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Li Y, Yu Z, Wu P, Chen J. Ability of an altered functional coupling between resting-state networks to predict behavioral outcomes in subcortical ischemic stroke: A longitudinal study. Front Aging Neurosci 2022; 14:933567. [PMID: 36185473 PMCID: PMC9520312 DOI: 10.3389/fnagi.2022.933567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/16/2022] [Indexed: 11/22/2022] Open
Abstract
Stroke can be viewed as an acute disruption of an individual's connectome caused by a focal or widespread loss of blood flow. Although individuals exhibit connectivity changes in multiple functional networks after stroke, the neural mechanisms that underlie the longitudinal reorganization of the connectivity patterns are still unclear. The study aimed to determine whether brain network connectivity patterns after stroke can predict longitudinal behavioral outcomes. Nineteen patients with stroke with subcortical lesions underwent two sessions of resting-state functional magnetic resonance imaging scanning at a 1-month interval. By independent component analysis, the functional connectivity within and between multiple brain networks (including the default mode network, the dorsal attention network, the limbic network, the visual network, and the frontoparietal network) was disrupted after stroke and partial recovery at the second time point. Additionally, regression analyses revealed that the connectivity between the limbic and dorsal attention networks at the first time point showed sufficient reliability in predicting the clinical scores (Fugl-Meyer Assessment and Neurological Deficit Scores) at the second time point. The overall findings suggest that functional coupling between the dorsal attention and limbic networks after stroke can be regarded as a biomarker to predict longitudinal clinical outcomes in motor function and the degree of neurological functional deficit. Overall, the present study provided a novel opportunity to improve prognostic ability after subcortical strokes.
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Affiliation(s)
- Yongxin Li
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Zeyun Yu
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ping Wu
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiaxu Chen
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
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52
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Almeida SRM, Stefano Filho CA, Vicentini J, Novi SL, Mesquita RC, Castellano G, Li LM. Modeling functional network topology following stroke through graph theory: functional reorganization and motor recovery prediction. Braz J Med Biol Res 2022; 55:e12036. [PMID: 35976269 PMCID: PMC9377533 DOI: 10.1590/1414-431x2022e12036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 06/10/2022] [Indexed: 11/21/2022] Open
Abstract
The study of functional reorganization following stroke has been steadily growing
supported by advances in neuroimaging techniques, such as functional magnetic
resonance imaging (fMRI). Concomitantly, graph theory has been increasingly
employed in neuroscience to model the brain's functional connectivity (FC) and
to investigate it in a variety of contexts. The aims of this study were: 1) to
investigate the reorganization of network topology in the ipsilesional (IL) and
contralesional (CL) hemispheres of stroke patients with (motor stroke group) and
without (control stroke group) motor impairment, and 2) to predict motor
recovery through the relationship between local topological variations of the
functional network and increased motor function. We modeled the brain's FC as a
graph using fMRI data, and we characterized its interactions with the following
graph metrics: degree, clustering coefficient, characteristic path length, and
betweenness centrality (BC). For both patient groups, BC yielded the largest
variations between the two analyzed time points, especially in the motor stroke
group. This group presented significant correlations (P<0.05) between average
BC changes and the improvements in upper-extremity Fugl-Meyer (UE-FM) scores at
the primary sensorimotor cortex and the supplementary motor area for the CL
hemisphere. These regions participate in processes related to the selection,
planning, and execution of movement. Generally, higher increases in average BC
over these areas were related to larger improvements in UE-FM assessment.
Although the sample was small, these results suggest the possibility of using BC
as an indication of brain plasticity mechanisms following stroke.
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Affiliation(s)
- S R M Almeida
- Departamento de Neurologia, Faculdade de Ciências Médicas, Universidade de Campinas, Campinas, SP, Brasil.,BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil
| | - C A Stefano Filho
- BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil.,Grupo de Neurofísica, Instituto de Física "Gleb Wataghin", Universidade de Campinas, Campinas, SP, Brasil
| | - J Vicentini
- Departamento de Neurologia, Faculdade de Ciências Médicas, Universidade de Campinas, Campinas, SP, Brasil.,BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil
| | - S L Novi
- BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil.,Grupo de Neurofísica, Instituto de Física "Gleb Wataghin", Universidade de Campinas, Campinas, SP, Brasil
| | - R C Mesquita
- BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil.,Grupo de Neurofísica, Instituto de Física "Gleb Wataghin", Universidade de Campinas, Campinas, SP, Brasil
| | - G Castellano
- BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil.,Grupo de Neurofísica, Instituto de Física "Gleb Wataghin", Universidade de Campinas, Campinas, SP, Brasil
| | - L M Li
- Departamento de Neurologia, Faculdade de Ciências Médicas, Universidade de Campinas, Campinas, SP, Brasil.,BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil
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53
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Sadeghihassanabadi F, Frey BM, Backhaus W, Choe CU, Zittel S, Schön G, Bönstrup M, Cheng B, Thomalla G, Gerloff C, Schulz R. Structural cerebellar reserve positively influences outcome after severe stroke. Brain Commun 2022; 4:fcac203. [PMID: 36337341 PMCID: PMC9629400 DOI: 10.1093/braincomms/fcac203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/30/2022] [Accepted: 08/02/2022] [Indexed: 12/25/2022] Open
Abstract
The concept of brain reserve capacity positively influencing the process of recovery after stroke has been continuously developed in recent years. Global measures of brain health have been linked with a favourable outcome. Numerous studies have evidenced that the cerebellum is involved in recovery after stroke. However, it remains an open question whether characteristics of cerebellar anatomy, quantified directly after stroke, might have an impact on subsequent outcome after stroke. Thirty-nine first-ever ischaemic non-cerebellar stroke patients underwent MRI brain imaging early after stroke and longitudinal clinical follow-up. Structural images were used for volumetric analyses of distinct cerebellar regions. Ordinal logistic regression analyses were conducted to associate cerebellar volumes with functional outcome 3-6 months after stroke, operationalized by the modified Rankin Scale. Larger volumes of cerebellar lobules IV, VI, and VIIIB were positively correlated with favourable outcome, independent of the severity of initial impairment, age, and lesion volume (P < 0.01). The total cerebellar volume did not exhibit a significant structure-outcome association. The present study reveals that pre-stroke anatomy of distinct cerebellar lobules involved in motor and cognitive functioning might be linked to outcome after acute non-cerebellar stroke, thereby promoting the emerging concepts of structural brain reserve for recovery processes after stroke.
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Affiliation(s)
| | - Benedikt M Frey
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Winifried Backhaus
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Chi-un Choe
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Simone Zittel
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Gerhard Schön
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Marlene Bönstrup
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany,Department of Neurology, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Bastian Cheng
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Robert Schulz
- Correspondence to: Robert Schulz MD University Medical Center Hamburg-Eppendorf Martinistraße 52, 20246 Hamburg, Germany E-mail:
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Holguin JA, Margetis JL, Narayan A, Yoneoka GM, Irimia A. Vascular Cognitive Impairment After Mild Stroke: Connectomic Insights, Neuroimaging, and Knowledge Translation. Front Neurosci 2022; 16:905979. [PMID: 35937885 PMCID: PMC9347227 DOI: 10.3389/fnins.2022.905979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Contemporary stroke assessment protocols have a limited ability to detect vascular cognitive impairment (VCI), especially among those with subtle deficits. This lesser-involved categorization, termed mild stroke (MiS), can manifest compromised processing speed that negatively impacts cognition. From a neurorehabilitation perspective, research spanning neuroimaging, neuroinformatics, and cognitive neuroscience supports that processing speed is a valuable proxy for complex neurocognitive operations, insofar as inefficient neural network computation significantly affects daily task performance. This impact is particularly evident when high cognitive loads compromise network efficiency by challenging task speed, complexity, and duration. Screening for VCI using processing speed metrics can be more sensitive and specific. Further, they can inform rehabilitation approaches that enhance patient recovery, clarify the construct of MiS, support clinician-researcher symbiosis, and further clarify the occupational therapy role in targeting functional cognition. To this end, we review relationships between insult-derived connectome alterations and VCI, and discuss novel clinical approaches for identifying disruptions of neural networks and white matter connectivity. Furthermore, we will frame knowledge translation efforts to leverage insights from cutting-edge structural and functional connectomics research. Lastly, we highlight how occupational therapists can provide expertise as knowledge brokers acting within their established scope of practice to drive substantive clinical innovation.
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Affiliation(s)
- Jess A. Holguin
- T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
- *Correspondence: Jess A. Holguin,
| | - John L. Margetis
- T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
| | - Anisha Narayan
- Tulane University School of Medicine, Tulane University, New Orleans, LA, United States
| | - Grant M. Yoneoka
- John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United States
| | - Andrei Irimia
- Leonard Davis School of Gerontology, Ethel Percy Andrus Gerontology Center, University of Southern California, Los Angeles, CA, United States
- Corwin D. Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
- Andrei Irimia,
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55
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Zhou Z, Chen S, Li Y, Zhao J, Li G, Chen L, Wu Y, Zhang S, Shi X, Chen X, Xu S, Ren M, Chang S, Shan C. Comparison of Sensory Observation and Somatosensory Stimulation in Mirror Neurons and the Sensorimotor Network: A Task-Based fMRI Study. Front Neurol 2022; 13:916990. [PMID: 35847217 PMCID: PMC9279701 DOI: 10.3389/fneur.2022.916990] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/25/2022] [Indexed: 12/03/2022] Open
Abstract
Objective This study aimed to investigate brain plasticity by somatosensory stimulation (SS) and sensory observation (SO) based on mirror neuron and embodied cognition theory. Action observation therapy has been widely adopted for motor function improvement in post-stroke patients. However, it is uncertain whether the SO approach can also contribute to the recovery of sensorimotor function after stroke. In this study, we explored the therapeutic potential of SO for sensorimotor dysfunction and provided new evidence for neurorehabilitation. Methods Twenty-six healthy right-handed adults (12 men and 14 women), aged 18–27 (mean, 22.12; SD, 2.12) years were included. All subjects were evaluated with task-based functional magnetic resonance imaging (fMRI) to discover the characteristics and differences in brain activation between SO and SS. We adopted a block design with two conditions during fMRI scanning: observing a sensory video of brushing (task condition A, defined as SO) and brushing subjects' right forearms while they watched a nonsense string (task condition B, defined as SS). One-sample t-tests were performed to identify brain regions and voxels activated for each task condition. A paired-sample t-test and conjunction analysis were performed to explore the differences and similarities between SO and SS. Results The task-based fMRI showed that the bilateral postcentral gyrus, left precentral gyrus, bilateral middle temporal gyrus, right supramarginal gyrus, and left supplementary motor area were significantly activated during SO or SS. In addition to these brain regions, SO could also activate areas containing mirror neurons, like the left inferior parietal gyrus. Conclusion SO could activate mirror neurons and sensorimotor network-related brain regions in healthy subjects like SS. Therefore, SO may be a promising novel therapeutic approach for sensorimotor dysfunction recovery in post-stroke patients.
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Affiliation(s)
- Zhiqing Zhou
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Songmei Chen
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai No. 3 Rehabilitation Hospital, Shanghai, China
| | - Yuanli Li
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
| | - Jingjun Zhao
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guanwu Li
- Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Chen
- Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuwei Wu
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Sicong Zhang
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaolong Shi
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xixi Chen
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shutian Xu
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
| | - Meng Ren
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shixin Chang
- Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Shixin Chang
| | - Chunlei Shan
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
- Chunlei Shan
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56
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Lindhardt TB, Gutiérrez-Jiménez E, Liang Z, Hansen B. Male and Female C57BL/6 Mice Respond Differently to Awake Magnetic Resonance Imaging Habituation. Front Neurosci 2022; 16:853527. [PMID: 35757553 PMCID: PMC9226328 DOI: 10.3389/fnins.2022.853527] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/18/2022] [Indexed: 01/20/2023] Open
Abstract
Traditionally, preclinical magnetic resonance imaging (MRI) has been performed in anesthetized animals. However, anesthesia has been shown to perturb normal brain function and physiology. Such effects limit our ability to detect subtle physiological alterations in disease models and treatment studies, thus hampering discovery and compromising generality of findings. Therefore, methods for awake animal MRI are needed to study the rodent brain in its natural physiological state, free of anesthetics. Current setups for awake animal MRI rely on restraining systems to avoid animal movement during scanning. To reduce restraint stress, animals are habituated to the scanner environment prior to MRI data collection. To date, however, most awake MRI studies employ male rodents only. This is a fundamental limitation as results obtained may be pertinent only to half of the population. We characterized training and habituation responses of male and female mice to provide improved, sex-dependent training procedures for awake mouse MRI. We recorded heart rate, monitored behavioral responses (body weight and fecal boli weight) and fecal corticosterone levels (FCM) as indicators of wellbeing and stress during a 14-day progressive habituation protocol. In addition, we also assessed discomfort levels and anxiety using the mouse grimace scale (MGS) and light/dark test (LDT), respectively. All scores were compared between both groups. We found that heart rate was significantly decreased after 10 and 11 days of training for both males and females, respectively. However, the specific time course for this decrease was significantly different between males and females, and females exhibited higher anxiety levels during habituation and 14 days after habituation than males. Lastly, we also found that mean FCM levels for both groups were decreased after 11 days of MRI habituation. The present work shows that mice can be successfully trained for extended MRI sessions which is necessary for many (particularly non-fMRI) studies. Importantly, we find that males and females differ in their response to awake MRI habituation, which should be considered in future awake MRI studies that aim to include male and female mice.
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Affiliation(s)
- Thomas Beck Lindhardt
- Department of Clinical Medicine, Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Eugenio Gutiérrez-Jiménez
- Department of Clinical Medicine, Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Zhifeng Liang
- CAS Center for Excellence in Brain Sciences and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Brian Hansen
- Department of Clinical Medicine, Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
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57
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Zhang M, Wei J, Wu X. Effects of whole-body vibration training on lower limb motor function and neural plasticity in patients with stroke: protocol for a randomised controlled clinical trial. BMJ Open 2022; 12:e060796. [PMID: 35768103 PMCID: PMC9240887 DOI: 10.1136/bmjopen-2022-060796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Lower limb motor dysfunction is common in patients with stroke, and usually caused by brain neural connectivity disorder. Previous studies have shown that the whole-body vibration training (WBVT) significantly improves the lower limb motor function in patients with stroke and may promote nerve remodelling. The prior purpose of this study is to explore effects of WBVT on lower limb motor function and neuroplasticity in patients with stroke. METHODS A single-blind randomised controlled trial will be conducted. Sixty patients with stroke will be recruited and allocated randomly to WBVT, routine rehabilitation training (RRT) and control group (CG). The WBVT and RRT interventions will be implemented as five 25 min sessions weekly for continuous 12 weeks; the CG will remain daily habitual living styles and routine treatments, in community or hospital, and will also receive telephone follow-up and health-related lectures. Transcranial magnetic stimulation will be used to assess neural plasticity while lower limb motor function is assessed using indicators of strength, walking ability and joint activity. The assessments will be conducted at the period of baseline, week 6, week 12 as well as on 4 and 8 weeks, respectively, after intervention completion. ETHICS AND DISSEMINATION This study has been approved by the Shanghai University of Sport Research Ethics Committee (102772021RT067) and will provide data on the effects of WBVT relative to RRT in terms of the improvement of stroke patients' lower limb motor function and neural plasticity. The results of this study will be disseminated via publications in peer-reviewed journals and presentations at international conference. TRIAL REGISTRATION NUMBER ChiCTR2200055143.
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Affiliation(s)
| | - Jianing Wei
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Xueping Wu
- Shanghai University of Sport, Shanghai, China
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58
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Yuan Z, Xu W, Bao J, Gao H, Li W, Peng Y, Wang L, Zhao Y, Song S, Qiao J, Wang G. Task-State Cortical Motor Network Characteristics by Functional Near-Infrared Spectroscopy in Subacute Stroke Show Hemispheric Dominance. Front Aging Neurosci 2022; 14:932318. [PMID: 35813955 PMCID: PMC9263394 DOI: 10.3389/fnagi.2022.932318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background There was a reorganization of the brain network after stroke. Some studies have compared the characteristics of activation or functional connectivity (FC) of cortical and subcortical regions between the dominant and non-dominant hemisphere stroke. Objectives To analyze hemispheric dominance differences in task-state motor network properties in subacute stroke by functional near-infrared spectroscopy (fNIRS). Materials and Methods Patients with first ischemic stroke in the basal ganglia within 1–3 months after onset and age- and sex-matched right-handed healthy subjects (HS) were enrolled. fNIRS with 29 channels was used to detect the oxyhemoglobin concentration changes when performing the hand grasping task. Activation patterns of motor cortex and two macroscale and two mesoscale brain network indicators based on graph theory were compared between dominant and non-dominant hemisphere stroke. Results We enrolled 17 subjects in each of left hemisphere stroke (LHS), right hemisphere stroke (RHS), and HS groups. Both patient groups showed bilateral activation. The average weighted clustering coefficient and global efficiency of patients were lower than those of healthy people, and the inter-density was higher than that of the HS group, but the significance was different between LHS and RHS groups. The intra-density changes in the RHS group were opposite to those in the LHS group. The correlation between mesoscale indicators and motor function differed between dominant and non-dominant hemisphere stroke. Conclusion The changes in macroscale cortical network indicators were similar between the two patient groups, while those of the mesoscale indicators were different. The mesoscale brain network characteristics were affected by the severity of dysfunction to varying degrees in the LHS and RHS patients.
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Affiliation(s)
- Ziwen Yuan
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Biomedical Engineering, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
- Department of Rehabilitation, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Weiwei Xu
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Biomedical Engineering, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
| | - Jiameng Bao
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Biomedical Engineering, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
| | - Hui Gao
- College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Wen Li
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Biomedical Engineering, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
| | - Yu Peng
- Department of Rehabilitation, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Lisha Wang
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Biomedical Engineering, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
- Department of Rehabilitation, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ye Zhao
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Biomedical Engineering, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
- Department of Rehabilitation, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Siming Song
- Department of Rehabilitation, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jin Qiao
- Department of Rehabilitation, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Jin Qiao,
| | - Gang Wang
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Biomedical Engineering, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
- Gang Wang,
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Liu J, Tan G, Wang J, Wei Y, Sheng Y, Chang H, Xie Q, Liu H. Closed-Loop Construction and Analysis of Cortico-Muscular-Cortical Functional Network After Stroke. IEEE TRANSACTIONS ON MEDICAL IMAGING 2022; 41:1575-1586. [PMID: 35030075 DOI: 10.1109/tmi.2022.3143133] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Brain networks allow a topological understanding into the pathophysiology of stroke-induced motor deficits, and have been an influential tool for investigating brain functions. Unfortunately, currently applied methods generally lack in the recognition of the dynamic changes in the cortical networks related to muscle activity, which is crucial to clarify the alterations of the cooperative working patterns in the motor control system after stroke. In this study, we integrate corticomuscular and intermuscular interactions to cortico-cortical network and propose a novel closed-loop construction of cortico-muscular-cortical functional network, named closed-loop network (CLN). Directional characteristic in terms of differentiating causal interactions is endowed on basis of the CLN framework, further expanding the definition of functional connectivity (FC) and effective connectivity (EC) dedicated to CLN. Next, CLN is applied to stroke patients to reveal the underlying after-effects mechanism of low frequency repetitive transcranial magnetic stimulation (rTMS) induced alterations of cortical physiologic functions during movement. Results show that the short-term modulation of rTMS is reflected in the enhancement of information interaction within the interhemispheric primary motor regions and inhibition of the coupling between motor cortex and effector muscles. CLN provides a new perspective for the study of motor-related cortical networks with muscle activities involvement instead of being restricted to brain network analysis of behaviors.
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Chen Q, Shen W, Sun H, Zhang H, Liu C, Chen Z, Yu L, Cai X, Ke J, Li L, Zhang L, Fang Q. The effect of coupled inhibitory-facilitatory repetitive transcranial magnetic stimulation on shaping early reorganization of the motor network after stroke. Brain Res 2022; 1790:147959. [PMID: 35654120 DOI: 10.1016/j.brainres.2022.147959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 11/29/2022]
Abstract
Neural plasticity is a major factor driving cortical reorganization after stroke. This study aimed to evaluate functional connectivity (FC) changes in the cortical motor network after coupled inhibitory-facilitatory repetitive transcranial magnetic stimulation (rTMS) treatment and to assess the correlation between FC changes and functional recovery, further characterizing the neural mechanisms underlying the beneficial effects of rTMS. We randomly divided 63 patients with acute stroke into four groups: (1) Group A received coupled inhibitory-facilitatory rTMS [1 Hz over the contralesional primary motor cortex (M1) and 10 Hz over ipsilesional M1]; (2) Group B received a contralesional sham stimulation and ipsilesional 10 Hz stimulation; (3) Group C received a contralesional 1 Hz rTMS and ipsilesional sham stimulation; and (4) Group D received bilateral sham stimulation only. Standardized rehabilitation therapy was performed immediately after rTMS, and each group was treated with their respective treatment modalities for 4 weeks. Twenty-four hours before and after the intervention, participants underwent resting-state functional magnetic resonance imaging. Additional functional assessments were conducted at baseline, after treatment, and at the 3 month follow-up. The rTMS treatment significantly changed the FCs of intra- and inter-hemispheric cortical motor networks in the rTMS groups (A and B) compared with the sham group (Group D). This effect was more pronounced in Group A, which displayed a changed FC between the contralesional postcentral gyrus and contralesional superior parietal gyrus, between the contralesional precentral gyrus and contralesional postcentral gyrus, and between the ipsilesional postcentral gyrus and contralesional superior parietal gyrus, when compared with Groups B and C. Importantly, FC changes were significantly correlated with improvement of motor function. In the early stages of ischemic stroke, coupled rTMS was more conducive to motor recovery by modulating the FCs of intra-hemispheric and inter-hemispheric motor networks. Our results suggested that FC changes were related to motor function recovery for early-stage cerebral stroke patients treated with coupled rTMS. These findings could help to understand the mechanism of coupled rTMS and further the use of this therapy as an adjunct rehabilitation technique in motor recovery.
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Affiliation(s)
- Qingmei Chen
- Department of Physical Medicine &Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China; Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China
| | - Wenjun Shen
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Haiwei Sun
- Department of Emergency Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China
| | - Hanjun Zhang
- Department of Physical Medicine &Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China
| | - Chuandao Liu
- Department of Physical Medicine &Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China
| | - Zhiguo Chen
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China
| | - Liqiang Yu
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China
| | - Xiuying Cai
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China
| | - Jun Ke
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China
| | - Li Li
- Department of Physical Medicine &Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China.
| | - Lichi Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200030, China.
| | - Qi Fang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China.
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61
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Tian N, Liang L, Luo X, Hu R, Long W, Song R. More than just statics: Altered complexity of dynamic amplitude of low-frequency fluctuations in the resting brain after stroke. J Neural Eng 2022; 19. [PMID: 35594839 DOI: 10.1088/1741-2552/ac71ce] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/20/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Previous neuroimaging studies mainly focused on static characteristics of brain activity, and little is known about its characteristics over time, especially in post-stroke (PS) patients. In this study, we aimed to investigate the static and dynamic characteristics of brain activity after stroke using functional magnetic resonance imaging (fMRI). APPROACH Twenty ischemic PS patients and nineteen healthy controls (HCs) were recruited to receive a resting-state fMRI scanning. The static amplitude of low-frequency fluctuations (sALFF) and fuzzy entropy of dynamic ALFF (FE-dALFF) were applied to identify the stroke-induced alterations. MAIN RESULTS Compared with the HCs, PS patients showed significantly increased FE-dALFF values in the right angular gyrus (ANG), bilateral precuneus (PCUN), and right inferior parietal lobule (IPL) as well as significantly decreased FE-dALFF values in the right postcentral gyrus (PoCG), right dorsolateral superior frontal gyrus (SFGdor), and right precentral gyrus (PreCG). The ROC analyses demonstrated that FE-dALFF and sALFF possess comparable sensitivity in distinguishing PS patients from the HCs. Moreover, a significantly positive correlation was observed between the FE-dALFF values and the Fugl-Meyer Assessment (FMA) scores in the right SFGdor (r =0.547), right IPL (r =0.522), and right PCUN (r =0.486). SIGNIFICANCE This study provided insight into the stroke-induced alterations in static and dynamic characteristics of local brain activity, highlighting the potential of FE-dALFF in understanding neurophysiological mechanisms and evaluating pathological changes.
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Affiliation(s)
- Na Tian
- Sun Yat-Sen University, Higher Mega Education Center, Guangzhou, Guangdong, 510006, CHINA
| | - Liuke Liang
- School of Biomedical Engineering, Sun Yat-Sen University, Higher Mega Education Center, Guangzhou, Guangdong, 510006, CHINA
| | - Xuemao Luo
- Department of Radiology, Jiangmen Central Hospital, Jiangmen, Guangdong, CN, Jiangmen, Guangdong, 529030, CHINA
| | - Rongliang Hu
- Department of Rehabilitation Medicine, Jiangmen Central Hospital, Jiangmen, Guangdong, CN, Jiangmen, Guangdong, 529030, CHINA
| | - Wansheng Long
- Department of Radiology, Jiangmen Central Hospital, Jiangmen, Guangdong, CN, Jiangmen, Guangdong, 529030, CHINA
| | - Rong Song
- Biomedical Engineering, National Sun Yat-sen University, Higher Mega Education Center, Guangzhou, 510006, CHINA
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Mariman JJ, Lorca E, Biancardi C, Burgos P, Álvarez-Ruf J. Brain’s Energy After Stroke: From a Cellular Perspective Toward Behavior. Front Integr Neurosci 2022; 16:826728. [PMID: 35651830 PMCID: PMC9149581 DOI: 10.3389/fnint.2022.826728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/18/2022] [Indexed: 11/13/2022] Open
Abstract
Stroke is a neurological condition that impacts activity performance and quality of life for survivors. While neurological impairments after the event explain the performance of patients in specific activities, the origin of such impairments has traditionally been explained as a consequence of structural and functional damage to the nervous system. However, there are important mechanisms related to energy efficiency (trade-off between biological functions and energy consumption) at different levels that can be related to these impairments and restrictions: first, at the neuronal level, where the availability of energy resources is the initial cause of the event, as well as determines the possibilities of spontaneous recovery. Second, at the level of neural networks, where the “small world” operation of the network is compromised after the stroke, implicating a high energetic cost and inefficiency in the information transfer, which is related to the neurological recovery and clinical status. Finally, at the behavioral level, the performance limitations are related to the highest cost of energy or augmented energy expenditure during the tasks to maintain the stability of the segment, system, body, and finally, the behavior of the patients. In other words, the postural homeostasis. In this way, we intend to provide a synthetic vision of the energy impact of stroke, from the particularities of the operation of the nervous system, its implications, as one of the determinant factors in the possibilities of neurological, functional, and behavioral recovery of our patients.
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Affiliation(s)
- Juan José Mariman
- Laboratorio de Cognición y Comportamiento Sensoriomotor, Departamento de Kinesiología, Facultad de Artes y Educación Física, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile
- Departamento de Kinesiología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Enrique Lorca
- Laboratorio de Cognición y Comportamiento Sensoriomotor, Departamento de Kinesiología, Facultad de Artes y Educación Física, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile
- Escuela de Enfermería, Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - Carlo Biancardi
- Biomechanics Lab, Departamento de Ciencias Biológicas, CENUR Litoral Norte, Universidad de la República, Paysandú, Uruguay
| | - Pablo Burgos
- Departamento de Kinesiología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Departamento de Neurociencias, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Joel Álvarez-Ruf
- Laboratorio de Cognición y Comportamiento Sensoriomotor, Departamento de Kinesiología, Facultad de Artes y Educación Física, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile
- Laboratorio de Biomecánica Clínica, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
- *Correspondence: Joel Álvarez-Ruf,
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van Assche M, Klug J, Dirren E, Richiardi J, Carrera E. Preparing for a Second Attack: A Lesion Simulation Study on Network Resilience After Stroke. Stroke 2022; 53:2038-2047. [DOI: 10.1161/strokeaha.121.037372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Does the brain become more resilient after a first stroke to reduce the consequences of a new lesion? Although recurrent strokes are a major clinical issue, whether and how the brain prepares for a second attack is unknown. This is due to the difficulties to obtain an appropriate dataset of stroke patients with comparable lesions, imaged at the same interval after onset. Furthermore, timing of the recurrent event remains unpredictable.
Methods:
Here, we used a novel clinical lesion simulation approach to test the hypothesis that resilience in brain networks increases during stroke recovery. Sixteen highly selected patients with a lesion restricted to the primary motor cortex were recruited. At 3 time points of the index event (10 days, 3 weeks, 3 months), we mimicked recurrent infarcts by deletion of nodes in brain networks (resting-state functional magnetic resonance imaging). Graph measures were applied to determine resilience (global efficiency after attack) and wiring cost (mean degree) of the network.
Results:
At 10 days and 3 weeks after stroke, resilience was similar in patients and controls. However, at 3 months, although motor function had fully recovered, resilience to clinically representative simulated lesions was higher compared to controls (cortical lesion
P
=0.012; subcortical:
P
=0.009; cortico-subcortical:
P
=0.009). Similar results were found after random (
P
=0.012) and targeted (
P
=0.015) attacks.
Conclusions:
Our results suggest that, in this highly selected cohort of patients with lesions restricted to the primary motor cortex, brain networks reconfigure to increase resilience to future insults. Lesion simulation is an innovative approach, which may have major implications for stroke therapy. Individualized neuromodulation strategies could be developed to foster resilient network reconfigurations after a first stroke to limit the consequences of future attacks.
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Affiliation(s)
- Mitsouko van Assche
- Stroke Research Group, Department of Clinical Neurosciences, University Hospital and Faculty of Medicine, Geneva, Switzerland (M.v.A., J.K., E.D., E.C.)
| | - Julian Klug
- Stroke Research Group, Department of Clinical Neurosciences, University Hospital and Faculty of Medicine, Geneva, Switzerland (M.v.A., J.K., E.D., E.C.)
| | - Elisabeth Dirren
- Stroke Research Group, Department of Clinical Neurosciences, University Hospital and Faculty of Medicine, Geneva, Switzerland (M.v.A., J.K., E.D., E.C.)
| | - Jonas Richiardi
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Switzerland (J.R.)
| | - Emmanuel Carrera
- Stroke Research Group, Department of Clinical Neurosciences, University Hospital and Faculty of Medicine, Geneva, Switzerland (M.v.A., J.K., E.D., E.C.)
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64
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Liu J, Wang C, Cheng J, Miao P, Li Z. Dynamic Relationship Between Interhemispheric Functional Connectivity and Corticospinal Tract Changing Pattern After Subcortical Stroke. Front Aging Neurosci 2022; 14:870718. [PMID: 35601612 PMCID: PMC9120434 DOI: 10.3389/fnagi.2022.870718] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background and PurposeIncreased interhemispheric resting-state functional connectivity (rsFC) between the bilateral primary motor cortex (M1) compensates for corticospinal tract (CST) impairment, which facilitates motor recovery in chronic subcortical stroke. However, there is a lack of data on the evolution patterns and correlations between M1–M1 rsFC and diffusion indices of CSTs with different origins after subcortical stroke and their relations with long-term motor outcomes.MethodsA total of 44 patients with subcortical stroke underwent longitudinal structural and functional magnetic resonance imaging (MRI) examinations and clinical assessments at four time points. Diffusion tensor imaging was used to extract fractional anisotropy (FA) values of the affected CSTs with different origins. Resting-state functional MRI was used to calculate the M1–M1 rsFC. Longitudinal patterns of functional and anatomic changes in connections were explored using a linear mixed-effects model. Dynamic relationships between M1–M1 rsFC and FA values of the affected specific CSTs and the impact of these variations on the long-term motor outcomes were analyzed in patients with subcortical stroke.ResultsStroke patients showed a significantly decreased FA in the affected specific CSTs and a gradually increasing M1–M1 rsFC from the acute to the chronic stage. The FA of the affected M1 fiber was negatively correlated with the M1–M1 rsFC from the subacute to the chronic stage, FA of the affected supplementary motor area fiber was negatively correlated with the M1–M1 rsFC in the subacute stage, and FA of the affected M1 fiber in the acute stage was correlated with the long-term motor recovery after subcortical stroke.ConclusionOur findings show that the FA of the affected M1 fiber in the acute stage had the most significant correlation with long-term motor recovery and may be used as an imaging biomarker for predicting motor outcomes after stroke. The compensatory role of the M1–M1 rsFC enhancement may start from the subacute stage in stroke patients with CST impairment.
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Affiliation(s)
- Jingchun Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
- Jingchun Liu
| | - Caihong Wang
- Department of MRI, Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Caihong Wang
| | - Jingliang Cheng
- Department of MRI, Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Peifang Miao
- Department of MRI, Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhen Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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65
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Hensel L, Lange F, Tscherpel C, Viswanathan S, Freytag J, Volz LJ, Eickhoff SB, Fink GR, Grefkes C. Recovered grasping performance after stroke depends on interhemispheric frontoparietal connectivity. Brain 2022; 146:1006-1020. [PMID: 35485480 PMCID: PMC9976969 DOI: 10.1093/brain/awac157] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/19/2022] [Accepted: 04/14/2022] [Indexed: 01/11/2023] Open
Abstract
Activity changes in the ipsi- and contralesional parietal cortex and abnormal interhemispheric connectivity between these regions are commonly observed after stroke, however, their significance for motor recovery remains poorly understood. We here assessed the contribution of ipsilesional and contralesional anterior intraparietal cortex (aIPS) for hand motor function in 18 recovered chronic stroke patients and 18 healthy control subjects using a multimodal assessment consisting of resting-state functional MRI, motor task functional MRI, online-repetitive transcranial magnetic stimulation (rTMS) interference, and 3D movement kinematics. Effects were compared against two control stimulation sites, i.e. contralesional M1 and a sham stimulation condition. We found that patients with good motor outcome compared to patients with more substantial residual deficits featured increased resting-state connectivity between ipsilesional aIPS and contralesional aIPS as well as between ipsilesional aIPS and dorsal premotor cortex. Moreover, interhemispheric connectivity between ipsilesional M1 and contralesional M1 as well as ipsilesional aIPS and contralesional M1 correlated with better motor performance across tasks. TMS interference at individual aIPS and M1 coordinates led to differential effects depending on the motor task that was tested, i.e. index finger-tapping, rapid pointing movements, or a reach-grasp-lift task. Interfering with contralesional aIPS deteriorated the accuracy of grasping, especially in patients featuring higher connectivity between ipsi- and contralesional aIPS. In contrast, interference with the contralesional M1 led to impaired grasping speed in patients featuring higher connectivity between bilateral M1. These findings suggest differential roles of contralesional M1 and aIPS for distinct aspects of recovered hand motor function, depending on the reorganization of interhemispheric connectivity.
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Affiliation(s)
- Lukas Hensel
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
| | - Fabian Lange
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
| | - Caroline Tscherpel
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Shivakumar Viswanathan
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Jana Freytag
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
| | - Lukas J Volz
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
| | - Simon B Eickhoff
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany,Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Gereon R Fink
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Christian Grefkes
- Correspondence to: Christian Grefkes Institute of Neuroscience and Medicine - Cognitive Neuroscience (INM-3) Research Centre Juelich, Juelich, Germany E-mail:
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He M, Li Y, Zhou L, Li Y, Lei T, Yan W, Song J, Chen L. Relationships Between Memory Impairments and Hippocampal Structure in Patients With Subcortical Ischemic Vascular Disease. Front Aging Neurosci 2022; 14:823535. [PMID: 35517055 PMCID: PMC9062133 DOI: 10.3389/fnagi.2022.823535] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background and PurposePatients with subcortical ischemic vascular disease (SIVD) suffer from memory disorders that are thought to be associated with the hippocampus. We aimed to explore changes in hippocampal subfields and the relationship between different hippocampal subfield volumes and different types of memory dysfunction in SIVD patients.MethodsA total of 77 SIVD patients with cognitive impairment (SIVD-CI, n = 39) or normal cognition (HC-SIVD, n = 38) and 41 matched healthy controls (HCs) were included in this study. Memory function was measured in all subjects, and structural magnetic resonance imaging (MRI) was performed. Then, the hippocampus was segmented and measured by FreeSurfer 6.0 software. One-way ANOVA was used to compare the volume of hippocampal subfields among the three groups while controlling for age, sex, education and intracranial volume (ICV). Then, post hoc tests were used to evaluate differences between each pair of groups. Finally, correlations between significantly different hippocampal subfield volumes and memory scores were tested in SIVD patients.ResultsAlmost all hippocampal subfields were significantly different among the three groups except for the bilateral hippocampal fissure (p = 0.366, p = 0.086, respectively.) and left parasubiculum (p = 0.166). Furthermore, the SIVD-CI patients showed smaller volumes in the right subiculum (p < 0.001), CA1 (p = 0.002), presubiculum (p = 0.002) and molecular layer of the hippocampus (p = 0.017) than the HC-SIVD patients. In addition, right subiculum volumes were positively related to Rey’s Auditory Verbal Learning Test (RAVLT) word recognition (r = 0.230, p = 0.050), reverse digit span test (R-DST) (r = 0.326, p = 0.005) and Rey–Osterrieth Complex Figure Test (ROCF) immediate recall (r = 0.247, p = 0.035) scores, right CA1 volumes were positively correlated with RAVLT word recognition (r = 0.261, p = 0.026), and right presubiculum volumes showed positive relationships with R-DST (r = 0.254, p = 0.030) and ROCF immediate recall (r = 0.242, p = 0.039) scores.ConclusionSIVD might lead to general reductions in volume in multiple hippocampal subfields. However, SIVD-CI patients showed atrophy in specific subfields, which might be associated with memory deficits.
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Affiliation(s)
- Miao He
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- Department of Radiology, Gaoping District People’s Hospital, Nanchong, China
| | - Yang Li
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Lijing Zhou
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yajun Li
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Ting Lei
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Wei Yan
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jiarui Song
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Li Chen
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- *Correspondence: Li Chen,
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Yuan B, Zhang N, Gong F, Wang X, Yan J, Lu J, Wu J. Longitudinal assessment of network reorganizations and language recovery in postoperative patients with glioma. Brain Commun 2022; 4:fcac046. [PMID: 35415604 PMCID: PMC8994117 DOI: 10.1093/braincomms/fcac046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/13/2021] [Accepted: 04/02/2022] [Indexed: 12/22/2022] Open
Abstract
For patients with glioma located in or adjacent to the linguistic eloquent cortex, awake surgery with an emphasis on the preservation of language function is preferred. However, the brain network basis of postoperative linguistic functional outcomes remains largely unknown. In this work, 34 patients with left cerebral gliomas who underwent awake surgery were assessed for language function and resting-state network properties before and after surgery. We found that there were 28 patients whose language function returned to at least 80% of the baseline scores within 3 months after surgery or to 85% within 6 months after surgery. For these patients, the spontaneous recovery of language function synchronized with changes within the language and cognitive control networks, but not with other networks. Specifically, compared with baseline values, language functions and global network properties were the worst within 1 month after surgery and gradually recovered within 6 months after surgery. The recovery of connections was tumour location dependent and was attributed to both ipsihemispheric and interhemispheric connections. In contrast, for six patients whose language function did not recover well, severe network disruptions were observed before surgery and persisted into the chronic phase. This study suggests the synchronization of functional network normalization and spontaneous language recovery in postoperative patients with glioma.
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Affiliation(s)
- Binke Yuan
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China
| | - Nan Zhang
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Glioma Surgery Division, Neurologic Surgery Department, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Fangyuan Gong
- Glioma Surgery Division, Neurologic Surgery Department, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xindi Wang
- National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Jing Yan
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junfeng Lu
- Glioma Surgery Division, Neurologic Surgery Department, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Brain Function Laboratory, Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
| | - Jinsong Wu
- Glioma Surgery Division, Neurologic Surgery Department, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Brain Function Laboratory, Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
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Pirovano I, Mastropietro A, Antonacci Y, Barà C, Guanziroli E, Molteni F, Faes L, Rizzo G. Resting State EEG Directed Functional Connectivity Unveils Changes in Motor Network Organization in Subacute Stroke Patients After Rehabilitation. Front Physiol 2022; 13:862207. [PMID: 35450158 PMCID: PMC9016279 DOI: 10.3389/fphys.2022.862207] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/14/2022] [Indexed: 01/01/2023] Open
Abstract
Brain plasticity and functional reorganization are mechanisms behind functional motor recovery of patients after an ischemic stroke. The study of resting-state motor network functional connectivity by means of EEG proved to be useful in investigating changes occurring in the information flow and find correlation with motor function recovery. In the literature, most studies applying EEG to post-stroke patients investigated the undirected functional connectivity of interacting brain regions. Quite recently, works started to investigate the directionality of the connections and many approaches or features have been proposed, each of them being more suitable to describe different aspects, e.g., direct or indirect information flow between network nodes, the coupling strength or its characteristic oscillation frequency. Each work chose one specific measure, despite in literature there is not an agreed consensus, and the selection of the most appropriate measure is still an open issue. In an attempt to shed light on this methodological aspect, we propose here to combine the information of direct and indirect coupling provided by two frequency-domain measures based on Granger’s causality, i.e., the directed coherence (DC) and the generalized partial directed coherence (gPDC), to investigate the longitudinal changes of resting-state directed connectivity associated with sensorimotor rhythms α and β, occurring in 18 sub-acute ischemic stroke patients who followed a rehabilitation treatment. Our results showed a relevant role of the information flow through the pre-motor regions in the reorganization of the motor network after the rehabilitation in the sub-acute stage. In particular, DC highlighted an increase in intra-hemispheric coupling strength between pre-motor and primary motor areas, especially in ipsi-lesional hemisphere in both α and β frequency bands, whereas gPDC was more sensitive in the detection of those connection whose variation was mostly represented within the population. A decreased causal flow from contra-lesional premotor cortex towards supplementary motor area was detected in both α and β frequency bands and a significant reinforced inter-hemispheric connection from ipsi to contra-lesional pre-motor cortex was observed in β frequency. Interestingly, the connection from contra towards ipsilesional pre-motor area correlated with upper limb motor recovery in α band. The usage of two different measures of directed connectivity allowed a better comprehension of those coupling changes between brain motor regions, either direct or mediated, which mostly were influenced by the rehabilitation, revealing a particular involvement of the pre-motor areas in the cerebral functional reorganization.
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Affiliation(s)
- Ileana Pirovano
- Istituto di Tecnologie Biomediche, Consiglio Nazionale delle Ricerche, Segrate, Italy
| | - Alfonso Mastropietro
- Istituto di Tecnologie Biomediche, Consiglio Nazionale delle Ricerche, Segrate, Italy
- *Correspondence: Alfonso Mastropietro,
| | - Yuri Antonacci
- Dipartimento di Ingegneria, Università di Palermo, Palermo, Italy
| | - Chiara Barà
- Dipartimento di Ingegneria, Università di Palermo, Palermo, Italy
| | | | - Franco Molteni
- Centro Riabilitativo Villa Beretta, Ospedale Valduce, Costa Masnaga, Italy
| | - Luca Faes
- Dipartimento di Ingegneria, Università di Palermo, Palermo, Italy
| | - Giovanna Rizzo
- Istituto di Tecnologie Biomediche, Consiglio Nazionale delle Ricerche, Segrate, Italy
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69
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Tan G, Wang J, Liu J, Sheng Y, Xie Q, Liu H. A framework for quantifying the effects of transcranial magnetic stimulation on motor recovery from hemiparesis: Corticomuscular Network. J Neural Eng 2022; 19. [PMID: 35366651 DOI: 10.1088/1741-2552/ac636b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/01/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Transcranial magnetic stimulation (TMS) is an experimental therapy for promoting motor recovery from hemiparesis. At present, hemiparesis patients' responses to TMS are variable. To maximize its therapeutic potential, we need an approach that relates the electrophysiology of motor recovery and TMS. To this end, we propose Corticomuscular Network (CMN) representing the holistic motor system, including the cortico-cortical pathway, corticospinal tract, and muscle co-activation. METHODS CMN is made up of coherence between pairs of electrode signals and spatial locations of the electrodes. We associated coherence and graph features of CMN with Fugl-Meyer Assessment (FMA) for the upper extremity. Besides, we compared CMN between 8 patients with hemiparesis and 6 healthy controls and contrasted CMN of patients before and after a 1Hz TMS. MAIN RESULTS Corticomuscular coherence (CMC) correlated positively with FMA. The regression model between FMA and CMC between 5 pairs of channels had 0.99 adjusted R^2 and a p-value less than 0.01. Compared to healthy controls, CMN of patients tended to be a small-world network and was more interconnected with higher CMC. CMC between cortex and triceps brachii long head was higher in patients. 15-minute 1Hz TMS protocol induced coherence changes beyond the stimulation side and had a limited impact on CMN parameters that are related to motor recovery. SIGNIFICANCE CMN is a potential clinical approach to quantify rehabilitating progress. It also sheds light on the desirable electrophysiological effects of TMS based on which rehabilitating strategies can be optimized.
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Affiliation(s)
- Gansheng Tan
- Washington University in St Louis, 520 S Euclid Ave, St. Louis, MO 63110, St Louis, Missouri, 63130-4899, UNITED STATES
| | - Jixian Wang
- Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, 800 Dongchuan Rd, Shanghai, 200025, CHINA
| | - Jinbiao Liu
- Shanghai Jiao Tong University, 800 Dongchuan Rd, Shanghai, 200240, CHINA
| | - Yixuan Sheng
- Shanghai Jiao Tong University, 800 Dongchuan Rd, Shanghai, 200240, CHINA
| | - Qing Xie
- Ruijin Hospital, 800 Dongchuan Rd, Shanghai, 200025, CHINA
| | - Honghai Liu
- Harbin Institute of Technology Shenzhen, Pingshan 1 Rd, Nanshan, Shenzhen, Guangdong, 518055, CHINA
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70
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Astrakas LG, Li S, Elbach S, Tzika AA. The Severity of Sensorimotor Tracts Degeneration May Predict Motor Performance in Chronic Stroke Patients, While Brain Structural Network Dysfunction May Not. Front Neurol 2022; 13:813763. [PMID: 35432180 PMCID: PMC9008887 DOI: 10.3389/fneur.2022.813763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 03/11/2022] [Indexed: 11/13/2022] Open
Abstract
Although the relationship between corticospinal tract (CST) fiber degeneration and motor outcome after stroke has been established, the relationship of sensorimotor cortical areas with CST fibers has not been clarified. Also limited research has been conducted on how abnormalities in brain structural networks are related to motor recovery. To address these gaps in knowledge, we conducted a diffusion tensor imaging (DTI) study with 12 chronic stroke patients (CSPs) and 12 age-matched healthy controls (HCs). We compared fractional anisotropy (FA) and mean diffusivity (MD) in 60 CST segments using the probabilistic sensorimotor area tract template (SMATT). Least Absolute Shrinkage and Selection Operator (LASSO) regressions were used to select independent predictors of Fugl-Meyer upper extremity (FM-UE) scores among FA and MD values of SMATT regions. The Graph Theoretical Network Analysis Toolbox was used to assess the structural network of each subject's brain. Global and nodal metrics were calculated, compared between the groups, and correlated with FM-UE scores. Mann–Whitney U-tests revealed reduced FA values in CSPs, compared to HCs, in many ipsilesional SMATT regions and in two contralesional regions. Mean FA value of the left (L.) primary motor cortex (M1)/supplementary motor area (SMA) region was predictive of FM-UE score (P = 0.004). Mean MD values for the L. M1/ventral premotor cortex (PMv) region (P = 0.001) and L. PMv/SMA region (P = 0.001) were found to be significant predictors of FM-UE scores. Network efficiency was the only global metric found to be reduced in CSPs (P = 0.006 vs. HCs). Nodal efficiency of the L. hippocampus, L. parahippocampal gyrus, L. fusiform gyrus (P = 0.001), and nodal local efficiency of the L. supramarginal gyrus (P < 0.001) were reduced in CSPs relative to HCs. No graph metric was associated with FM-UE scores. In conclusion, the integrity of CSTs connected to M1, SMA, and PMv were shown to be independent predictors of motor performance in CSPs, while stroke-induced topological changes in the brain's structural connectome may not be. A sensorimotor cortex-specific tract template can refine CST degeneration data and the relationship of CST degeneration with motor performance.
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Affiliation(s)
- Loukas G. Astrakas
- Department of Medical Physics, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Shasha Li
- Department of Radiology, Athinoula A. Martinos Center of Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- NMR Surgical Laboratory, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Sabrina Elbach
- Department of Radiology, Athinoula A. Martinos Center of Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- NMR Surgical Laboratory, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - A. Aria Tzika
- Department of Radiology, Athinoula A. Martinos Center of Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- NMR Surgical Laboratory, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- *Correspondence: A. Aria Tzika
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71
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Wu J, Nahab F, Allen JW, Hu R, Dehkharghani S, Qiu D. Alterations in Functional Network Topology Within Normal Hemispheres Contralateral to Anterior Circulation Steno-Occlusive Disease: A Resting-State BOLD Study. Front Neurol 2022; 13:780896. [PMID: 35392638 PMCID: PMC8980268 DOI: 10.3389/fneur.2022.780896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/21/2022] [Indexed: 11/20/2022] Open
Abstract
The purpose of this study was to assess spatially remote effects of hemodynamic impairment on functional network topology contralateral to unilateral anterior circulation steno-occlusive disease (SOD) using resting-state blood oxygen level-dependent (BOLD) imaging, and to investigate the relationships between network connectivity and cerebrovascular reactivity (CVR), a measure of hemodynamic stress. Twenty patients with unilateral, chronic anterior circulation SOD and 20 age-matched healthy controls underwent resting-state BOLD imaging. Five-minute standardized baseline BOLD acquisition was followed by acetazolamide infusion to measure CVR. The BOLD baseline was used to analyze network connectivity contralateral to the diseased hemispheres of SOD patients. Compared to healthy controls, reduced network degree (z-score = −1.158 ± 1.217, P < 0.001, false discovery rate (FDR) corrected), local efficiency (z-score = −1.213 ± 1.120, P < 0.001, FDR corrected), global efficiency (z-score = −1.346 ± 1.119, P < 0.001, FDR corrected), and enhanced modularity (z-score = 1.000 ± 1.205, P = 0.002, FDR corrected) were observed in the contralateral, normal hemispheres of SOD patients. Network degree (P = 0.089, FDR corrected; P = 0.027, uncorrected) and nodal efficiency (P = 0.089, FDR corrected; P = 0.045, uncorrected) showed a trend toward a positive association with CVR. The results indicate remote abnormalities in functional connectivity contralateral to the diseased hemispheres in patients with unilateral SOD, despite the absence of macrovascular disease or demonstrable hemodynamic impairment. The clinical impact of remote functional disruptions requires dedicated investigation but may portend far reaching consequence for even putatively unilateral cerebrovascular disease.
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Affiliation(s)
- Junjie Wu
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Fadi Nahab
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Jason W. Allen
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
- Joint Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, United States
| | - Ranliang Hu
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Seena Dehkharghani
- Department of Radiology, New York University Langone Medical Center, New York, NY, United States
- Department of Neurology, New York University Langone Medical Center, New York, NY, United States
| | - Deqiang Qiu
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States
- Joint Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, United States
- *Correspondence: Deqiang Qiu
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72
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Gongcheng X, Congcong H, Jiahui Y, Wenhao L, Hui X, Xiangyang L, Zengyong L, Yonghui W, Daifa W. Effective brain network analysis in unilateral and bilateral upper limb exercise training in subjects with stroke. Med Phys 2022; 49:3333-3346. [PMID: 35262918 DOI: 10.1002/mp.15570] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/23/2021] [Accepted: 02/01/2022] [Indexed: 11/11/2022] Open
Abstract
PURPOSE Knowing the patterns of brain activation that occur and networks involved under different interventions is important for motor recovery in subjects with stroke. This study aimed to study the patterns of brain activation and networks in two interventions, affected upper limb side and bilateral exercise training, using concurrent functional near-infrared spectroscopy (fNIRS) imaging. METHODS Thirty-two patients in the early subacute stage were randomly divided into two groups: unilateral and bilateral groups. The patients in the unilateral group underwent isokinetic muscle strength training on the affected upper limb side and patients in the bilateral group underwent bilateral upper limb training. Oxyhemoglobin and deoxyhemoglobin concentration changes (ΔHbO2 and ΔHbR, respectively) were recorded in the ipsilateral and contralateral prefrontal cortex (IPFC and CPFC, respectively) and ipsilateral and contralateral motor cortex (IMC and CMC, respectively) by fNIRS equipment in the resting state and training conditions. The phase information of a 0.01-0.08 Hz fNIRS signal was extracted by the wavelet transform method. Dynamic Bayesian inference was adopted to calculate the coupling strength and direction of effective connectivity. The network threshold was determined by surrogate signal method, the global (weighted clustering coefficient, global efficiency and small-worldness) and local (degree, betweenness centrality and local efficiency) network metrics were calculated. The degree of cerebral lateralization was also compared between the two groups. RESULTS The results of covariance analysis showed that, compared with bilateral training, the coupling effect of CMC→IMC was significantly enhanced (p = 0.03); also, the local efficiency of the IMC (p = 0.01), IPFC (p<0.001), and CPFC (p = 0.006) and the hemispheric autonomy index of IPFC (p = 0.007) were significantly increased in unilateral training. In addition, there was a significant positive correlation between the coupling intensity of the inter-hemispheric motor area and the shifted local efficiency. CONCLUSIONS The results indicated that unilateral upper limb training could more effectively promote the interaction and balance of bilateral motor hemispheres and help brain reorganization in the IMC and prefrontal cortex in stroke patients. The method provided in this study could be used to evaluate dynamic brain activation and network reorganization under different interventions, thus improving the strategy of rehabilitation intervention in a timely manner and resulting in better motor recovery. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Xu Gongcheng
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100086, China.,Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, 100176, China
| | - Huo Congcong
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100086, China
| | - Yin Jiahui
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, 100176, China
| | - Li Wenhao
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100086, China
| | - Xie Hui
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100086, China.,Key Laboratory of Neuro-functional Information and Rehabilitation Engineering of the Ministry of Civil Affairs, Beijing, 100176, China
| | - Li Xiangyang
- Nanchang Key Laboratory of Medical and Technology Research, Nanchang University, Nanchang, 330031, China
| | - Li Zengyong
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, 100176, China.,Key Laboratory of Neuro-functional Information and Rehabilitation Engineering of the Ministry of Civil Affairs, Beijing, 100176, China
| | - Wang Yonghui
- Department of physical medicine and rehabilitation, Qilu hospital, Shandong University, Jinan, 250061, China
| | - Wang Daifa
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100086, China.,Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, 100083, China
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73
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Huang Q, Lin D, Huang S, Cao Y, Jin Y, Wu B, Fan L, Tu W, Huang L, Jiang S. Brain Functional Topology Alteration in Right Lateral Occipital Cortex Is Associated With Upper Extremity Motor Recovery. Front Neurol 2022; 13:780966. [PMID: 35309550 PMCID: PMC8927543 DOI: 10.3389/fneur.2022.780966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/17/2022] [Indexed: 12/02/2022] Open
Abstract
Stroke is a chief cause of sudden brain damage that severely disrupts the whole-brain network. However, the potential mechanisms of motor recovery after stroke are uncertain and the prognosis of poststroke upper extremity recovery is still a challenge. This study investigated the global and local topological properties of the brain functional connectome in patients with subacute ischemic stroke and their associations with the clinical measurements. A total of 57 patients, consisting of 29 left-sided and 28 right-sided stroke patients, and 32 age- and gender-matched healthy controls (HCs) were recruited to undergo a resting-state functional magnetic resonance imaging (rs-fMRI) study; patients were also clinically evaluated with the Upper Extremity Fugl-Meyer Assessment (FMA_UE). The assessment was repeated at 15 weeks to assess upper extremity functional recovery for the patient remaining in the study (12 left- 20 right-sided stroke patients). Global graph topological disruption indices of stroke patients were significantly decreased compared with HCs but these indices were not significantly associated with FMA_UE. In addition, local brain network structure of stroke patients was altered, and the altered regions were dependent on the stroke site. Significant associations between local degree and motor performance and its recovery were observed in the right lateral occipital cortex (R LOC) in the right-sided stroke patients. Our findings suggested that brain functional topologies alterations in R LOC are promising as prognostic biomarkers for right-sided subacute stroke. This cortical area might be a potential target to be further validated for non-invasive brain stimulation treatment to improve poststroke upper extremity recovery.
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Affiliation(s)
- Qianqian Huang
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Intelligent Rehabilitation Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, China
| | - Dinghong Lin
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Intelligent Rehabilitation Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, China
| | - Shishi Huang
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yungang Cao
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yun Jin
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Intelligent Rehabilitation Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, China
| | - Bo Wu
- Department of Information, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Linyu Fan
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wenzhan Tu
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Intelligent Rehabilitation Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, China
| | - Lejian Huang
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- *Correspondence: Lejian Huang
| | - Songhe Jiang
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Intelligent Rehabilitation Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, China
- Songhe Jiang
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74
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Rosso C, Moulton EJ, Kemlin C, Leder S, Corvol JC, Mehdi S, Obadia MA, Obadia M, Yger M, Meseguer E, Perlbarg V, Valabregue R, Magno S, Lindberg P, Meunier S, Lamy JC. Cerebello-Motor Paired Associative Stimulation and Motor Recovery in Stroke: a Randomized, Sham-Controlled, Double-Blind Pilot Trial. Neurotherapeutics 2022; 19:491-500. [PMID: 35226342 PMCID: PMC9226244 DOI: 10.1007/s13311-022-01205-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 12/27/2022] Open
Abstract
Cerebellum is a key structure for functional motor recovery after stroke. Enhancing the cerebello-motor pathway by paired associative stimulation (PAS) might improve upper limb function. Here, we conducted a randomized, double-blind, sham-controlled pilot trial investigating the efficacy of a 5-day treatment of cerebello-motor PAS coupled with physiotherapy for promoting upper limb motor function compared to sham stimulation. The secondary objectives were to determine in the active treated group (i) whether improvement of upper limb motor function was associated with changes in corticospinal excitability or changes in functional activity in the primary motor cortex and (ii) whether improvements were correlated to the structural integrity of the input and output pathways. To that purpose, hand dexterity and maximal grip strength were assessed along with TMS recordings and multimodal magnetic resonance imaging, before the first treatment, immediately after the last one and a month later. Twenty-seven patients were analyzed. Cerebello-motor PAS was effective compared to sham in improving hand dexterity (p: 0.04) but not grip strength. This improvement was associated with increased activation in the ipsilesional primary motor cortex (p: 0.04). Moreover, the inter-individual variability in clinical improvement was partly explained by the structural integrity of the afferent (p: 0.06) and efferent pathways (p: 0.02) engaged in this paired associative stimulation (i.e., cortico-spinal and dentato-thalamo-cortical tracts). In conclusion, cerebello-motor-paired associative stimulation combined with physiotherapy might be a promising approach to enhance upper limb motor function after stroke.Clinical Trial Registration URL: http://www.clinicaltrials.gov . Unique identifier: NCT02284087.
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Affiliation(s)
- Charlotte Rosso
- Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France.
- ICM Infrastructure Stroke Network, STAR Team, Hôpital Pitié-Salpêtrière, 75013, Paris, France.
- AP-HP, Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, DMU Neuroscience 6, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Eric Jr Moulton
- Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
- ICM Infrastructure Stroke Network, STAR Team, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - Claire Kemlin
- Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
- ICM Infrastructure Stroke Network, STAR Team, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - Sara Leder
- AP-HP, Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, DMU Neuroscience 6, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
| | - Jean-Christophe Corvol
- Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
- ICM Infrastructure Stroke Network, STAR Team, Hôpital Pitié-Salpêtrière, 75013, Paris, France
- AP-HP, Hôpital Pitié-Salpêtrière, Département de neurologieDMU Neuroscience 6, 75013, Paris, France
| | - Sophien Mehdi
- Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
- Centre de Neuro-Imagerie de Recherche, Institut du Cerveau, CENIR, Paris Brain Institute - ICM, 75013, Paris, France
| | - Mickael A Obadia
- Service de Neurologie, Fondation Rothschild, 75019, Paris, France
| | - Mickael Obadia
- Service de Neurologie, Fondation Rothschild, 75019, Paris, France
| | - Marion Yger
- AP-HP, Hôpital Saint Antoine, Unité neurovasculaire, 75012, Paris, France
| | - Elena Meseguer
- AP-HP, Service de Neurologie, Hôpital Bichat, 75018, Paris, France
- Laboratory for Vascular Translational Science, INSERM UMRS1148, 75018, Paris, France
| | - Vincent Perlbarg
- Centre de Neuro-Imagerie de Recherche, Institut du Cerveau, CENIR, Paris Brain Institute - ICM, 75013, Paris, France
| | - Romain Valabregue
- Centre de Neuro-Imagerie de Recherche, Institut du Cerveau, CENIR, Paris Brain Institute - ICM, 75013, Paris, France
| | - Serena Magno
- Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
- ICM Infrastructure Stroke Network, STAR Team, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - Pavel Lindberg
- Inserm U894, Université Paris Descartes, 75013, Paris, France
| | - Sabine Meunier
- Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jean-Charles Lamy
- Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
- Centre de Neuro-Imagerie de Recherche, Institut du Cerveau, CENIR, Paris Brain Institute - ICM, 75013, Paris, France
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75
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Obando C, Rosso C, Siegel J, Corbetta M, De Vico Fallani F. Temporal exponential random graph models of longitudinal brain networks after stroke. J R Soc Interface 2022; 19:20210850. [PMID: 35232279 PMCID: PMC8889176 DOI: 10.1098/rsif.2021.0850] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Plasticity after stroke is a complex phenomenon. Functional reorganization occurs not only in the perilesional tissue but throughout the brain. However, the local connection mechanisms generating such global network changes remain largely unknown. To address this question, time must be considered as a formal variable of the problem rather than a simple repeated observation. Here, we hypothesized that the presence of temporal connection motifs, such as the formation of temporal triangles (T) and edges (E) over time, would explain large-scale brain reorganization after stroke. To test our hypothesis, we adopted a statistical framework based on temporal exponential random graph models (tERGMs), where the aforementioned temporal motifs were implemented as parameters and adapted to capture global network changes after stroke. We first validated the performance on synthetic time-varying networks as compared to standard static approaches. Then, using real functional brain networks, we showed that estimates of tERGM parameters were sufficient to reproduce brain network changes from 2 weeks to 1 year after stroke. These temporal connection signatures, reflecting within-hemisphere segregation (T) and between hemisphere integration (E), were associated with patients' future behaviour. In particular, interhemispheric temporal edges significantly correlated with the chronic language and visual outcome in subcortical and cortical stroke, respectively. Our results indicate the importance of time-varying connection properties when modelling dynamic complex systems and provide fresh insights into modelling of brain network mechanisms after stroke.
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Affiliation(s)
- Catalina Obando
- Sorbonne Université, Institut du Cerveau, Paris Brain Institute, ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, 75013 Paris, France
| | - Charlotte Rosso
- Sorbonne Université, Institut du Cerveau, Paris Brain Institute, ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, 75013 Paris, France,AP-HP, Urgences Cerebro-Vasculaires, Hopital Pitie-Salpetriere, Paris, France,ICM Infrastructure Stroke Network, STAR team, Hopital Pitie-Salpetriere, Paris, France
| | - Joshua Siegel
- Department of Psychiatry, Washington University, St Louis, MO, USA
| | - Maurizio Corbetta
- Department of Neuroscience and Padova Neuroscience Center, University of Padova, Padova, Italy,Venetian Institute of Molecular Medicine (VIMM), Padova, Italy
| | - Fabrizio De Vico Fallani
- Sorbonne Université, Institut du Cerveau, Paris Brain Institute, ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, 75013 Paris, France
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Gu F, Gong A, Qu Y, Bao A, Wu J, Jiang C, Fu Y. From Expert to Elite? — Research on Top Archer’s EEG Network Topology. Front Hum Neurosci 2022; 16:759330. [PMID: 35280210 PMCID: PMC8916709 DOI: 10.3389/fnhum.2022.759330] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/14/2022] [Indexed: 12/17/2022] Open
Abstract
It is not only difficult to be a sports expert but also difficult to grow from a sports expert to a sports elite. Professional athletes are often concerned about the differences between an expert and an elite and how to eventually become an elite athlete. To explore the differences in brain neural mechanism between experts and elites in the process of motor behavior and reveal the internal connection between motor performance and brain activity, we collected and analyzed the electroencephalography (EEG) findings of 14 national archers and 14 provincial archers during aiming and resting states and constructed the EEG brain network of the two archer groups based on weighted phase lag index; the graph theory was used to analyze and compare the network characteristics via local network and global network topologies. The results showed that compared with the expert archers, the elite archers had stronger functional coupling in beta1 and beta2 bands, and the difference was evident in the frontal and central regions; in terms of global characteristics of brain network topology, the average clustering coefficient and global efficiency of elite archers were significantly higher than that of expert archers, and the eigenvector centrality of expert archers was higher; for local characteristics, elite archers had higher local efficient; and the brain network characteristics of expert archers showed a strong correlation with archery performance. This suggests that compared with expert archers, elite archers showed stronger functional coupling, higher integration efficiency of global and local information, and more independent performance in the archery process. These findings reveal the differences in brain electrical network topologies between elite and expert archers in the archery preparation stage, which is expected to provide theoretical reference for further training and promotion of professional athletes.
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Affiliation(s)
- Feng Gu
- School of Information Engineering, Engineering University of People’s Armed Police, Xi’an, China
| | - Anmin Gong
- School of Information Engineering, Engineering University of People’s Armed Police, Xi’an, China
- *Correspondence: Anmin Gong,
| | - Yi Qu
- School of Information Engineering, Engineering University of People’s Armed Police, Xi’an, China
| | - Aiyong Bao
- School of Military Basic Education, Engineering University of People’s Armed Police, Xi’an, China
| | - Jin Wu
- Department of Physical Education, Beijing City University, Beijing, China
| | - Changhao Jiang
- Key Laboratory of Sports Performance Evaluation and Technical Analysis, Capital Institute of Physical Education, Beijing, China
| | - Yunfa Fu
- School of Automation and Information Engineering, Kunming University of Science and Technology, Kunming, China
- Yunfa Fu,
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Chang WK, Park J, Lee JY, Cho S, Lee J, Kim WS, Paik NJ. Functional Network Changes After High-Frequency rTMS Over the Most Activated Speech-Related Area Combined With Speech Therapy in Chronic Stroke With Non-fluent Aphasia. Front Neurol 2022; 13:690048. [PMID: 35222235 PMCID: PMC8866644 DOI: 10.3389/fneur.2022.690048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 01/12/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE High-frequency repetitive transcranial magnetic stimulation (HF-rTMS) to the lesional hemisphere requires prudence in selecting the appropriate stimulation spot. Functional near-IR spectroscopy (fNIRS) can be used in both selecting the stimulation spot and assessing the changes of the brain network. This study aimed to evaluate the effect of HF-rTMS on the most activated spot identified with fNIRS and assess the changes of brain functional network in the patients with poststroke aphasia. METHODS A total of five patients received HF-rTMS to the most activated area on the lesional hemisphere, followed by 30 min of speech therapy for 10 days. The Korean version of the Western aphasia battery (K-WAB) and fNIRS evaluation were done 1 day before the treatment, 1 day and 1 month after the last treatment session. Changes of K-WAB and paired cortical interaction and brain network analysis using graph theory were assessed. RESULTS Aphasia quotient in K-WAB significantly increased after the treatment (P = 0.043). The correlation analysis of cortical interactions showed increased connectivity between language production and processing areas. Clustering coefficients of the left hemisphere were increased over a sparsity range between 0.45 and 0.58 (0.015 < p < 0.031), whereas the clustering coefficients of the right hemisphere, decreased over a sparsity range 0.15-0.87 (0.063 < p < 0.095). The global efficiency became lower over a network sparsity range between 0.47 and 0.75 (0.015 < p < 0.063). CONCLUSION Improvement of language function and changes of corticocortical interaction between language-related cortical areas were observed after HF-rTMS on the most activated area identified by fNIRS with combined speech therapy in the patients with poststroke aphasia.
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Affiliation(s)
| | | | | | | | | | | | - Nam-Jong Paik
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, South Korea
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Naro A, Pignolo L, Calabrò RS. Brain Network Organization Following Post-Stroke Neurorehabilitation. Int J Neural Syst 2022; 32:2250009. [PMID: 35139774 DOI: 10.1142/s0129065722500095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Brain network analysis can offer useful information to guide the rehabilitation of post-stroke patients. We applied functional network connection models based on multiplex-multilayer network analysis (MMN) to explore functional network connectivity changes induced by robot-aided gait training (RAGT) using the Ekso, a wearable exoskeleton, and compared it to conventional overground gait training (COGT) in chronic stroke patients. We extracted the coreness of individual nodes at multiple locations in the brain from EEG recordings obtained before and after gait training in a resting state. We found that patients provided with RAGT achieved a greater motor function recovery than those receiving COGT. This difference in clinical outcome was paralleled by greater changes in connectivity patterns among different brain areas central to motor programming and execution, as well as a recruitment of other areas beyond the sensorimotor cortices and at multiple frequency ranges, contemporarily. The magnitude of these changes correlated with motor function recovery chances. Our data suggest that the use of RAGT as an add-on treatment to COGT may provide post-stroke patients with a greater modification of the functional brain network impairment following a stroke. This might have potential clinical implications if confirmed in large clinical trials.
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Affiliation(s)
- Antonino Naro
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy. Via Palermo, SS 113, Ctr. Casazza, 98124, Messina, Italy
| | - Loris Pignolo
- Sant'Anna Institute, Via Siris, 11, 88900 Crotone, Italy
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy. Via Palermo, SS 113, Ctr. Casazza, 98124, Messina, Italy
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Navid MS, Niazi IK, Lelic D, Amjad I, Kumari N, Shafique M, Holt K, Rashid U, Drewes AM, Haavik H. Chiropractic Spinal Adjustment Increases the Cortical Drive to the Lower Limb Muscle in Chronic Stroke Patients. Front Neurol 2022; 12:747261. [PMID: 35185747 PMCID: PMC8854235 DOI: 10.3389/fneur.2021.747261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/31/2021] [Indexed: 11/13/2022] Open
Abstract
This study aimed to investigate the effects of a single session of chiropractic spinal adjustment on the cortical drive to the lower limb in chronic stroke patients. In a single-blinded, randomized controlled parallel design study, 29 individuals with chronic stroke and motor weakness in a lower limb were randomly divided to receive either chiropractic spinal adjustment or a passive movement control intervention. Before and immediately after the intervention, transcranial magnetic stimulation (TMS)-induced motor evoked potentials (MEPs) were recorded from the tibialis anterior (TA) muscle of the lower limb with the greatest degree of motor weakness. Differences in the averaged peak-peak MEP amplitude following interventions were calculated using a linear regression model. Chiropractic spinal adjustment elicited significantly larger MEP amplitude (pre = 0.24 ± 0.17 mV, post = 0.39 ± 0.23 mV, absolute difference = +0.15 mV, relative difference = +92%, p < 0.001) compared to the control intervention (pre = 0.15 ± 0.09 mV, post = 0.16 ± 0.09 mV). The results indicate that chiropractic spinal adjustment increases the corticomotor excitability of ankle dorsiflexor muscles in people with chronic stroke. Further research is required to investigate whether chiropractic spinal adjustment increases dorsiflexor muscle strength and walking function in people with stroke.
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Affiliation(s)
- Muhammad Samran Navid
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand
| | - Imran Khan Niazi
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand
- Faculty of Health and Environmental Sciences, Health and Rehabilitation Research Institute, AUT University, Auckland, New Zealand
- Department of Health Science and Technology, Centre for Sensory-Motor Interactions, Aalborg University, Aalborg, Denmark
- *Correspondence: Imran Khan Niazi
| | - Dina Lelic
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | - Imran Amjad
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
- Faculty of Engineering and Applied Sciences, Riphah International University, Islamabad, Pakistan
| | - Nitika Kumari
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand
- Faculty of Health and Environmental Sciences, Health and Rehabilitation Research Institute, AUT University, Auckland, New Zealand
| | - Muhammad Shafique
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
| | - Kelly Holt
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand
| | - Usman Rashid
- Faculty of Health and Environmental Sciences, Health and Rehabilitation Research Institute, AUT University, Auckland, New Zealand
| | - Asbjørn Mohr Drewes
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Heidi Haavik
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand
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Xu J, Schoenfeld MA, Rossini PM, Tatlisumak T, Nürnberger A, Antal A, He H, Gao Y, Sabel BA. Adaptive and maladaptive brain functional network reorganization after stroke in hemianopia patients: an EEG-tracking study. Brain Connect 2022; 12:725-739. [PMID: 35088596 DOI: 10.1089/brain.2021.0145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Hemianopia following occipital stroke is believed to be mainly due to local damage at or near the lesion site. Yet, MRI studies suggest functional connectivity network (FCN) reorganization also in distant brain regions. Because it is unclear if reorganization is adaptive or maladaptive, compensating for, or aggravating vision loss, we characterized FCNs electrophysiologically to explore local and global brain plasticity and correlated FCN reorganization with visual performance. METHODS Resting-state EEG was recorded in chronic, unilateral stroke patients and healthy age-matched controls (n=24 each). The correlation of oscillating EEG activity was calculated with the imaginary part of coherence between pairs of interested regions, and FCN graph theory metrics (degree, strength, clustering coefficient) were correlated with stimulus detection and reaction time. RESULTS Stroke brains showed altered FCNs in the alpha- and beta-band in numerous occipital, temporal and frontal brain structures. On a global level, FCN had a less efficient network organization while on the local level node networks reorganized especially in the intact hemisphere. Here, the occipital network was 58% more rigid (with a more "regular" network structure) while the temporal network was 32% more efficient (showing greater "small-worldness"), both of which correlated with worse or better visual processing, respectively. CONCLUSIONS Occipital stroke is associated with both local and global FCN reorganization, but this can be both, adaptive and maladaptive. We propose that the more "regular" FCN structure in the intact visual cortex indicates maladaptive plasticity where less processing efficacy with reduced signal/noise ratio may cause perceptual deficits in the intact visual field. In contrast, reorganization in intact temporal brain regions is presumably adaptive, possibly supporting enhanced peripheral movement perception.
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Affiliation(s)
- Jiahua Xu
- Otto von Guericke Universität Magdeburg, 9376, Magdeburg, Sachsen-Anhalt, Germany;
| | | | | | | | - Andreas Nürnberger
- Otto von Guericke Universität Magdeburg, 9376, Magdeburg, Sachsen-Anhalt, Germany;
| | - Andrea Antal
- University Medical Center Göttingen, 84922, Gottingen, Niedersachsen, Germany;
| | - Huiguang He
- Chinese Academy of Sciences Institute of Automation, 74522, Beijing, Beijing, China;
| | - Ying Gao
- Chinese Academy of Sciences Institute of Automation, 74522, Beijing, Beijing, China;
| | - Bernhard A Sabel
- Otto von Guericke Universität Magdeburg, 9376, Magdeburg, Sachsen-Anhalt, Germany;
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81
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Laaksonen K, Ward NS. Biomarkers of plasticity for stroke recovery. HANDBOOK OF CLINICAL NEUROLOGY 2022; 184:287-298. [PMID: 35034742 DOI: 10.1016/b978-0-12-819410-2.00033-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Stroke is the commonest cause of physical disability in the world. Our understanding of the biologic mechanisms involved in recovery and repair has advanced to the point that therapeutic opportunities to promote recovery through manipulation of post-stroke plasticity have never been greater. This work has almost exclusively been carried out in rodent models of stroke with little translation into human studies. The challenge ahead is to develop a mechanistic understanding of recovery from stroke in humans. Advances in neuroimaging techniques can now provide the appropriate intermediate level of description to bridge the gap between a molecular and cellular account of recovery and a behavioral one. Clinical trials can then be designed in a stratified manner taking into account when an intervention should be delivered and who is most likely to benefit. This approach is most likely to lead to the step-change in how restorative therapeutic strategies are delivered in human stroke patients.
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Affiliation(s)
- Kristina Laaksonen
- Department of Neurology, Helsinki University Hospital, and Clinical Neurosciences, Neurology, University of Helsinki, Helsinki, Finland
| | - Nick S Ward
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
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82
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Liu F, Chen C, Hong W, Bai Z, Wang S, Lu H, Lin Q, Zhao Z, Tang C. Selectively disrupted sensorimotor circuits in chronic stroke with hand dysfunction. CNS Neurosci Ther 2022; 28:677-689. [PMID: 35005843 PMCID: PMC8981435 DOI: 10.1111/cns.13799] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 12/24/2022] Open
Abstract
Aim To investigate the directional and selective disconnection of the sensorimotor cortex (SMC) subregions in chronic stroke patients with hand dysfunction. Methods We mapped the resting‐state fMRI effective connectivity (EC) patterns for seven SMC subregions in each hemisphere of 65 chronic stroke patients and 40 healthy participants and correlated these patterns with paretic hand performance. Results Compared with controls, patients demonstrated disrupted EC in the ipsilesional primary motor cortex_4p, ipsilesional primary somatosensory cortex_2 (PSC_2), and contralesional PSC_3a. Moreover, we found that EC values of the contralesional PSC_1 to contralesional precuneus, the ipsilesional inferior temporal gyrus to ipsilesional PSC_1, and the ipsilesional PSC_1 to contralesional postcentral gyrus were correlated with paretic hand performance across all patients. We further divided patients into partially (PPH) and completely (CPH) paretic hand subgroups. Compared with CPH patients, PPH patients demonstrated decreased EC in the ipsilesional premotor_6 and ipsilesional PSC_1. Interestingly, we found that paretic hand performance was positively correlated with seven sensorimotor circuits in PPH patients, while it was negatively correlated with five sensorimotor circuits in CPH patients. Conclusion SMC neurocircuitry was selectively disrupted after chronic stroke and associated with diverse hand outcomes, which deepens the understanding of SMC reorganization.
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Affiliation(s)
- FeiWen Liu
- Department of Rehabilitation Medicine, Chengdu Second People's Hospital, Chengdu, China
| | - ChangCheng Chen
- Department of Rehabilitation Medicine, Qingtian People's Hospital, Lishui, China
| | - WenJun Hong
- Department of Rehabilitation Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - ZhongFei Bai
- Yangzhi Rehabilitation Hospital Affiliated to Tongji University (Shanghai Sunshine Rehabilitation Center), Shanghai, China
| | - SiZhong Wang
- Centre for Health, Activity and Rehabilitation Research (CHARR), School of Physiotherapy, The University of Otago, Dunedin, New Zealand
| | - HanNa Lu
- Neuromodulation Laboratory, Department of Psychiatry, School of Medicine, The Chinese University of Hong Kong, HKSAR, China.,Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - QiXiang Lin
- Department of Neurology, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - ZhiYong Zhao
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China
| | - ChaoZheng Tang
- Capacity Building and Continuing Education Center, National Health Commission of the People's Republic of China, Beijing, China
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83
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Páscoa dos Santos F, Verschure PFMJ. Excitatory-Inhibitory Homeostasis and Diaschisis: Tying the Local and Global Scales in the Post-stroke Cortex. Front Syst Neurosci 2022; 15:806544. [PMID: 35082606 PMCID: PMC8785563 DOI: 10.3389/fnsys.2021.806544] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 11/29/2021] [Indexed: 12/28/2022] Open
Abstract
Maintaining a balance between excitatory and inhibitory activity is an essential feature of neural networks of the neocortex. In the face of perturbations in the levels of excitation to cortical neurons, synapses adjust to maintain excitatory-inhibitory (EI) balance. In this review, we summarize research on this EI homeostasis in the neocortex, using stroke as our case study, and in particular the loss of excitation to distant cortical regions after focal lesions. Widespread changes following a localized lesion, a phenomenon known as diaschisis, are not only related to excitability, but also observed with respect to functional connectivity. Here, we highlight the main findings regarding the evolution of excitability and functional cortical networks during the process of post-stroke recovery, and how both are related to functional recovery. We show that cortical reorganization at a global scale can be explained from the perspective of EI homeostasis. Indeed, recovery of functional networks is paralleled by increases in excitability across the cortex. These adaptive changes likely result from plasticity mechanisms such as synaptic scaling and are linked to EI homeostasis, providing a possible target for future therapeutic strategies in the process of rehabilitation. In addition, we address the difficulty of simultaneously studying these multiscale processes by presenting recent advances in large-scale modeling of the human cortex in the contexts of stroke and EI homeostasis, suggesting computational modeling as a powerful tool to tie the meso- and macro-scale processes of recovery in stroke patients.
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Affiliation(s)
- Francisco Páscoa dos Santos
- Eodyne Systems SL, Barcelona, Spain
- Laboratory of Synthetic, Perceptive, Emotive and Cognitive Systems (SPECS), Institute for Bioengineering of Catalonia (IBEC), Barcelona, Spain
- Department of Information and Communications Technologies (DTIC), Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Paul F. M. J. Verschure
- Laboratory of Synthetic, Perceptive, Emotive and Cognitive Systems (SPECS), Institute for Bioengineering of Catalonia (IBEC), Barcelona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
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84
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Nemati PR, Backhaus W, Feldheim J, Bönstrup M, Cheng B, Thomalla G, Gerloff C, Schulz R. OUP accepted manuscript. Brain Commun 2022; 4:fcac049. [PMID: 35274100 PMCID: PMC8905614 DOI: 10.1093/braincomms/fcac049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/10/2021] [Accepted: 02/21/2022] [Indexed: 11/17/2022] Open
Abstract
Analyses of alterations of brain networks have gained an increasing interest in stroke rehabilitation research. Compared with functional networks derived from resting-state analyses, there is limited knowledge of how structural network topology might undergo changes after stroke and, more importantly, if structural network information obtained early after stroke could enhance recovery models to infer later outcomes. The present work re-analysed cross-sectional structural imaging data, obtained within the first 2 weeks, of 45 acute stroke patients (22 females, 24 right-sided strokes, age 68 ± 13 years). Whole-brain tractography was performed to reconstruct structural connectomes and graph-theoretical analyses were employed to quantify global network organization with a focus on parameters of network integration and modular processing. Graph measures were compared between stroke patients and 34 healthy controls (15 females, aged 69 ± 10 years) and they were integrated with four clinical scores of the late subacute stage, covering neurological symptom burden (National Institutes of Health Stroke Scale), global disability (modified Rankin Scale), activity-related disability (Barthel Index) and motor functions (Upper-Extremity Score of the Fugl-Meyer Assessment). The analyses were employed across the complete cohort and, based on clustering analysis, separately within subgroups stratified in mild to moderate (n = 21) and severe (n = 24) initial deficits. The main findings were (i) a significant reduction of network’s global efficiency, specifically in patients with severe deficits compared with controls (P = 0.010) and (ii) a significant negative correlation of network efficiency with the extent of persistent functional deficits at follow-up after 3–6 months (P ≤ 0.032). Specifically, regression models revealed that this measure was capable to increase the explained variance in future deficits by 18% for the modified Rankin Scale, up to 24% for National Institutes of Health Stroke Scale, and 16% for Barthel Index when compared with models including the initial deficits and the lesion volume. Patients with mild to moderate deficits did not exhibit a similar impact of network efficiency on outcome inference. Clustering coefficient and modularity, measures of segregation and modular processing, did not exhibit comparable structure–outcome relationships, neither in severely nor in mildly affected patients. This study provides empirical evidence that structural network efficiency as a graph-theoretical marker of large-scale network topology, quantified early after stroke, relates to recovery. Notably, this contribution was only evident in severely but not mildly affected stroke patients. This suggests that the initial clinical deficit might shape the dependency of recovery on global network topology after stroke.
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Affiliation(s)
- Paul R. Nemati
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Winifried Backhaus
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Jan Feldheim
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Marlene Bönstrup
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
- Department of Neurology, University Medical Center, 04103 Leipzig, Germany
| | - Bastian Cheng
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Robert Schulz
- Correspondence to: Robert Schulz, MD University Medical Center Hamburg-Eppendorf Martinistraße 52, 20246 Hamburg, Germany E-mail:
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85
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Yang J, Kudulaiti N, Chen Z, Gao L, Hameed NUF, Feng R, Lu S. OUP accepted manuscript. Cereb Cortex 2022; 32:4422-4435. [PMID: 35106532 DOI: 10.1093/cercor/bhab492] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jingwen Yang
- Teaching Laboratory of Neurolinguistics, Department of Chinese Language and Literature, Sun Yat-sen University, Guangzhou 510275, P.R. China
- Department of Clinical Neurolinguistic Research, Mental and Neurological Diseases Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, P.R. China
| | - Nijiati Kudulaiti
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
- Neurosurgical Institute of Fudan University, Shanghai 200040, P.R. China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai 200040, P.R. China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai 200040, P.R. China
| | - Zelin Chen
- School of Data and Computer Science, Sun Yat-sen University, Guangzhou 510275, P.R. China
| | - Leyan Gao
- Teaching Laboratory of Neurolinguistics, Department of Chinese Language and Literature, Sun Yat-sen University, Guangzhou 510275, P.R. China
| | - N U Farrukh Hameed
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
- Neurosurgical Institute of Fudan University, Shanghai 200040, P.R. China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai 200040, P.R. China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai 200040, P.R. China
| | - Rui Feng
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
- Neurosurgical Institute of Fudan University, Shanghai 200040, P.R. China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai 200040, P.R. China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai 200040, P.R. China
| | - Shuo Lu
- Department of Clinical Neurolinguistic Research, Mental and Neurological Diseases Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, P.R. China
- School of Foreign langugues, Shenzhen University, Shenzhen, 518060, P.R. China
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Alionte C, Notte C, Strubakos CD. From symmetry to chaos and back: Understanding and imaging the mechanisms of neural repair after stroke. Life Sci 2022; 288:120161. [PMID: 34813796 DOI: 10.1016/j.lfs.2021.120161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/06/2021] [Accepted: 11/15/2021] [Indexed: 11/27/2022]
Abstract
Neuroscience has made strides in recent years allowing us insight into the workings of the brain - from the molecular to the regional anatomy. These insights have given researchers an advantage in seeking novel therapies for neurological disorders, specifically stroke. Yet despite these discoveries, many aspects of stroke remain poorly understood - specifically post-stroke recovery. This review article seeks to outline cutting-edge neuroimaging technologies, and the current level of understanding of neurological repair after stroke, with the main focus on the mechanism of axonal sprouting. Neuronal connectivity has varying levels of complexity that allow neuronal networks to process information and give rise to our day-to-day functioning. As stroke causes the death of groups of regional neurons, it is likely that the reestablishment of function seen in some stroke patients is related to shifting patterns of functional connectivity. This paper touches on the timeline and limits on the amount of functional recovery, as well as the differences in organization of neuronal networks in a healthy versus post stroke brain. Finally, we discuss how the previously mentioned methods of imaging are critical in understanding the mechanisms of functional recovery. The mechanism of axonal sprouting and its theorized different types are explained, along with potential ways of imaging them in rodents. The hope is that, with a better understanding of the mechanisms underlying brain recovery, researchers can apply this knowledge to better help stroke patients and be of use in clinical settings.
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Affiliation(s)
- Caroline Alionte
- Department of Physics, University of Windsor, Windsor, Ontario N9B 3P4, Canada
| | - Christian Notte
- Department of Physics, University of Windsor, Windsor, Ontario N9B 3P4, Canada
| | - Christos D Strubakos
- Department of Psychology, University of Windsor, Windsor, Ontario N9B 3P4, Canada; Department of Languages, Literatures, and Cultures, University of Windsor, Windsor, Ontario N9B 3P4, Canada.
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87
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Cassidy JM, Mark JI, Cramer SC. Functional connectivity drives stroke recovery: shifting the paradigm from correlation to causation. Brain 2021; 145:1211-1228. [PMID: 34932786 DOI: 10.1093/brain/awab469] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/20/2021] [Accepted: 11/26/2021] [Indexed: 11/14/2022] Open
Abstract
Stroke is a leading cause of disability, with deficits encompassing multiple functional domains. The heterogeneity underlying stroke poses significant challenges in the prediction of post-stroke recovery, prompting the development of neuroimaging-based biomarkers. Structural neuroimaging measurements, particularly those reflecting corticospinal tract injury, are well-documented in the literature as potential biomarker candidates of post-stroke motor recovery. Consistent with the view of stroke as a 'circuitopathy', functional neuroimaging measures probing functional connectivity may also prove informative in post-stroke recovery. An important step in the development of biomarkers based on functional neural network connectivity is the establishment of causality between connectivity and post-stroke recovery. Current evidence predominantly involves statistical correlations between connectivity measures and post-stroke behavioral status, either cross-sectionally or serially over time. However, the advancement of functional connectivity application in stroke depends on devising experiments that infer causality. In 1965, Sir Austin Bradford Hill introduced nine viewpoints to consider when determining the causality of an association: [1] Strength, [2] Consistency [3] Specificity, [4] Temporality, [5] Biological gradient, [6] Plausibility, [7] Coherence, [8] Experiment, and [9] Analogy. Collectively referred to as the Bradford Hill Criteria, these points have been widely adopted in epidemiology. In this review, we assert the value of implementing Bradford Hill's framework to stroke rehabilitation and neuroimaging. We focus on the role of neural network connectivity measurements acquired from task-oriented and resting-state functional magnetic resonance imaging, electroencephalography, magnetoencephalography, and functional near-infrared spectroscopy in describing and predicting post-stroke behavioral status and recovery. We also identify research opportunities within each Bradford Hill tenet to shift the experimental paradigm from correlation to causation.
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Affiliation(s)
- Jessica M Cassidy
- Department of Allied Health Sciences, Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Jasper I Mark
- Department of Allied Health Sciences, Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Steven C Cramer
- Department of Neurology, University of California, Los Angeles; and California Rehabilitation Institute, Los Angeles, CA USA
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88
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Nasrallah FA, Mohamed AZ, Yap HK, Lai HS, Yeow CH, Lim JH. Effect of proprioceptive stimulation using a soft robotic glove on motor activation and brain connectivity in stroke survivors. J Neural Eng 2021; 18:066049. [PMID: 34933283 DOI: 10.1088/1741-2552/ac456c] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Soft-robotic-assisted training may improve motor function during post-stroke recovery, but the underlying physiological changes are not clearly understood. We applied a single-session of intensive proprioceptive stimulation to stroke survivors using a soft robotic glove to delineate its short-term influence on brain functional activity and connectivity. APPROACH In this study, we utilized task-based and resting-state functional magnetic resonance imaging (fMRI) to characterize the changes in different brain networks following a soft robotic intervention. Nine stroke patients with hemiplegic upper limb engaged in resting-state and motor-task fMRI. The motor tasks comprised two conditions: active movement of fingers (active task) and glove-assisted active movement using a robotic glove (glove-assisted task), both with visual instruction. Each task was performed using bilateral hands simultaneously or the affected hand only. The same set of experiments was repeated following a 30-minute treatment of continuous passive motion (CPM) using a robotic glove. MAIN RESULTS On simultaneous bimanual movement, increased activation of supplementary motor area (SMA) and primary motor area (M1) were observed after CPM treatment compared to the pre-treatment condition, both in active and glove-assisted task. However, when performing the tasks solely using the affected hand, the phenomena of increased activity were not observed either in active or glove-assisted task. The comparison of the resting-state fMRI between before and after CPM showed the connectivity of the supramarginal gyrus and SMA was increased in the somatosensory network and salience network. SIGNIFICANCE This study demonstrates how passive motion exercise activates M1 and SMA in the post-stroke brain. The effective proprioceptive motor integration seen in bimanual exercise in contrast to the unilateral affected hand exercise suggests that the unaffected hemisphere might reconfigure connectivity to supplement damaged neural networks in the affected hemisphere. The somatosensory modulation rendered by the intense proprioceptive stimulation would affect the motor learning process in stroke survivors.
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Affiliation(s)
- Fatima A Nasrallah
- The University of Queensland Queensland Brain Institute, The University of Queensland, Brisbane, Saint Lucia, Queensland, 4072, AUSTRALIA
| | - Abdalla Z Mohamed
- The University of Queensland Queensland Brain Institute, The University of Queensland, Brisbane, Australia., Saint Lucia, Queensland, 4072, AUSTRALIA
| | - Hong Kai Yap
- Roceso Technologies, 83 Science Park Dr #04-01, Singapore, 118258, SINGAPORE
| | - Hwa Sen Lai
- National University of Singapore, Biomedical Engineering, Singapore, 119260, SINGAPORE
| | - Chen-Hua Yeow
- National University of Singapore, Biomedical Engineering, Singapore, 119260, SINGAPORE
| | - Jeong Hoon Lim
- School of Medicine, Medicine, National University of Singapore, NUHS Tower block level 10 1E, Kent Ridge Road, Singapore, Singapore, 119228, SINGAPORE
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89
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Connectivity modulations induced by reach&grasp movements: a multidimensional approach. Sci Rep 2021; 11:23097. [PMID: 34845265 PMCID: PMC8630117 DOI: 10.1038/s41598-021-02458-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 11/08/2021] [Indexed: 11/09/2022] Open
Abstract
Reach&grasp requires highly coordinated activation of different brain areas. We investigated whether reach&grasp kinematics is associated to EEG-based networks changes. We enrolled 10 healthy subjects. We analyzed the reach&grasp kinematics of 15 reach&grasp movements performed with each upper limb. Simultaneously, we obtained a 64-channel EEG, synchronized with the reach&grasp movement time points. We elaborated EEG signals with EEGLAB 12 in order to obtain event related synchronization/desynchronization (ERS/ERD) and lagged linear coherence between Brodmann areas. Finally, we evaluated network topology via sLORETA software, measuring network local and global efficiency (clustering and path length) and the overall balance (small-worldness). We observed a widespread ERD in α and β bands during reach&grasp, especially in the centro-parietal regions of the hemisphere contralateral to the movement. Regarding functional connectivity, we observed an α lagged linear coherence reduction among Brodmann areas contralateral to the arm involved in the reach&grasp movement. Interestingly, left arm movement determined widespread changes of α lagged linear coherence, specifically among right occipital regions, insular cortex and somatosensory cortex, while the right arm movement exerted a restricted contralateral sensory-motor cortex modulation. Finally, no change between rest and movement was found for clustering, path length and small-worldness. Through a synchronized acquisition, we explored the cortical correlates of the reach&grasp movement. Despite EEG perturbations, suggesting that the non-dominant reach&grasp network has a complex architecture probably linked to the necessity of a higher visual control, the pivotal topological measures of network local and global efficiency remained unaffected.
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90
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Juan Du, Yao W, Li J, Yang F, Hu J, Xu Q, Liu L, Lv Q, Liu R, Ye R, Ma M, Zhu W, Zhang Z, Liu X. Motor Network Reorganization After Repetitive Transcranial Magnetic Stimulation in Early Stroke Patients: A Resting State fMRI Study. Neurorehabil Neural Repair 2021; 36:61-68. [PMID: 34711080 DOI: 10.1177/15459683211054184] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare the effects of high-frequency (10 Hz) versus low-frequency (1 Hz) repetitive Transcranial Magnetic Stimulation (rTMS) on motor recovery and functional reorganization of the cortical motor network during the early phase of stroke. METHODS Forty-six hospitalized, first-ever ischemic stroke patients in early stage (within two weeks) with upper limb motor deficits were recruited. They were randomly allocated to three groups with 10 Hz ipsilesional rTMS, 1 Hz contralesional rTMS, and sham rTMS of five daily session. All patients underwent motor function (Upper Extremity Fugl-Meyer), neurophysiological and resting-state functional Magnetic Resonance Imaging (fMRI) (rs-fMRI) assessments before and after rTMS intervention. Motor recovery (△Fugl-Meyer Assessment) was defined as motor function changes before and after rTMS intervention. Motor function assessment was reevaluated at time point of three month follow-up. RESULTS The two real rTMS groups manifested greater motor improvements than the sham group. The effect sustained for at least 3 months after the end of the treatment sessions. Compared with the sham group, 10 Hz ipsilesional rTMS group presented increased resting-state functional connectivity (FC) between ipsilesional primary motor cortex (M1) and contralesional M1 (P = .007), whereas 1 Hz contralesional rTMS group presented increased FC between contralesional M1 and ipsilesional supplementary motor area (P = .010), which were positively correlated with motor recovery (P < .05). CONCLUSION Beneficial effect of rTMS on motor recovery might be underlaid by increased FC between stimulating site and the remote motor areas, highlighting the motor network reorganization mechanism of rTMS in early post-stroke phase.
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Affiliation(s)
- Juan Du
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Weihe Yao
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jianrui Li
- Department of Medical Imaging, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Fang Yang
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jingze Hu
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qiang Xu
- Department of Medical Imaging, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Ling Liu
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qiushi Lv
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Rui Liu
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Ruidong Ye
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Minmin Ma
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wusheng Zhu
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhiqiang Zhang
- Department of Medical Imaging, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China.,State Key Laboratory of Analytical Chemistry for Life Science, Nanjing University, Nanjing, China
| | - Xinfeng Liu
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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91
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Dirren E, Bourgeois A, Klug J, Kleinschmidt A, van Assche M, Carrera E. The neural correlates of intermanual transfer. Neuroimage 2021; 245:118657. [PMID: 34687859 DOI: 10.1016/j.neuroimage.2021.118657] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 10/09/2021] [Accepted: 10/11/2021] [Indexed: 11/18/2022] Open
Abstract
Intermanual transfer of motor learning is a form of learning generalization that leads to behavioral advantages in various tasks of daily life. It might also be useful for rehabilitation of patients with unilateral motor deficits. Little is known about neural structures and cognitive processes that mediate intermanual transfer. Previous studies have suggested a role for primary motor cortex (M1) and the supplementary motor area (SMA). Here, we investigated the functional neuroanatomy of intermanual transfer with a special emphasis on functional connectivity within the motor network and between motor regions and attentional networks, including the fronto-parietal executive control network and visual attention networks. We designed a finger tapping task, in which young, heathy subjects trained the non-dominant left hand in the MRI scanner. Behaviorally, transfer of sequence learning was observed in most cases, independently of the trained hand's performance. Pre- and post-training functional connectivity patterns of cortical motor seeds were investigated using generalized psychophysiological interaction analyses. Transfer was correlated with the strength of connectivity between the left premotor cortex and structures within the dorsal attention network (superior parietal cortex, left middle temporal gyrus) and executive control network (right prefrontal regions) during pre-training, relative to post-training. Changes in connectivity within the motor network, and more particularly between trained and untrained M1, as well as between the SMA and untrained M1, correlated with transfer after training. Together, these results suggest that the interplay between attentional, executive and motor networks may support processes leading to transfer, whereas, following training, transfer translates into increased connectivity within the motor network.
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Affiliation(s)
- Elisabeth Dirren
- Stroke Research Group, Department of Clinical Neurosciences, University Hospital and Faculty of Medicine, Geneva 1205, Switzerland.
| | - Alexia Bourgeois
- Stroke Research Group, Department of Clinical Neurosciences, University Hospital and Faculty of Medicine, Geneva 1205, Switzerland; Laboratory of Cognitive Neurorehabilitation, Faculty of Medicine, University of Geneva, Geneva 1205, Switzerland
| | - Julian Klug
- Stroke Research Group, Department of Clinical Neurosciences, University Hospital and Faculty of Medicine, Geneva 1205, Switzerland
| | - Andreas Kleinschmidt
- Stroke Research Group, Department of Clinical Neurosciences, University Hospital and Faculty of Medicine, Geneva 1205, Switzerland
| | - Mitsouko van Assche
- Stroke Research Group, Department of Clinical Neurosciences, University Hospital and Faculty of Medicine, Geneva 1205, Switzerland
| | - Emmanuel Carrera
- Stroke Research Group, Department of Clinical Neurosciences, University Hospital and Faculty of Medicine, Geneva 1205, Switzerland
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92
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Longitudinal Changes of Sensorimotor Resting-State Functional Connectivity Differentiate between Patients with Thalamic Infarction and Pontine Infarction. Neural Plast 2021; 2021:7031178. [PMID: 34659397 PMCID: PMC8519702 DOI: 10.1155/2021/7031178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/13/2021] [Accepted: 09/14/2021] [Indexed: 12/01/2022] Open
Abstract
Purpose. We investigated the disparate influence of lesion location on functional damage and reorganization of the sensorimotor brain network in patients with thalamic infarction and pontine infarction. Methods. Fourteen patients with unilateral infarction of the thalamus and 14 patients with unilateral infarction of the pons underwent longitudinal fMRI measurements and motor functional assessment five times during a 6-month period (<7 days, at 2 weeks, 1 month, 3 months, and 6 months after stroke onset). Twenty-five age- and sex-matched controls underwent MRI examination across five consecutive time points in 6 months. Functional images from patients with left hemisphere lesions were first flipped from the left to the right side. The voxel-wise connectivity analyses between the reference time course of each ROI (the contralateral dorsal lateral putamen (dl-putamen), pons, ventral anterior (VA), and ventral lateral (VL) nuclei of the thalamus) and the time course of each voxel in the sensorimotor area were performed for all five measurements. One-way ANOVA was used to identify between-group differences in functional connectivity (FC) at baseline stage (<7 days after stroke onset), with infarction volume included as a nuisance variable. The family-wise error (FWE) method was used to account for multiple comparison issues using SPM software. Post hoc repeated-measure ANOVA was applied to examine longitudinal FC reorganization. Results. At baseline stage, significant differences were detected between the contralateral VA and ipsilateral postcentral gyrus (cl_VA-ip_postcentral), contralateral VL and ipsilateral precentral gyrus (cl_VL-ip_precentral). Repeated measures ANOVA revealed that the FC change of cl_VA-ip_postcentral differ significantly among the three groups over time. The significant changes of FC between cl_VA and ip_postcentral at different time points in the thalamic infarction group showed that compared with 7 days after stroke onset, there was significantly increased FC of cl_VA-ip_postcentral at 1 month, 3 months, and 6 months after stroke onset. Conclusions. The different patterns of sensorimotor functional damage and reorganization in patients with pontine infarction and thalamic infarction may provide insights into the neural mechanisms underlying functional recovery after stroke.
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93
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Integrity of the Inferior Cerebellar Peduncle Correlates with Ambulatory Function after Hemorrhagic Stroke. J Stroke Cerebrovasc Dis 2021; 30:106164. [PMID: 34655972 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/28/2021] [Accepted: 10/03/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Cerebro-cerebellar connectivity plays a critical role in motor recovery after stroke; however, the underlying mechanism of walking recovery is unclear. The dorsal spinocerebellar pathway has been suggested as a biomarker of poststroke ambulatory function. We aimed to explore the association between ambulatory function and the dorsal spinocerebellar pathway's integrity after intracerebral hemorrhage (ICH). MATERIALS AND METHODS Twenty-seven patients with ICH who were admitted for inpatient rehabilitation during the subacute phase of stroke and 27 age-matched healthy controls were included retrospectively. Ambulatory function was assessed using the Berg Balance Scale and Mobility score. We measured the fractional anisotropy (FA) values of the corticospinal tract (CST) and inferior cerebellar peduncle (ICP) as the final route of the dorsal spinocerebellar pathway. The FA laterality indices, representing the degree of degeneration, were calculated. A Spearman correlation analysis and multivariate linear regression models were used to determine the associations between the FA laterality indices and ambulatory function. RESULTS An FA reduction was found in both the ipsilesional CST and contralesional ICP of the patients. The ICP FA laterality index exhibited a moderate correlation with ambulatory function (Berg Balance Scale, ρBBS=0.589; Mobility score, ρMS=0.619). On dividing the patient group into the moderate (mRS 3, 4) and severe disability (mRS 5) groups, a stronger correlation was found (ρBBS=0.777, ρMS=0.856, moderate disability; ρBBS=0.732, ρMS=0.797, severe disability). The ICP FA laterality index and age were independently associated with the Mobility score (R2=0.525). CONCLUSIONS ICP degeneration occurs after ICH, and its degree is associated with ambulatory function after ICH.
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94
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Giulia L, Adolfo V, Julie C, Quentin D, Simon B, Fleury M, Leveque-Le Bars E, Bannier E, Lécuyer A, Barillot C, Bonan I. The impact of neurofeedback on effective connectivity networks in chronic stroke patients: an exploratory study. J Neural Eng 2021; 18. [PMID: 34551403 DOI: 10.1088/1741-2552/ac291e] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 09/22/2021] [Indexed: 11/12/2022]
Abstract
Objective.In this study, we assessed the impact of electroencephalography-functional magnetic resonance imaging (EEG-fMRI) neurofeedback (NF) on connectivity strength and direction in bilateral motor cortices in chronic stroke patients. Most of the studies using NF or brain computer interfaces for stroke rehabilitation have assessed treatment effects focusing on successful activation of targeted cortical regions. However, given the crucial role of brain network reorganization for stroke recovery, our broader aim was to assess connectivity changes after an NF training protocol targeting localized motor areas.Approach.We considered changes in fMRI connectivity after a multisession EEG-fMRI NF training targeting ipsilesional motor areas in nine stroke patients. We applied the dynamic causal modeling and parametric empirical Bayes frameworks for the estimation of effective connectivity changes. We considered a motor network including both ipsilesional and contralesional premotor, supplementary and primary motor areas.Main results.Our results indicate that NF upregulation of targeted areas (ipsilesional supplementary and primary motor areas) not only modulated activation patterns, but also had a more widespread impact on fMRI bilateral motor networks. In particular, inter-hemispheric connectivity between premotor and primary motor regions decreased, and ipsilesional self-inhibitory connections were reduced in strength, indicating an increase in activation during the NF motor task.Significance.To the best of our knowledge, this is the first work that investigates fMRI connectivity changes elicited by training of localized motor targets in stroke. Our results open new perspectives in the understanding of large-scale effects of NF training and the design of more effective NF strategies, based on the pathophysiology underlying stroke-induced deficits.
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Affiliation(s)
- Lioi Giulia
- Univ Rennes, Inria, CNRS, Inserm, IRISA, Rennes, France.,IMT Atlantique, Lab-STICC, UMR CNRS 6285, Brest, F-29238, France
| | - Veliz Adolfo
- Univ Rennes, Inria, CNRS, Inserm, IRISA, Rennes, France
| | | | - Duché Quentin
- Univ Rennes, Inria, CNRS, Inserm, IRISA, Rennes, France.,Department of Physical and Rehabilitation Medicine, CHU Rennes, Rennes, France
| | - Butet Simon
- Department of Physical and Rehabilitation Medicine, CHU Rennes, Rennes, France
| | - Mathis Fleury
- Univ Rennes, Inria, CNRS, Inserm, IRISA, Rennes, France
| | | | - Elise Bannier
- Univ Rennes, Inria, CNRS, Inserm, IRISA, Rennes, France.,Department of Radiology, CHU Rennes, Rennes, France
| | | | | | - Isabelle Bonan
- Department of Physical and Rehabilitation Medicine, CHU Rennes, Rennes, France
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95
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Averna A, Hayley P, Murphy MD, Barban F, Nguyen J, Buccelli S, Nudo RJ, Chiappalone M, Guggenmos DJ. Entrainment of Network Activity by Closed-Loop Microstimulation in Healthy Ambulatory Rats. Cereb Cortex 2021; 31:5042-5055. [PMID: 34165137 PMCID: PMC8491688 DOI: 10.1093/cercor/bhab140] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 11/13/2022] Open
Abstract
As our understanding of volitional motor function increases, it is clear that complex movements are the result of the interactions of multiple cortical regions rather than just the output properties of primary motor cortex. However, our understanding of the interactions among these regions is limited. In this study, we used the activity-dependent stimulation (ADS) technique to determine the short/long-term effects on network activity and neuroplasticity of intracortical connections. ADS uses the intrinsic neural activity of one region to trigger stimulations in a separate region of the brain and can manipulate neuronal connectivity in vivo. Our aim was to compare single-unit neuronal activity within premotor cortex (rostral forelimb area, [RFA] in rats) in response to ADS (triggered from RFA) and randomly-generated stimulation in the somatosensory area (S1) within single sessions and across 21 consecutive days of stimulation. We examined firing rate and correlation between spikes and stimuli in chronically-implanted healthy ambulatory rats during spontaneous and evoked activity. At the end of the treatment, we evaluated changes of synaptophysin expression. Our results demonstrated the ability of ADS to modulate RFA firing properties and to promote synaptogenesis in S1, strengthening the idea that this Hebbian-inspired protocol can be used to modulate cortical connectivity.
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Affiliation(s)
- Alberto Averna
- Rehab Technologies, Istituto Italiano di Tecnologia, Genova 16163, Italy.,CRC Aldo Ravelli, Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20122, Milano, Italy
| | - Page Hayley
- Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City 66160, USA.,Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Maxwell D Murphy
- Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City 66160, USA.,Bioengineering Graduate Program, University of Kansas, Kansas 66045, USA
| | - Federico Barban
- Rehab Technologies, Istituto Italiano di Tecnologia, Genova 16163, Italy.,Department of Informatics, Bioengineering, Robotics and System Engineering (DIBRIS), University of Genova, Genova 16145, Italy
| | - Jimmy Nguyen
- University of Kansas School of Medicine, Kansas 66160, USA
| | - Stefano Buccelli
- Rehab Technologies, Istituto Italiano di Tecnologia, Genova 16163, Italy
| | - Randolph J Nudo
- Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City 66160, USA.,Landon Center on Aging, University of Kansas Medical Center, Kansas 66160, USA
| | - Michela Chiappalone
- Rehab Technologies, Istituto Italiano di Tecnologia, Genova 16163, Italy.,Department of Informatics, Bioengineering, Robotics and System Engineering (DIBRIS), University of Genova, Genova 16145, Italy
| | - David J Guggenmos
- Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City 66160, USA
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96
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Geng W, Zhang J, Shang S, Chen H, Shi M, Jiang L, Yin X, Chen YC. Reduced functional network connectivity is associated with upper limb dysfunction in acute ischemic brainstem stroke. Brain Imaging Behav 2021; 16:802-810. [PMID: 34586538 DOI: 10.1007/s11682-021-00554-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
This study aimed to detect alterations in intra- and inter-network functional connectivity (FC) of multiple networks in acute brainstem ischemic stroke patients, and the relationship between FC and movement assessment scores to assess their ability to predict upper extremity motor impairment. Resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired from acute brainstem ischemic stroke patients (n = 50) and healthy controls (HCs) (n = 45). Resting-state networks (RSNs) were established based on independent component analysis (ICA) and the functional network connectivity (FNC) analysis was performed. Subsequently, correlation analysis was subsequently used to explore the relationship between FNC abnormalities and upper extremity motor impairment. Altered FC within default mode network (DMN), executive control network (ECN), the salience network (SN), auditory network (AN), and cerebellum network (CN) were found in the acute brainstem ischemic stroke group relative to HCs. Moreover, different patterns of altered network interactions were found between the patients and HCs, including the SN-CN, SN-AN, and ECN-DMN connections. Correlations between functional disconnection and upper limb dysfunction measurements in acute brainstem ischemic stroke patients were also found. This study intimated that widespread FNC impairment and altered integration existed in brainstem ischemic stroke at acute stage, suggesting that FNC disruption may be applied for early diagnosis and prediction of upper limb dysfunction in acute brainstem ischemic stroke.
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Affiliation(s)
- Wen Geng
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China
| | - Juan Zhang
- Department of Neurology, Nanjing Yuhua Hospital, Yuhua Branch of Nanjing First Hospital, Nanjing, 210006, China
| | - Song'an Shang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China
| | - Huiyou Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China
| | - Mengye Shi
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China
| | - Liang Jiang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China.
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China.
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97
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Zakharov AV, Khivintseva EV, Chaplygin SS, Starikovsky MY, Elizarov MA, Kolsanov AV. [Motor rehabilitation of patients in the acute period of stroke using virtual reality technology]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:71-75. [PMID: 34553585 DOI: 10.17116/jnevro202112108271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To study an effect of adjuvant rehabilitation using implicit virtual reality on the dynamics of the motor function of the lower extremities in patients in the acute period of ischemic stroke. MATERIALS AND METHODS The study was carried out to assess the effectiveness and safety of rehabilitation using virtual reality in 60 patients with lower central paresis in the acute period of ischemic stroke, lasting from 3 to 5 days. Patients of the study group additionally received rehabilitation using the hardware-software complex ReviVR, which allows to stimulate the patient's plantar surface by means of pneumo cuffs synchronously with the step of his animated body. Animation of movement was demonstrated to the patient using virtual reality glasses. The duration of the classes was 10 days, 20-25 minutes each. The total duration of rehabilitation measures in the study and comparison groups was 3-4 hours. RESULTS A significant regression on NIHSS (3 [-4; -1] and -1 [-2; 0], p<0.001) and a progress on RMI (3 [1; 3] and 2 [0; 2], p<0.001, respectively), between the study group and the control group were found. Changes on FMA-LE section (E-F) occurred on day 10, between the study and comparison groups (9 [5; 16] and 4 [0; 7], respectively, p=0.04). The improvement in FMA-LE out of synergy, in the standing position, indicated an increased readiness of the patient to form an independent walk. CONCLUSION The study has shown that the use of virtual reality rehabilitation increases the effectiveness of motor rehabilitation in patients with lower central paresis in the acute period of stroke.
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98
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Kunadia A, Aughtman S, Hoffmann M, Rossi F. Superlative Artistic Abilities in a Patient With Post-traumatic Brain Injury. Cureus 2021; 13:e16697. [PMID: 34462704 PMCID: PMC8389864 DOI: 10.7759/cureus.16697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/28/2021] [Indexed: 12/05/2022] Open
Abstract
This case describes a patient who exhibits newfound superlative abilities in painting, music, philosophy, culinary, and performing arts after a traumatic brain injury (TBI) involving the frontal and temporal lobes. Such a dramatic change in de novo artistic behavior after brain injury is rare but has been reported in other patients with frontotemporal dementia, as well as other neurological diseases. Previous studies have shown that mild frontal cortical dysfunction likely plays a role in facilitating creative endeavors and that artistic circuitry is distributed throughout the brain. The neuronal reorganization which occurs after injuries enhances synapse formation and neural plasticity, which may contribute to the acceleration of artistic output after brain injury. This is likely an underdiagnosed phenomenon and a deeper understanding is required to allow clinicians to more effectively recognize and nurture newfound creativity in the setting of brain damage.
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Affiliation(s)
- Anuj Kunadia
- Internal Medicine, University of Central Florida College of Medicine, Orlando, USA
| | - Shelby Aughtman
- Internal Medicine, University of Central Florida College of Medicine, Orlando, USA
| | - Michael Hoffmann
- Internal Medicine and Neurology, University of Central Florida College of Medicine, Orlando, USA
| | - Fabian Rossi
- Clinical Neurophysiology Laboratory, Orlando Veterans Affairs Medical Center, Orlando, USA
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99
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Astrakas LG, Li S, Ottensmeyer MP, Pusatere C, Moskowitz MA, Tzika AA. Peak Activation Shifts in the Sensorimotor Cortex of Chronic Stroke Patients Following Robot-assisted Rehabilitation Therapy. Open Neuroimag J 2021; 14:8-15. [PMID: 34434290 PMCID: PMC8384467 DOI: 10.2174/1874440002114010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background: Ischemic stroke is the most common cause of complex chronic disability and the third leading cause of death worldwide. In recovering stroke patients, peak activation within the ipsilesional primary motor cortex (M1) during the performance of a simple motor task has been shown to exhibit an anterior shift in many studies and a posterior shift in other studies. Objective: We investigated this discrepancy in chronic stroke patients who completed a robot-assisted rehabilitation therapy program. Methods: Eight chronic stroke patients with an intact M1 and 13 Healthy Control (HC) volunteers underwent 300 functional magnetic resonance imaging (fMRI) scans while performing a grip task at different force levels with a robotic device. The patients were trained with the same robotic device over a 10-week intervention period and their progress was evaluated serially with the Fugl-Meyer and Modified Ashworth scales. Repeated measure analyses were used to assess group differences in locations of peak activity in the sensorimotor cortex (SM) and the relationship of such changes with scores on the Fugl-Meyer Upper Extremity (FM UE) scale. Results: Patients moving their stroke-affected hand had proportionally more peak activations in the primary motor area and fewer peak activations in the somatosensory cortex than the healthy controls (P=0.009). They also showed an anterior shift of peak activity on average of 5.3-mm (P<0.001). The shift correlated negatively with FM UE scores (P=0.002). Conclusion: A stroke rehabilitation grip task with a robotic device was confirmed to be feasible during fMRI scanning and thus amenable to be used to assess plastic changes in neurological motor activity. Location of peak activity in the SM is a promising clinical neuroimaging index for the evaluation and monitoring of chronic stroke patients.
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Affiliation(s)
- Loukas G Astrakas
- Medical Physics, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Shasha Li
- Harvard Medical School, Boston, MA, USA.,NMR Surgical Laboratory, Department of Surgery, Center for Surgery, Innovation and Bioengineering, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Athinoula A. Martinos Center of Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark P Ottensmeyer
- Harvard Medical School, Boston, MA, USA.,Medical Device & Simulation Laboratory, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Christian Pusatere
- NMR Surgical Laboratory, Department of Surgery, Center for Surgery, Innovation and Bioengineering, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Athinoula A. Martinos Center of Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael A Moskowitz
- Harvard Medical School, Boston, MA, USA.,Athinoula A. Martinos Center of Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Neuroscience Center, Departments of Neurology and Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
| | - A Aria Tzika
- Harvard Medical School, Boston, MA, USA.,NMR Surgical Laboratory, Department of Surgery, Center for Surgery, Innovation and Bioengineering, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Athinoula A. Martinos Center of Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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100
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The disrupted topological properties of structural networks showed recovery in ischemic stroke patients: a longitudinal design study. BMC Neurosci 2021; 22:47. [PMID: 34340655 PMCID: PMC8330082 DOI: 10.1186/s12868-021-00652-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 07/22/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction Stroke is one of the leading causes of substantial disability worldwide. Previous studies have shown brain functional and structural alterations in adults with stroke. However, few studies have examined the longitudinal reorganization in whole-brain structural networks in stroke. Methods Here, we applied graph theoretical analysis to investigate the longitudinal topological organization of white matter networks in 20 ischemic stroke patients with a one-month interval between two timepoints. Two sets of clinical scores, Fugl-Meyer motor assessment (FMA) and neurological deficit scores (NDS), were assessed for all patients on the day the image data were collected. Results The stroke patients exhibited significant increases in FMA scores and significant reductions in DNS between the two timepoints. All groups exhibited small-world organization (σ > 1) in the brain structural network, including a high clustering coefficient (γ > 1) and a low normalized characteristic path length (λ ≈ 1). However, compared to healthy controls, stroke patients showed significant decrease in nodal characteristics at the first timepoint, primarily in the right supplementary motor area, right middle temporal gyrus, right inferior parietal lobe, right postcentral gyrus and left posterior cingulate gyrus. Longitudinal results demonstrated that altered nodal characteristics were partially restored one month later. Additionally, significant correlations between the nodal characteristics of the right supplementary motor area and the clinical scale scores (FMA and NDS) were observed in stroke patients. Similar behavioral-neuroimaging correlations were found in the right inferior parietal lobe. Conclusion Altered topological properties may be an effect of stroke, which can be modulated during recovery. The longitudinal results and the neuroimaging-behavioral relationship may provide information for understanding brain recovery from stroke. Future studies should detect whether observed changes in structural topological properties can predict the recovery of daily cognitive function in stroke. Supplementary Information The online version contains supplementary material available at 10.1186/s12868-021-00652-1.
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