Prevalence and Imaging Correlates of Cerebral Diaschisis After Ischemic Stroke: A Systematic Review and Meta-Analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of non-randomized observational imaging studies
PubMed 41594771 · doi:10.3390/brainsci16010050
What was done
A systematic review and meta-analysis (PROSPERO: CRD420251017909) searched PubMed and Embase through February 2025 for studies reporting quantitative measures of diaschisis after ischemic stroke using perfusion, metabolic, or functional imaging. Authors evaluated pooled prevalence across imaging modalities, examined diaschisis subtypes, and tested the effects of stroke severity, age, and study quality.
What was found
Across 66 studies (3,021 patients), the overall pooled prevalence of diaschisis was 53% (95% CI: 47–58%). Crossed cerebellar diaschisis was the most frequently studied subtype (49%). Detection varied primarily by imaging modality: ASL MRI (67%) and PET (58%) showed the highest detection rates, SPECT (53%) and CTP (49%) were intermediate, and DSC-PWI was lowest (28%). Age had no measurable effect and stroke severity had only a modest effect on detection. Egger's tests indicated minimal publication bias.
Why it matters
This review establishes that post-stroke diaschisis is present in over half of patients and is predominantly determined by neuroanatomical disconnection rather than clinical demographics. It highlights that choice of imaging modality strongly influences diagnostic sensitivity.
Limits
The abstract does not specify time from stroke onset to imaging, quantitative criteria for defining diaschisis across studies, or clinical outcome correlations. The included primary studies are non-randomized observational imaging cohorts.
Cited by
- supports Damage to the left frontal lobe turns off or suppresses activity in the right cerebellum due to cross-cerebellar diaschisis.