MRI scans
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While post-stroke recovery can be quite unpredictable, a new observational study shows a possible association between age-related damage in brain regions that have white matter and recovery after stroke.

Age-Related Brain White Matter Changes and Stroke Recovery

The observational study, entitled "Modulation of the Association Between Corticospinal Tract Damage and Outcome After Stroke by White Matter Hyperintensities," used MRI images to measure the brain area that experienced damage due to stroke. The study specifically examined white matter hyperintensities, which are damage sites within the brain.

The authors discovered that age-related white matter changes within the brain could influence stroke recovery. Sook-Lei Liew, PhD, the study's lead author and an associate professor from th USC Keck School of Medicine Department of Neurology and the USC Viterbi School Department of Biomedical Engineering, explains that the study is one of the few to show the link between motor control post-stroke and white matter hyperintensities.

With data taken from the ENIGMA Stroke Recovery Working Group, the researchers monitored 223 stroke patients across seven different research sites in four countries.

The participants were asked regarding their symptoms of motor control. Those who participated in the study had various recovery stages post-stroke. The data revealed an average of 147 days after stroke.

Researchers found that the size of the white matter hyperintensity and the brain region impacted by stroke were positively associated with motor control symptoms. They also discovered that in individuals who had fewer white matter hyperintensities, the motor control symptoms were linked more to the size of the area that the stroke affected.

On the contrary, individuals who had larger white matter hyperintensities exhibited a stronger association with corticospinal tract damage.

The researchers suggest that such findings could shed light on how white matter hyperintensities modify the motor control recovery of an individual post-stroke.

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White Matter Hyperintensities

White matter hyperintensities appear as they do in MRI scans because they represent areas of fluid accumulation. They can be found in more than half of individuals over 60 and are also related to aging.

Such areas have been revealed to increase with age and are associated with cognition and Alzheimer's Disease risk. José Morales, MD, a neuro-interventional surgeon and vascular neurologist from the Pacific Neuroscience Institute, says that white matter hyperintensities are a radiological finding commonly identified in MRI scan's FLAIR (Fluid Attenuated Inversion Recovery) sequence.

These hyperintensities refer specifically to lesions on the brain's white matter tracts.

Earlier research has revealed that white matter hyperintensity volume is linked to a shorter telomere length. Telomeres are repetitive, non-coding DNA sequences at the end of chromosomes and shorten cell division time. This means that, as a person ages, cell telomeres become shorter.

Liew explains that white matter hyperintensity is lesions of white matter in the brain that are believed to result from ischemic damage and/or reduced blood flow. While this can result from various things, recent research reveals that this could also be reversed. They are typically linked to stroke risk, cognitive decline, and other vascular conditions. It is believed that lifestyle modifications for high blood pressure reduction could be quite beneficial.

The researchers' next steps would be to identify white matter hyperintensity biomarkers.

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