Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery
Abstract Adaptive recovery of cerebral perfusion after pediatric arterial ischemic stroke (AIS) is sought to be crucial for sustainable rehabilitation of cognitive functions. We therefore examined cerebral blood flow (CBF) in the chronic stage after stroke and its association with cognitive outcome...
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| Format: | Article |
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Nature Portfolio
2021-09-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-98309-w |
| _version_ | 1818342373671829504 |
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| author | Leonie Steiner Andrea Federspiel Jasmine Jaros Nedelina Slavova Roland Wiest Maja Steinlin Sebastian Grunt Regula Everts |
| author_facet | Leonie Steiner Andrea Federspiel Jasmine Jaros Nedelina Slavova Roland Wiest Maja Steinlin Sebastian Grunt Regula Everts |
| author_sort | Leonie Steiner |
| collection | DOAJ |
| description | Abstract Adaptive recovery of cerebral perfusion after pediatric arterial ischemic stroke (AIS) is sought to be crucial for sustainable rehabilitation of cognitive functions. We therefore examined cerebral blood flow (CBF) in the chronic stage after stroke and its association with cognitive outcome in patients after pediatric AIS. This cross-sectional study investigated CBF and cognitive functions in 14 patients (age 13.5 ± 4.4 years) after pediatric AIS in the middle cerebral artery (time since AIS was at least 2 years prior to assessment) when compared with 36 healthy controls (aged 13.8 ± 4.3 years). Cognitive functions were assessed with neuropsychological tests, CBF was measured with arterial spin labeled imaging in the anterior, middle, and posterior cerebral artery (ACA, MCA, PCA). Patients had significantly lower IQ scores and poorer cognitive functions compared to healthy controls (p < 0.026) but mean performance was within the normal range in all cognitive domains. Arterial spin labeled imaging revealed significantly lower CBF in the ipsilesional MCA and PCA in patients compared to healthy controls. Further, we found significantly higher interhemispheric perfusion imbalance in the MCA in patients compared to controls. Higher interhemispheric perfusion imbalance in the MCA was significantly associated with lower working memory performance. Our findings revealed that even years after a pediatric stroke in the MCA, reduced ipsilesional cerebral blood flow occurs in the MCA and PCA and that interhemispheric imbalance is associated with cognitive performance. Thus, our data suggest that cerebral hypoperfusion might underlie some of the variability observed in long-term outcome after pediatric stroke. |
| first_indexed | 2024-12-13T16:13:40Z |
| format | Article |
| id | doaj.art-2954234530984df98c58e6a4557c7a30 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-13T16:13:40Z |
| publishDate | 2021-09-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-2954234530984df98c58e6a4557c7a302022-12-21T23:38:53ZengNature PortfolioScientific Reports2045-23222021-09-0111111010.1038/s41598-021-98309-wCerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral arteryLeonie Steiner0Andrea Federspiel1Jasmine Jaros2Nedelina Slavova3Roland Wiest4Maja Steinlin5Sebastian Grunt6Regula Everts7Division of Neuropediatrics, Development and Rehabilitation, Department of Pediatrics, Inselspital, Bern University Hospital, University of BernPsychiatric Neuroimaging Unit, Translational Research Center, University Hospital of Psychiatry, University of BernDivision of Neuropediatrics, Development and Rehabilitation, Department of Pediatrics, Inselspital, Bern University Hospital, University of BernDepartment of Interventional, Pediatric and Diagnostic Radiology, Inselspital, University Hospital, and University of BernInstitute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University HospitalDivision of Neuropediatrics, Development and Rehabilitation, Department of Pediatrics, Inselspital, Bern University Hospital, University of BernDivision of Neuropediatrics, Development and Rehabilitation, Department of Pediatrics, Inselspital, Bern University Hospital, University of BernDivision of Neuropediatrics, Development and Rehabilitation, Department of Pediatrics, Inselspital, Bern University Hospital, University of BernAbstract Adaptive recovery of cerebral perfusion after pediatric arterial ischemic stroke (AIS) is sought to be crucial for sustainable rehabilitation of cognitive functions. We therefore examined cerebral blood flow (CBF) in the chronic stage after stroke and its association with cognitive outcome in patients after pediatric AIS. This cross-sectional study investigated CBF and cognitive functions in 14 patients (age 13.5 ± 4.4 years) after pediatric AIS in the middle cerebral artery (time since AIS was at least 2 years prior to assessment) when compared with 36 healthy controls (aged 13.8 ± 4.3 years). Cognitive functions were assessed with neuropsychological tests, CBF was measured with arterial spin labeled imaging in the anterior, middle, and posterior cerebral artery (ACA, MCA, PCA). Patients had significantly lower IQ scores and poorer cognitive functions compared to healthy controls (p < 0.026) but mean performance was within the normal range in all cognitive domains. Arterial spin labeled imaging revealed significantly lower CBF in the ipsilesional MCA and PCA in patients compared to healthy controls. Further, we found significantly higher interhemispheric perfusion imbalance in the MCA in patients compared to controls. Higher interhemispheric perfusion imbalance in the MCA was significantly associated with lower working memory performance. Our findings revealed that even years after a pediatric stroke in the MCA, reduced ipsilesional cerebral blood flow occurs in the MCA and PCA and that interhemispheric imbalance is associated with cognitive performance. Thus, our data suggest that cerebral hypoperfusion might underlie some of the variability observed in long-term outcome after pediatric stroke.https://doi.org/10.1038/s41598-021-98309-w |
| spellingShingle | Leonie Steiner Andrea Federspiel Jasmine Jaros Nedelina Slavova Roland Wiest Maja Steinlin Sebastian Grunt Regula Everts Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery Scientific Reports |
| title | Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery |
| title_full | Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery |
| title_fullStr | Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery |
| title_full_unstemmed | Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery |
| title_short | Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery |
| title_sort | cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery |
| url | https://doi.org/10.1038/s41598-021-98309-w |
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