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Myelin Water Imaging of Nerve Recovery in Rehabilitating Stroke Patients

Authors
 Muyul Park  ;  Yejin Cho  ;  Dae Hyun Kim  ;  Hyun Seok Choi  ;  Dong-Hyun Kim  ;  Deog Young Kim 
Citation
 JOURNAL OF MAGNETIC RESONANCE IMAGING, Vol.56(5) : 1548-1556, 2022-11 
Journal Title
JOURNAL OF MAGNETIC RESONANCE IMAGING
ISSN
 1053-1807 
Issue Date
2022-11
MeSH
Anisotropy ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Myelin Sheath* ; Stroke* / diagnostic imaging ; Water
Keywords
brain plasticity ; corticospinal tract ; myelin water imaging ; rehabilitation ; stroke
Abstract
Background: Myelin water imaging (MWI) using MRI has been introduced as a method to quantify the integrity of myelin in vivo. However, the investigation of its potential to probe myelin changes has been limited.

Purpose: To determine the myelin change using MWI in the corticospinal tract (CST) during the rehabilitation of stroke patients.

Study type: Longitudinal.

Population: A total of 24 stroke patients within 6 months from the onset (64.3 ± 16.1 years, 14 women, 10 men) and 10 healthy volunteers (27.0 ± 2.2 years, 2 women, 8 men).

Field strength/sequence: Three-dimensional multiecho gradient echo sequence and diffusion-weighted echoplanar imaging sequence at 3 T.

Assessment: The changes of myelin water fraction (MWF) and fractional anisotropy (FA) during rehabilitation were analyzed in the CST and other regions using tractography software and region of interest drawings by the radiologist.

Statistical tests: A paired t-test was performed to investigate the change of MRI metrics during rehabilitation. In addition, an independent two-sample t-test was performed to investigate the effects of different rehabilitation protocols. A P-value <0.05 was considered significant.

Results: In the CST, MWF significantly changed from 5.83 ± 0.91% to 6.23 ± 0.97% after rehabilitation while changes of FA (0.442 ± 0.038 to 0.443 ± 0.035) were not significant (P = 0.656). The rate of change in MWF and FA, which were 6.69% and 0.439% respectively, were significantly different. Other regions did not show significant changes (range of MWF change: -3.44% to -1.61%, range of FA change: -1.39% to 0.79%, and range of P-value: 0.144-0.761). Further analysis showed that those with additional robot-assisted rehabilitation had a significantly larger MWF change than those with conventional rehabilitation only (rate of change: 11.2% vs. 3.2%).

Data conclusion: The feasibility of using MWI to monitor myelin content was demonstrated by showing the MWF changes during rehabilitation.

Level of evidence: 2 TECHNICAL EFFICACY STAGE: 2.
Full Text
https://onlinelibrary.wiley.com/doi/10.1002/jmri.28185
DOI
10.1002/jmri.28185
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Hyun(김대현)
Kim, Deog Young(김덕용) ORCID logo https://orcid.org/0000-0001-7622-6311
Choi, Hyun Seok(최현석) ORCID logo https://orcid.org/0000-0003-4999-8513
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/192322
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