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. 2021 Aug;36(8):1264-1273.
doi: 10.1002/gps.5520. Epub 2021 Feb 26.

Magnetisation transfer imaging revealed microstructural changes related to apathy symptoms after ischaemic stroke

Elzbieta Klimiec-Moskal  1 , Paulina Karcz  2 , Katarzyna Kowalska  1 , Agnieszka Slowik  1 , Izabela Herman-Sucharska  2 , Tomasz Dziedzic  1
Affiliations

Magnetisation transfer imaging revealed microstructural changes related to apathy symptoms after ischaemic stroke

Elzbieta Klimiec-Moskal et al. Int J Geriatr Psychiatry. 2021 Aug.

Abstract

Objectives: Apathy after stroke is common and has a negative impact on functional recovery. Neuroimaging correlates of poststroke apathy remain unclear. We aimed to investigate microstructural changes associated with the severity of poststroke apathy symptoms.

Methods: We assessed 67 patients with cerebral ischaemia who underwent magnetisation transfer brain imaging 12-15 months after stroke. We used magnetisation transfer ratio (MTR) to represent microstructural integrity. We performed whole-brain voxel-based analysis and subsequent region of interest analysis to investigate the association between MTR and symptoms of poststroke apathy. To assess apathy symptoms, we used clinician-reported version of the Apathy Evaluation Scale.

Results: Voxel-based analysis showed the association between symptoms of apathy and decreased MTR in areas overlapping with structures located in both hemispheres: left thalamus, bilateral hippocampus, bilateral fornix/stria terminalis, right amygdala, splenium of the corpus callosum, the retrolenticular part of left internal capsule and left sagittal stratum. In the region of interest analysis, only lower MTR in right fornix/stria terminalis was associated with greater poststroke apathy symptoms in a multivariate logistic model (odds ratio: 1.25, 95% CI: 1.09-1.46, p = 0.003). These associations were independent of depressive symptoms.

Conclusion: Magnetisation transfer brain imaging 12-15 months after stroke revealed changes in microstructural integrity associated with apathy symptoms in brain areas related to processing emotional information and reward valuation.

Keywords: apathysymptoms; ischaemic stroke; magnetisation transfer ratio; microstructural integrity.

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References

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