Abstract 75: Gliosis After Perinatal Stroke: Quantification And Outcomes
Background: Perinatal stroke diseases cause most hemiparetic cerebral palsy: Neonatal Arterial Ischemic Stroke (NAIS), arterial presumed perinatal stroke (APPIS), and periventricular venous infarctions (PVI). Gliosis, a brain reaction to injury, may be both a marker of lesion timing and a potential barrier to cell-based therapies. We hypothesized that gliosis is measureable, comparable between NAIS and APPIS, and associated with poor outcome.
Methods: Children from the Alberta Perinatal Stroke Project were included with: (1) unilateral NAIS, APPIS, or PVI, (2) axial FLAIR MRI >24mos of age, and (3) >24mos follow-up (Pediatric Stroke Outcome Measure). Novel ImageJ software protocols quantifying gliosis were developed (Figure). Gliosis scores (GS) corrected for infarct and brain volume were compared across stroke types, and outcomes (motor, overall).
Results: Of 149 APSP children, 39 were studied (median 10 years, 51% male). GS ranged from 19-1191 (mean 369±361) and did not correlate with age at imaging. GS were comparable between NAIS (438±171) and APPIS (444±380, p=0.97). Arterial GS tended to be higher than PVI lesions (443±337 vs 266±378, p=0.15). Arterial GS correlated with good motor outcome (705±338 vs 312±259, p=0.008) but not overall outcome (p=0.53). PVI GS were not associated with overall or motor outcome. Method reliability was excellent (ρ=0.99).
Conclusion: MRI quantification of gliosis is feasible in children with perinatal stroke. Comparable gliosis in NAIS and APPIS provide further indirect evidence of similar perinatal timing. The association of gliosis with good motor outcome warrants further study.
- © 2012 by American Heart Association, Inc.