julien Poublanc; Daniel M Mandell; Frank L Silver; Michael Tymianski; Joseph A Fisher; David J Mikulis
Related Documents :
20526744 - Hypopituitarism following brain injury: when does it occur and how best to test?
14663624 - Evaluation of the effects of methylprednisolone pulse therapy in patients with systemic...
17538744 - Neurogenic fever.
3602224 - The activation of red blood cell transketolase in groups of patients especially at risk...
20422814 - Effectiveness of treating the renal anemia in chronic hemodialyzed patients by epoietin...
8104424 - Changing perspectives of h2 antagonists for stress ulcer prophylaxis.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-24
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  41     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1610-6     Citation Subset:  IM    
Department of Medical Imaging, Toronto Western Hospital, Toronto, Ontario, Canada.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Brain / physiopathology*
Brain Mapping
Cerebrovascular Circulation
Diffusion Magnetic Resonance Imaging
Image Processing, Computer-Assisted
Middle Aged
Moyamoya Disease / physiopathology*
Patient Selection
Subclavian Steal Syndrome / physiopathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  MicroRNAs Induced During Ischemic Preconditioning.
Next Document:  Characterization of Carotid Plaque Hemorrhage. A CT Angiography and MR Intraplaque Hemorrhage Study.