| Background: Stroke is the second leading cause of death in the world,second only to ischemic heart disease,and also the main cause of disability in adults.Early protection of the white matter microstructure of Acute ischemic stroke(AIS)is of great significance to reduce mortality and improve the prognosis of patients.Vitamin D(VitD)deficiency is very common in patients with acute stroke.Studies believe that VitD,as a neurosteroid hormone,is not only related to the incidence of hypertension,diabetes,obesity,tumor,cardiovascular disease,and other diseases,but also has a great correlation with the occurrence and development of stroke.Diffusion tensor imaging(DTI)and Track density imaging(TDI)were used to investigate the effect of vitamin D on the microstructure of white matter in patients with AIS.Objective: The aim of this study was to investigate whether serum 25-hydroxy vitamin D [25-hydroxy vitamin D,25(OH)D] levels are associated with early white matter microstructural changes in patients with acute ischemic stroke using DTI and TDI.Methods: The subjects were selected according to the project design,and the patients were divided into VitD-deficient group and VitD-sufficient group according to the serum 25(OH)D level at admission.DWI and DTI scanning were completed for all patients,and optical fiber track density tracking was performed on DWI data through relevant post-processing software to analyze the differences in FA values and TDI values between the two groups.Results:1.A total of 33 patients were divided into two groups according to serum 25(OH)D concentration: VitD deficiency group(n=14)and VitD sufficiency group(n= 19).There were no significant differences between the two groups in gender(P =0.445),hypertension(P =0.716),diabetes(P =0.745),dyslipidemia(P =0.238),smoking history(P =0.723),drinking history(P =0.491),NIHSS(P =0.396),infarction volume(P =0.329),etc.Age(P =0.02,r=-0.117)and BMI(P =0.001,r=-0.515)were negatively correlated with serum 25(OH)D.2.The FA and TDI values on the focal side were significantly lower than those on the healthy side in the center of the semiovale,the corona radiata,the hind limb of the internal capsule,and the foot of the brain,and the difference was statistically significant(P < 0.05).Two groups of upper and lower levels of cerebral white matter lesions FA and TDI value reduction(Δ FA,Δ TDI)there was no statistically significant difference(p > 0.05).3.On the side of the lesion,the FA and TDI values of white matter at all levels in the VitD-deficient group were lower than those in the VitD-sufficient group,but there was no statistical significance.The FA value of the healthy side only in the cranial foot level VitD deficient group was significantly lower than that of the VitD sufficient group,and the rest had no statistical significance.Conclusion: After AIS,the structural integrity of local white matter fiber bundles is destroyed and the number of fibers is reduced.VitD has a certain protective effect on the nervous system after stroke,which may be due to the effects of vascular protection,immune regulation and neurotrophic factors of VitD.There is still no theoretical support for the role of TDI in tracing white matter fiber density at the molecular level,which makes it impossible to be used as an imaging marker of nerve fiber bundle in clinic alone. |
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