Influence of leukoaraiosis on the perception of verticality and lateropulsion after stroke: a prospective cohort study.

• Grant number: 22/11731-5
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: November 01, 2022
• End date: October 31, 2023
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Taiza Elaine Grespan Santos Edwards
• Grantee: Luís Fernando Frameschi Souto
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Brain lesions due to stroke are the leading cause of orientation disorder concerning the gravitational vertical, sometimes called "graviceptive neglect." Our prospective systematic study observed that 73.96% of patients after acute stroke have disorientation concerning the vertical, evidenced by the perception of Visual Verticality (VV) outside the normal range. Evidence indicates that white matter hyperintensity (WMH) is associated with more severe spatial neglect and worse recovery from post-stroke spatial neglect. However, no studies have investigated such a relationship with "graviceptive neglect" in post-stroke patients. The present study investigates the relationship between the presence and severity of WMH with the occurrence and recovery of VV pathological tilt and analyzes the influence of WMH on lateropulsion after stroke. Ninety-six patients in the acute phase after the first stroke included in our prospective cohort study will be analyzed. The investigation of leukoaraiosis will be carried out using the Fazekas visual classification scale based on computed tomography or magnetic resonance (MRI) images of the skull. Underlying this, in patients with MRI, the UBO Detector and OPMAL tools will be used to segment the WMH, establish their volume and map the lesions in atlases. Thus, we will use logistic regression analysis to try to answer the influence of WMH on VV and lateropulsion after stroke. In addition, we will assess which tracts were injured due to WMH and perform a hypothesis test to analyze the difference in lesion load from WMH in these respective subjects.