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<p>Visual spatial neglect (VSN) is a common dysfunction of the right hemisphere following stroke and is associated with poor outcomes in activities of daily living. The first 3 months after stroke are critical for patient recovery. However, the neuroanatomical mechanisms underlying VSN, particularly those involving white matter microstructures during recovery, remain unclear.&#xa0;In this retrospective study, we included 41 patients with VSN after right hemisphere stroke. All patients underwent diffusion tensor imaging (DTI) and a series of paper-and-pencil tests at 3–6 weeks post-stroke, followed by repeat testing at 3 months post-stroke. Patients were subdivided into two groups: a non-recovery group (23 patients) and a rapid recovery group (18 patients). Tract-based spatial statistics (TBSS) and voxel-based analysis (VBA) were used to analyse the differences between the two groups.&#xa0;Compared with the rapid recovery group, the non-recovery group showed significant reductions in TBSS-fractional anisotropy (FA) values in the right superior hemispheric superior longitudinal fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, inferior longitudinal fasciculus, genu of the corpus callosum, posterior limb of the internal capsule, anterior corona radiata, and superior corona radiata. Significant differences were observed between the two groups in baseline star cancellation performance, age, and Fugl-Meyer&#xa0;Assessment (FMA). Logistic regression analysis revealed associations between VSN prognosis, line bisection and FMA. White matter microstructures represented by the superior longitudinal fasciculus play a crucial role in the recovery of VSN after stroke. These structures are involved not only in the affected hemisphere but also in the contralateral hemisphere.</p>

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Analysis of recovery-related white matter microstructures in visual spatial neglect based on diffusion tensor imaging

  • 期刊论文

  • 发表日期：

    2026年2月19日

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  • Linlin Ye,
  • Wanying Zhao,
  • Weiqun Song,
  • Huaqing Yang,
  • Huanxin Xie,
  • Lei Cao

摘要

Visual spatial neglect (VSN) is a common dysfunction of the right hemisphere following stroke and is associated with poor outcomes in activities of daily living. The first 3 months after stroke are critical for patient recovery. However, the neuroanatomical mechanisms underlying VSN, particularly those involving white matter microstructures during recovery, remain unclear. In this retrospective study, we included 41 patients with VSN after right hemisphere stroke. All patients underwent diffusion tensor imaging (DTI) and a series of paper-and-pencil tests at 3–6 weeks post-stroke, followed by repeat testing at 3 months post-stroke. Patients were subdivided into two groups: a non-recovery group (23 patients) and a rapid recovery group (18 patients). Tract-based spatial statistics (TBSS) and voxel-based analysis (VBA) were used to analyse the differences between the two groups. Compared with the rapid recovery group, the non-recovery group showed significant reductions in TBSS-fractional anisotropy (FA) values in the right superior hemispheric superior longitudinal fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, inferior longitudinal fasciculus, genu of the corpus callosum, posterior limb of the internal capsule, anterior corona radiata, and superior corona radiata. Significant differences were observed between the two groups in baseline star cancellation performance, age, and Fugl-Meyer Assessment (FMA). Logistic regression analysis revealed associations between VSN prognosis, line bisection and FMA. White matter microstructures represented by the superior longitudinal fasciculus play a crucial role in the recovery of VSN after stroke. These structures are involved not only in the affected hemisphere but also in the contralateral hemisphere.