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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Autores principales:	Leonie Steiner, Andrea Federspiel, Jasmine Jaros, Nedelina Slavova, Roland Wiest, Maja Steinlin, Sebastian Grunt, Regula Everts
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2954234530984df98c58e6a4557c7a30
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spelling	oai:doaj.org-article:2954234530984df98c58e6a4557c7a302021-12-02T19:16:54ZCerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery10.1038/s41598-021-98309-w2045-2322https://doaj.org/article/2954234530984df98c58e6a4557c7a302021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-98309-whttps://doaj.org/toc/2045-2322Abstract 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.Leonie SteinerAndrea FederspielJasmine JarosNedelina SlavovaRoland WiestMaja SteinlinSebastian GruntRegula EvertsNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q 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
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.
format	article
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
title	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_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_sort	cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/2954234530984df98c58e6a4557c7a30
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Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery

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