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The following is a summary of “Localization and network connectivity of lesions causing limb ataxia in patients with stroke,” published in the August 2024 issue of Neurology by Liesmäki et al.
Ataxia usually originates from the cerebellum damage. However, it can grow, like in anterior circulation strokes, without evident cerebellar injury.
Researchers conducted a prospective study investigating if strokes causing limb ataxia affect a common brain network.
They studied adult patients with stroke history at Turku University Hospital, examining them for limb ataxia at their hospital stay baseline and again after 4 months. The lesion locations and brain connectivity between patients with and without ataxia were compared using voxel-based methods, and findings were confirmed in an independent patient group with stroke.
The results showed that out of 197 patients (average age 67.2 years, 39%female), 35 had had acute limb ataxia at the start, and 162 (67.0 years, 40%female) did not. By follow-up, 4 additional patients developed ataxia, bringing the total to 39 patients (average age 68.6 years, 36%female) with limb ataxia. A 118 patients (average age 66.2 years, 40%female) never had ataxia, with 40 missing follow-up data. For those with acute limb ataxia, 54% had lesions outside the cerebellum and cerebellar peduncles, and no specific lesion locations were linked to ataxia. However, these lesions were connected to a common network centered on the intermediate cerebellum and cerebellar peduncles (PFWE<0.05). This network connection was also seen when including all ataxia cases or excluding cerebellar lesions (PFWE <0.05). The results were confirmed in an independent dataset (n = 96), showing an OR of 2.27 (95% CI: 1.32–3.91) for limb ataxia per standard deviation increase in network damage score.
Investigators concluded that lesions causing limb ataxia can be connected to a shared brain network in various locations.
Source: neurology.org/doi/10.1212/WNL.0000000000209803
