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Prognostic Importance of Lesion Location on Functional Outcome in Patients with Cerebellar Ischemic Stroke: a Prospective Pilot Study

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Abstract

To date, few studies focused on prediction of functional recovery after cerebellar stroke. The main aim of this prospective pilot study was to determine the association between cerebellar lesion location and functional outcome in adults with acute cerebellar infarction. We examined 14 patients with first-ever unilateral cerebellar ischemic stroke within 7 days and at 90 days from the onset of stroke by means of the International Cooperative Ataxia Rating Scale. Cerebellar lesions were traced from magnetic resonance imaging performed within 72 h since stroke and region of interest were generated. The association between the International Cooperative Ataxia Rating Scale score and lesion location was determined with the voxel-based lesion-symptom mapping methods implemented in the MRIcro software. Colored lesion-symptom maps representing the z statistics were generated and overlaid onto the MNI-ICBM 152 linear probabilistic atlas of the human brain and the Johns Hopkins University white matter templates. Our results documented that injuries to the V, VI, VIIA Crus I, VIIA Crus II, VIIB, VIIIA, and VIIIB lobules and the middle cerebellar peduncle are significantly associated with the International Cooperative Ataxia Rating Scale (ICARS) score at 1 week after the onset of stroke. Furthermore, we found that injuries to the VI, VIIA Crus I, VIIA Crus II, VIIB, VIIIA, and VIIIB lobules, the dentate nucleus, and the middle cerebellar peduncle are significantly associated with the ICARS score at 3 months since the cerebellar stroke onset. The findings of this pilot study might improve prognostic accuracy of functional outcome in patients with acute cerebellar infarction.

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Acknowledgments

We would like to recognize the contribution of Marco Veronese in helping us with the preparation of various figures in the paper.

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Authors and Affiliations

  1. Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Italy. P.le L.A. Scuro, 10, 37134, Verona, Italy

    Alessandro Picelli & Nicola Smania

  2. Physical Medicine and Rehabilitation Unit, “Villa Salus” Hospital, Venice, Mestre, Italy

    Paola Zuccher

  3. Stroke Unit, Division of Neurology, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy

    Giampaolo Tomelleri & Paolo Bovi

  4. Division of Neurology, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy

    Giuseppe Moretto

  5. Department of Neurological Rehabilitation, “Villa Melitta” Private Hospital, Bolzano, Italy

    Andreas Waldner

  6. Research Department for Neurorehabilitation South Tyrol, Bolzano, Italy

    Andreas Waldner & Leopold Saltuari

  7. Department of Neurology, Hochzirl Hospital, Zirl, Austria

    Leopold Saltuari

  8. Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy

    Nicola Smania

Authors
  1. Alessandro Picelli
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  2. Paola Zuccher
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  3. Giampaolo Tomelleri
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  4. Paolo Bovi
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  5. Giuseppe Moretto
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  6. Andreas Waldner
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  7. Leopold Saltuari
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  8. Nicola Smania
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Corresponding author

Correspondence to Alessandro Picelli.

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Compliance with Ethical Standards

All patients gave their informed consent for participation in the current study, which was carried out according to the Declaration of Helsinki and approved by the local Ethics Committee.

Conflict of Interest

The authors declare that they have no competing interests.

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Picelli, A., Zuccher, P., Tomelleri, G. et al. Prognostic Importance of Lesion Location on Functional Outcome in Patients with Cerebellar Ischemic Stroke: a Prospective Pilot Study. Cerebellum 16, 257–261 (2017). https://doi.org/10.1007/s12311-015-0757-6

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  • DOI: https://doi.org/10.1007/s12311-015-0757-6

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