This Article Full Text Full Text (PDF) All Versions of this Article: 35/2/472    most recent 01.STR.0000109771.56160.F5v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Komaba, Y. Articles by Mori, O. Search for Related Content PubMed PubMed Citation Articles by Komaba, Y. Articles by Mori, O. Related Collections PET and SPECT

(Stroke. 2004;35:472.)
© 2004 American Heart Association, Inc.

Original Contributions

Crossed Cerebellar Diaschisis in Patients With Cortical Infarction

Logistic Regression Analysis to Control for Confounding Effects

Yuichi Komaba, MD; Masahiro Mishina, MD; Kouichi Utsumi, MD; Yasuo Katayama, MD; Shiro Kobayashi, MD Osamu Mori, MD

From the Second Department of Internal Medicine (Y.K., M.M., K.U., Y.K.), Department of Neurosurgery (S.K.), and Second Department of Pathology (O.M.), Nippon Medical School, Tokyo, Japan.

Correspondence to Yuichi Komaba, MD, Second Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi Bunkyo-ku, Tokyo 113-0022, Japan.

Background and Purpose— Crossed cerebellar diaschisis (CCD) refers to reduced metabolism and blood flow in the cerebellar hemisphere contralateral to a cerebral lesion. Many cortical areas have been reported to cause CCD without consideration of confounding factors. We performed single-photon emission computed tomography (SPECT) in patients with cortical infarction to identify regions independently related to CCD, controlling for possible confounding effects.

Methods— Patients with unilateral cortical infarction (n=113; 75 male, 38 female; mean±SD age, 66±13 years) underwent SPECT of the brain with N-isopropyl-p-[¹²³I]iodoamphetamine (¹²³I-IMP). Regional cerebral blood flow was measured autoradiographically. Asymmetry indices (AIs) were calculated on the basis of ratios representing symmetrical regional cerebral blood flow in the cerebellum and 16 cerebral regions. CCD was defined as AI for cerebellum >0.1. AIs for 16 cortical regions were considered for both dichotomous and continuous variables for analysis of CCD occurrence by means of backward logistic regression.

Results— For dichotomized variables, hypoperfusion of postcentral (odds ratio [OR]=7.607; 95% CI, 2.299 to 25.174) and supramarginal (OR=3.916; 95% CI, 1.394 to 11.003) regions independently influenced CCD. For continuous variables, hypoperfusion of postcentral (OR=1.044; 95% CI, 1.019 to 1.068) and supramarginal (OR=1.021; 95% CI, 1.001 to 1.041) regions (and, as a negative factor, medial occipital regions; OR=0.942; 95% CI, 0.895 to 0.991) independently influenced CCD.

Conclusions— Many cortical areas apparently do not contribute to CCD. Correspondence of CCD between dichotomized and continuous analyses suggests that location of a lesion, not severity, is the main determinant of CCD.

Key Words: cerebellar diseases • neural pathways • radiopharmaceuticals • tomography, emission computed, single-photon

This article has been cited by other articles:

				J. J. Volpe Cerebellum of the Premature Infant: Rapidly Developing, Vulnerable, Clinically Important J Child Neurol, September 1, 2009; 24(9): 1085 - 1104. [Abstract] [PDF]

				L. Srinivasan, J. Allsop, S.J. Counsell, J.P. Boardman, A.D. Edwards, and M. Rutherford Smaller Cerebellar Volumes in Very Preterm Infants at Term-Equivalent Age are Associated with the Presence of Supratentorial Lesions AJNR Am. J. Neuroradiol., March 1, 2006; 27(3): 573 - 579. [Abstract] [Full Text] [PDF]

				A. C. Flint, M. C. Naley, and C. B. Wright Ataxic Hemiparesis From Strategic Frontal White Matter Infarction With Crossed Cerebellar Diaschisis Stroke, January 1, 2006; 37(1): e1 - e2. [Abstract] [Full Text] [PDF]

				J. Kim, S.-K. Lee, J. D. Lee, Y. W. Kim, and D. I. Kim Decreased Fractional Anisotropy of Middle Cerebellar Peduncle in Crossed Cerebellar Diaschisis: Diffusion-Tensor Imaging-Positron-Emission Tomography Correlation Study AJNR Am. J. Neuroradiol., October 1, 2005; 26(9): 2224 - 2228. [Abstract] [Full Text] [PDF]