Combining Cortical Neurometabolic Changes and Structural Disconnection Improves Stroke Severity Prediction: A High-Resolution 1H-MRSI Study

Motivation: Understanding distant metabolic changes resulting from stroke injuries can offer valuable prognostic biomarkers for patient recovery but remains underexplored. Goal(s): Our goal was to investigate the relationship between lesional and cortical neurometabolic changes, structural disconnections, and their collective impact on stroke severity using high-resolution 3D 1H-MRSI. Approach: 3D 1H-MRSI scanning using SPICE technology (scan time: 8 minutes, resolution: 2×3×3 mm3, FOV: 240×240×72 mm3) was performed on 105 acute ischemic stroke patients. Results: Cortical neurometabolic changes were associated with lesional metabolic levels and structural disconnections, which can be used jointly to improve symptom severity prediction in stroke patients. Impact: The demonstrated predictive value of combining structural disconnections with distant cortical metabolic disruptions may offer prognostic biomarkers useful for treatment and management of stroke patients.