DTI-MR tractography of white matter damage in stroke patients with neglect

M. Urbanski, M. Thiebaut de Schotten, S. Rodrigo, C. Oppenheim, E. Touzé, J.-F. Méder, K. Moreau, C. Loeper-Jeny, B. Dubois, P. Bartolomeo
Exp Brain Res. 2010-11-27; 208(4): 491-505
DOI: 10.1007/s00221-010-2496-8

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1. Exp Brain Res. 2011 Feb;208(4):491-505. doi: 10.1007/s00221-010-2496-8. Epub 2010
Nov 27.

DTI-MR tractography of white matter damage in stroke patients with neglect.

Urbanski M(1), Thiebaut de Schotten M, Rodrigo S, Oppenheim C, Touzé E, Méder JF,
Moreau K, Loeper-Jeny C, Dubois B, Bartolomeo P.

Author information:
(1)INSERM-UPMC UMR S 975, G.H. Pitié-Salpêtrière, 47 boulevard de l’Hôpital,
75013 Paris, France,

Left visual neglect is a dramatic neurological condition that impairs awareness
of left-sided events. Neglect has been classically reported after strokes in the
territory of the right middle cerebral artery. However, the precise lesional
correlates of neglect within this territory remain discussed. Recent evidence
strongly suggests an implication of dysfunction of large-scale perisylvian
networks in chronic neglect, but the quantitative relationships between neglect
signs and damage to white matter (WM) tracts have never been explored. In this
prospective study, we used diffusion tensor imaging (DTI) tractography in twelve
patients with a vascular stroke in the right hemisphere. Six of these patients
showed signs of neglect. Nonparametric voxel-based comparisons between neglect
and controls on fractional anisotropy maps revealed clusters in the perisylvian
WM and in the external capsule. Individual DTI tractography identified specific
disconnections of the fronto-parietal and fronto-occipital pathways in the
neglect group. Voxel-based correlation statistics highlighted correlations
between patients’ performance on two visual search tasks and damage to WM
clusters. These clusters were located in the anterior limb of the internal
capsule and in the WM underlying the inferior frontal gyrus, along the trajectory
of the anterior segment of the arcuate fasciculus (asAF). These results indicate
that chronic visual neglect can result from, and correlate with, damage to
fronto-parietal connections in the right hemisphere, within large-scale cortical
networks important for orienting of spatial attention, arousal and spatial
working memory.

DOI: 10.1007/s00221-010-2496-8
PMID: 21113581 [Indexed for MEDLINE]

Auteurs Bordeaux Neurocampus