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Longitudinal synaptic density PET with 11 C-UCB-J 6 months after ischemic stroke

Ann Neurol. 2022 Dec 31. doi: 10.1002/ana.26593. Online ahead of print.


OBJECTIVE: To explore longitudinal changes in synaptic density after ischemic stroke in vivo with synaptic vesicle protein 2A (SV2A) PET.

METHODS: We recruited patients with an ischemic stroke to undergo 11 C-UCB-J PET/MR within the first month and 6 months after stroke. We investigated longitudinal changes of partial volume corrected 11 C-UCB-J SUVR (standardized uptake value ratio; relative to centrum semiovale) within the ischemic lesion, peri-ischemic area and unaffected ipsilesional and contralesional grey matter. We also explored crossed cerebellar diaschisis at 6 months. Additionally, we defined brain regions potentially influencing upper limb motor recovery after stroke and studied 11 C-UCB-J SUVR evolution in comparison to baseline.

RESULTS: In 13 patients (age = 67±15 years) we observed decreasing 11 C-UCB-J SUVR in the ischemic lesion (ΔSUVR = -1.0, p=0.001) and peri-ischemic area (ΔSUVR = -0.31, p=0.02) at 6 months after stroke compared to baseline. Crossed cerebellar diaschisis as measured with 11 C-UCB-J SUVR was present in 11/13 (85%) patients at 6 months. 11 C-UCB-J SUVR did not augment in ipsilesional or contralesional brain regions associated with motor recovery. On the contrary, there was an overall trend of declining 11 C-UCB-J SUVR in these brain regions, reaching statistical significance only in the non-lesioned part of the ipsilesional supplementary motor area (ΔSUVR = -0.83, p=0.046).

INTERPRETATION: At 6 months after stroke, synaptic density further declined in the ischemic lesion and peri-ischemic area compared to baseline. Brain regions previously demonstrated to be associated with motor recovery after stroke did not show increases in synaptic density. This article is protected by copyright. All rights reserved.

PMID:36585914 | DOI:10.1002/ana.26593

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