Evidence map›Paper›PMID 32629166›Full record

ArticleNeuroImage. Clinical2020

Diaschisis revisited: quantitative evaluation of thalamic hypoperfusion in anterior circulation stroke.

Paul Reidler, Franziska Mueller, Lena Stueckelschweiger, Katharina Feil, Lars Kellert, Matthias P Fabritius, Thomas Liebig, Steffen Tiedt, Daniel Puhr-Westerheide, Wolfgang G Kunz

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in NeuroImage. Clinical, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Paul ReidlerDepartment of Radiology, University Hospital, LMU Munich, Germany.
Franziska MuellerDepartment of Radiology, University Hospital, LMU Munich, Germany.
Lena StueckelschweigerDepartment of Radiology, University Hospital, LMU Munich, Germany.
Katharina FeilDepartment of Neurology, University Hospital, LMU Munich, Germany.
Lars KellertDepartment of Neurology, University Hospital, LMU Munich, Germany.
Matthias P FabritiusDepartment of Radiology, University Hospital, LMU Munich, Germany.
Thomas LiebigDepartment of Neuroradiology, University Hospital, LMU Munich, Germany.
Steffen TiedtInstitute for Stroke and Dementia Research, LMU Munich, Germany.
Daniel Puhr-WesterheideDepartment of Radiology, University Hospital, LMU Munich, Germany.
Wolfgang G KunzDepartment of Radiology, University Hospital, LMU Munich, Germany. Electronic address: wolfgang.kunz@med.lmu.de.
LMU Klinikum · DELudwig-Maximilians-Universität München · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIpsilateral thalamic diaschisis (ITD) refers to the phenomenon of thalamic hypoperfusion or hypometabolism due to a distant cerebral injury. To further investigate the characteristics and spectrum of ITD, we analyzed quantitative measurements of thalamic hypoperfusion in acute anterior circulation stroke.

methodsWe selected consecutive patients with large-vessel occlusion (LVO) anterior circulation stroke and available CT perfusion (CTP) examination on admission who underwent endovascular thrombectomy. Thalamic perfusion parameters on CTP were tested between ipsi- and contralesional thalamus and ischemic territory. Values were compared with thresholds from CTP analysis software. Associations of thalamic perfusion parameters with acute imaging and clinical data were determined in uni- and multivariate logistic regression analyses.

resultsNinety-nine patients were included. All perfusion parameters indicated significant non-ischemic hypoperfusion of the thalamus, not reaching the levels of ischemia in the middle cerebral artery territory due to LVO (all p < 0.002). Multiple perfusion parameters exhibited significant association with ischemic lesion extent (relative cerebral blood flow [CBF]: β =  - 0.23, p = 0.022; Δtime to drain: β = 0.33, p < 0.001; ΔTmax: β =  - 0.36, p < 0.001) and involvement of the Lentiform Nucleus (Δmean transit time: β = 0.64, p = 0.04; Δtime to drain: β = 0.81, p = 0.01; ΔTmax: β =  - 0.82, p = 0.01). Symptom severity on admission exhibited minor significant association with reduction of thalamic CBF in uncorrected analysis (Odds ratio: 0.05, p = 0.049), but short- and long-term outcomes were unaffected by perfusion status. ITD reached guideline-based software-threshold levels in only one patient.

conclusionsITD in acute stroke is a non-binary phenomenon affected by lesion extent and involvement of the lentiform nucleus. We found uncorrected association of ITD with early clinical presentation, but no association with short- or long-term outcome was evident. Relevant misclassification of ITD by guideline-based CTP software was not indicated, which needs further dedicated testing.

Indexed as

Brain IschemiaStrokeCerebrovascular CirculationHumansPerfusion ImagingRetrospective StudiesThalamusThrombectomyTomography, X-Ray ComputedCerebral ischemiaCerebrovascular circulationComputed tomographyStrokeThalamus

Identifiers

PMID32629166
PMCPMC7334597
OpenAlexW3037941141

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.