Age-associated hippocampal volume changes in childhood arterial ischemic stroke
- 110 Downloads
Recent evidence suggests that recovery from secondary neurodegeneration following arterial ischemic stroke (AIS) may be related to age at injury and site of occlusion. We conducted a study of hippocampal volume (HCV) in a cohort of pediatric patients with middle cerebral artery (MCA) territory AIS to determine whether HCV would be preserved in younger children as compared to older children.
This single-center, HIPAA-compliant retrospective study was approved by the institutional review board. The medical records of 149 children treated for AIS between 2000 and 2016 were reviewed for inclusion criteria: unilateral MCA territory AIS and availability of high-resolution T1-weighted MR imaging at both acute and chronic time periods. Manual segmentation was utilized to measure stroke-side HCV, contralateral HCV, hemispheric volumes, and stroke volume on each scan. To correct for variable brain size, HCV measurements were ratio normalized. Patients were divided into two age-at-stroke groups: younger (30 days–9 years old) and older (> 9–18 years old). Analysis was performed using Fisher’s test or Student’s t test.
The MR imaging of 19 children (9 younger, 10 older) was analyzed. At follow-up, the average stroke-side HCV increased by 10.9% in the younger group and decreased by 6.3% in the older group (P = 0.010); this between-group difference remained significant even when ratio normalized (P = 0.003). The total brain volume-adjusted acute stroke size between groups was not statistically different (P = 0.649).
In children with AIS, younger age is associated with the relative preservation of HCV, which could reflect differences in age-related plasticity.
KeywordsMagnetic resonance imaging Arterial ischemic stroke Pediatric stroke Hippocampal volume
This study was funded by the American Heart Association Predoctoral Fellowship to Z.R. (Award 15PRE25550151), the American Stroke Association/Bugher Foundation Stroke Collaborative Research Center (Grant 14BFSC17540000), and the Maternal and Child Health Bureau 340B Program at the Mountain States Hemophilia and Thrombosis Center.
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
For this type of study, formal consent was not required.
- 1.Xie M, Yi C, Luo X, Xu S, Yu Z, Tang Y, Zhu W, Du Y, Jia L, Zhang Q, Dong Q, Zhu W, Zhang X, Bu B, Wang W (2011) Glial gap junctional communication involvement in hippocampal damage after middle cerebral artery occlusion. Ann Neurol 70(1):121–132. https://doi.org/10.1002/ana.22386 CrossRefGoogle Scholar
- 2.Tang X, Wang C, Xia L, Zhu W, Zhao L, Zhu W (2012) Volumetric MRI and 1H MRS study of hippocampus in unilateral MCAO patients: relationship between hippocampal secondary damage and cognitive disorder following stroke. Eur J Radiol 81(10):2788–2793. https://doi.org/10.1016/j.ejrad.2011.08.010 CrossRefGoogle Scholar
- 5.Orfila JE, Grewal H, Bernard TJ, Macklin WB, Traystman RJ, Herson PS (2015) Neurophysiological responses of recovery in pediatric mice compared to adult mice with transient focal cerebral ischemia. [abstract]. Stroke 46:A19–A19Google Scholar
- 7.Boccardi M, Bocchetta M, Apostolova LG, Barnes J, Bartzokis G, Corbetta G, DeCarli C, deToledo-Morrell L, Firbank M, Ganzola R, Gerritsen L, Henneman W, Killiany RJ, Malykhin N, Pasqualetti P, Pruessner JC, Redolfi A, Robitaille N, Soininen H, Tolomeo D, Wang L, Watson C, Wolf H, Duvernoy H (2015) Duchesne S16, Jack CR Jr, Frisoni GB; EADC-ADNI working group on the harmonized protocol for manual hippocampal segmentation. Delphi definition of the EADC-ADNI harmonized protocol for hippocampal segmentation on magnetic resonance. Alzheimers Dement 11(2):126–138. https://doi.org/10.1016/j.jalz.2014.02.009 CrossRefGoogle Scholar
- 11.Deng G, Yonchek J, Quillinan N, Strnad FA, Exo J, Herson PS, Traystman RJ (2014) A novel mouse model of pediatric cardiac arrest and cardiopulmonary resuscitation reveals age-dependent neuronal sensitivities to ischemic injury. J Neurosci Methods 222:34–41. https://doi.org/10.1016/j.jneumeth.2013.10.015 CrossRefGoogle Scholar
- 12.Gold JJ, Trauner DA (2014) Hippocampal volume and memory performance in children with perinatal stroke. Pediatr Neurol 50(1):18–25. https://doi.org/10.1016/j.pediatrneurol.2013.08.029 CrossRefGoogle Scholar