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Jin JF, Guo ZT, Zhang YP, Chen YY. Prediction of motor recovery after ischemic stroke using diffusion tensor imaging: A meta-analysis. World J Emerg Med 2017; 8:99-105. [PMID: 28458752 PMCID: PMC5409242 DOI: 10.5847/wjem.j.1920-8642.2017.02.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 03/18/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND This systematic review aims to investigate the prediction value of diffusion tensor imaging for motor function recovery of ischemic stroke patients. METHODS Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2016, Issue 9), PubMed, Embase, Clarivate Analytics, Scopus, CINAHL, Chinese Biomedical Literature Database, China National Knowledge Infrastructure and Google Scholar were searched for either motor recovery or corticospinal tract integrity by diffusion tensor imaging in different stroke phase from January 1, 1970, to October 31, 2016. The study design and participants were subjected to metrological analysis. Correlation coefficient (r) was used for evaluating the relationship between fractional anisotropy (FA) and motor function outcome. Correlation coefficient values were extracted from each study, and 95% confidence intervals (CIs) were calculated by Fisher's z transformation. Meta-analysis was conducted by STATA software. RESULTS Fifteen studies with a total of 414 patients were included. Meta-analysis showed that FA in the subacute phase had the significant correlation with motor function outcome (ES=0.75, 95%CI 0.62-0.87), which showed moderate quality based on GRADE system. The weight correlation coefficient revealed that an effect size (ES) of FA in acute phase and chronic phase was 0.51 (95%CI 0.33-0.68) and 0.62 (95%CI 0.47-0.77) respectively. CONCLUSION This meta-analysis reveals that FA in the subacute phase after ischemic stroke is a good predictor for functional motor recovery, which shows moderate quality based on the GRADE system.
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Affiliation(s)
- Jing-fen Jin
- Nursing Department, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Zhi-ting Guo
- Neurology Department, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Yu-ping Zhang
- Nursing Department, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Yuan-yuan Chen
- Neurology Department, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
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Bajaj S, Housley SN, Wu D, Dhamala M, James GA, Butler AJ. Dominance of the Unaffected Hemisphere Motor Network and Its Role in the Behavior of Chronic Stroke Survivors. Front Hum Neurosci 2016; 10:650. [PMID: 28082882 PMCID: PMC5186808 DOI: 10.3389/fnhum.2016.00650] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 12/08/2016] [Indexed: 12/15/2022] Open
Abstract
Balance of motor network activity between the two brain hemispheres after stroke is crucial for functional recovery. Several studies have extensively studied the role of the affected brain hemisphere to better understand changes in motor network activity following stroke. Very few studies have examined the role of the unaffected brain hemisphere and confirmed the test-retest reliability of connectivity measures on unaffected hemisphere. We recorded blood oxygenation level dependent functional magnetic resonance imaging (fMRI) signals from nine stroke survivors with hemiparesis of the left or right hand. Participants performed a motor execution task with affected hand, unaffected hand, and both hands simultaneously. Participants returned for a repeat fMRI scan 1 week later. Using dynamic causal modeling (DCM), we evaluated effective connectivity among three motor areas: the primary motor area (M1), the premotor cortex (PMC) and the supplementary motor area for the affected and unaffected hemispheres separately. Five participants' manual motor ability was assessed by Fugl-Meyer Motor Assessment scores and root-mean square error of participants' tracking ability during a robot-assisted game. We found (i) that the task performance with the affected hand resulted in strengthening of the connectivity pattern for unaffected hemisphere, (ii) an identical network of the unaffected hemisphere when participants performed the task with their unaffected hand, and (iii) the pattern of directional connectivity observed in the affected hemisphere was identical for tasks using the affected hand only or both hands. Furthermore, paired t-test comparison found no significant differences in connectivity strength for any path when compared with one-week follow-up. Brain-behavior linear correlation analysis showed that the connectivity patterns in the unaffected hemisphere more accurately reflected the behavioral conditions than the connectivity patterns in the affected hemisphere. Above findings enrich our knowledge of unaffected brain hemisphere following stroke, which further strengthens our neurobiological understanding of stroke-affected brain and can help to effectively identify and apply stroke-treatments.
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Affiliation(s)
- Sahil Bajaj
- Department of Physics and Astronomy, Georgia State University, AtlantaGA, USA; Department of Psychiatry, College of Medicine, University of Arizona, TucsonAZ, USA
| | - Stephen N Housley
- Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University, Atlanta GA, USA
| | - David Wu
- Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University, Atlanta GA, USA
| | - Mukesh Dhamala
- Department of Physics and Astronomy, Georgia State University, AtlantaGA, USA; Joint Center for Advanced Brain Imaging, Center for Behavioral Neuroscience, Center for Nano-Optics, Center for Diagnostics and Therapeutics, Georgia State University, AtlantaGA, USA; Neuroscience Institute, Georgia State University, AtlantaGA, USA
| | - G A James
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock AR, USA
| | - Andrew J Butler
- Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University, AtlantaGA, USA; Neuroscience Institute, Georgia State University, AtlantaGA, USA; Department of Veterans Affairs, Atlanta Rehabilitation Research and Development Center of Excellence, DecaturGA, USA
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Baldassarre A, Ramsey LE, Siegel JS, Shulman GL, Corbetta M. Brain connectivity and neurological disorders after stroke. Curr Opin Neurol 2016; 29:706-713. [PMID: 27749394 PMCID: PMC5682022 DOI: 10.1097/wco.0000000000000396] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW An important challenge in neurology is identifying the neural mechanisms underlying behavioral deficits after brain injury. Here, we review recent advances in understanding the effects of focal brain lesions on brain networks and behavior. RECENT FINDINGS Neuroimaging studies indicate that the human brain is organized in large-scale resting state networks (RSNs) defined via functional connectivity, that is the temporal correlation of spontaneous activity between different areas. Prior studies showed that focal brain lesion induced behaviorally relevant changes of functional connectivity beyond the site of damage. Recent work indicates that across domains, functional connectivity changes largely conform to two patterns: a reduction in interhemispheric functional connectivity and an increase in intrahemispheric functional connectivity between networks that are normally anticorrelated, for example dorsal attention and default networks. Abnormal functional connectivity can exhibit a high degree of behavioral specificity such that deficits in a given behavioral domain are selectively related to functional connectivity of the corresponding RSN, but some functional connectivity changes allow prediction across domains. Finally, as behavioral recovery proceeds, the prestroke pattern of functional connectivity is restored. SUMMARY Investigating changes in RSNs may shed light on the neural mechanisms underlying brain dysfunction after stroke. Therefore, resting state functional connectivity may represent an important tool for clinical diagnosis, tracking recovery and rehabilitation.
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Affiliation(s)
| | | | - Joshua S. Siegel
- Department of Neurology, School of Medicine, Washington University in Saint Louis, Saint Louis, USA
| | - Gordon L. Shulman
- Department of Neurology, School of Medicine, Washington University in Saint Louis, Saint Louis, USA
| | - Maurizio Corbetta
- Department of Neurology, School of Medicine, Washington University in Saint Louis, Saint Louis, USA
- Department of Radiology, School of Medicine, Washington University in Saint Louis, Saint Louis, USA
- Department of Neuroscience, School of Medicine, Washington University in Saint Louis, Saint Louis, USA
- Department of Bioengineering, School of Medicine, Washington University in Saint Louis, Saint Louis, USA
- Department of Neuroscience, University of Padua, Padua, Italy
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MRI Biomarkers for Hand-Motor Outcome Prediction and Therapy Monitoring following Stroke. Neural Plast 2016; 2016:9265621. [PMID: 27747108 PMCID: PMC5056270 DOI: 10.1155/2016/9265621] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 08/23/2016] [Indexed: 01/01/2023] Open
Abstract
Several biomarkers have been identified which enable a considerable prediction of hand-motor outcome after cerebral damage already in the subacute stage after stroke. We here review the value of MRI biomarkers in the evaluation of corticospinal integrity and functional recruitment of motor resources. Many of the functional imaging parameters are not feasible early after stroke or for patients with high impairment and low compliance. Whereas functional connectivity parameters have demonstrated varying results on their predictive value for hand-motor outcome, corticospinal integrity evaluation using structural imaging showed robust and high predictive power for patients with different levels of impairment. Although this is indicative of an overall higher value of structural imaging for prediction, we suggest that this variation be explained by structure and function relationships. To gain more insight into the recovering brain, not only one biomarker is needed. We rather argue for a combination of different measures in an algorithm to classify fine-graded subgroups of patients. Approaches to determining biomarkers have to take into account the established markers to provide further information on certain subgroups. Assessing the best therapy approaches for individual patients will become more feasible as these subgroups become specified in more detail. This procedure will help to considerably save resources and optimize neurorehabilitative therapy.
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Zhang Y, Li KS, Ning YZ, Fu CH, Liu HW, Han X, Cui FY, Ren Y, Zou YH. Altered structural and functional connectivity between the bilateral primary motor cortex in unilateral subcortical stroke: A multimodal magnetic resonance imaging study. Medicine (Baltimore) 2016; 95:e4534. [PMID: 27495109 PMCID: PMC4979863 DOI: 10.1097/md.0000000000004534] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
A large number of functional imaging studies have focused on the understanding of motor-related neural activities after ischemic stroke. However, the knowledge is still limited in the structural and functional changes of the interhemispheric connections of the bilateral primary motor cortices (M1s) and their potential influence on motor function recovery following stroke.Twenty-four stroke patients with right hemispheric subcortical infarcts and 25 control subjects were recruited to undergo multimodal magnetic resonance imaging examinations. Structural impairments between the bilateral M1s were measured by fractional anisotropy. Functional changes of the bilateral M1s were assessed via M1-M1 resting-state functional connectivity. Task-evoked activation analysis was applied to identify the roles of the bilateral hemispheres in motor function recovery. Compared with control subjects, unilateral subcortical stroke patients revealed significantly decreased fractional anisotropy and functional connectivity between the bilateral M1s. Stroke patients also revealed higher activations in multiple brain regions in both hemispheres and that more regions were located in the contralesional hemisphere.This study increased our understanding of the structural and functional alterations between the bilateral M1s that occur in unilateral subcortical stroke and provided further evidence for the compensatory role played by the contralesional hemisphere for these alterations during motor function recovery.
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Affiliation(s)
- Yong Zhang
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine
| | - Kuang-Shi Li
- Department of Emergency, Beijing Gulou Hospital of Traditional Chinese Medicine, Beijing, China
| | - Yan-Zhe Ning
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine
| | - Cai-Hong Fu
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine
| | - Hong-Wei Liu
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine
| | - Xiao Han
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine
| | - Fang-Yuan Cui
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine
| | - Yi Ren
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine
| | - Yi-Huai Zou
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine
- Correspondence: Yihuai Zou, Department of Neurology and Stroke Center, Dongzhimen Hospital, No 5, Haiyuncang, Dongcheng District, Beijing 100700, China (e-mail: )
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Julkunen P, Määttä S, Säisänen L, Kallioniemi E, Könönen M, Jäkälä P, Vanninen R, Vaalto S. Functional and structural cortical characteristics after restricted focal motor cortical infarction evaluated at chronic stage - Indications from a preliminary study. Clin Neurophysiol 2016; 127:2775-2784. [PMID: 27417053 DOI: 10.1016/j.clinph.2016.05.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 05/04/2016] [Accepted: 05/10/2016] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To assess the inter-hemispheric differences in neuronal function and structure of the motor cortex in a small group of chronic stroke patients having suffered a restricted ischemic lesion affecting hand motor representation. GABAergic intracortical inhibition, known to be affected by stroke lesion, was also investigated. METHODS Eight patients exhibiting little or no motor impairment were studied using transcranial magnetic stimulation (TMS) and diffusion weighted imaging (DWI) >15months from diagnosis. Resting motor threshold (MT) for 50μV and 2mV motor evoked potentials, and short-interval intracortical inhibition (SICI) were measured from hand muscles. Apparent diffusion coefficients (ADCs) were analyzed from the DWI for the primary motor cortex (M1), the supplementary motor area (SMA) and thalamus for reflecting changes in neuronal organization. RESULTS The MTs did not differ between the affected (AH) and unaffected hemisphere (UH) in 50μV responses, while the MTs for 2mV responses were higher (p=0.018) in AH. SICI was weakened in AH (p=0.008). ADCs were higher in the affected M1 compared to the unaffected M1 (p=0.018) while there were no inter-hemispheric differences in SMA or thalamus. CONCLUSIONS Inter-hemispheric asymmetry and neuronal organization demonstrated abnormalities in the M1. However, no confident inference can be made whether the observed alterations in neurophysiological and imaging measures have causal role for motor rehabilitation in these patients. SIGNIFICANCE Neurophysiological changes persist and are detectable using TMS years after stroke even though clinical symptoms have normalized.
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Affiliation(s)
- Petro Julkunen
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland; Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
| | - Sara Määttä
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland; Department of Clinical Neurophysiology, Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Laura Säisänen
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland; Department of Clinical Neurophysiology, Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Elisa Kallioniemi
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland; Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Mervi Könönen
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland; Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Pekka Jäkälä
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland; Department of Neurology, Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Ritva Vanninen
- Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland; Department of Clinical Radiology, Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Selja Vaalto
- Department of Clinical Neurophysiology, Helsinki University Hospital, Helsinki, Finland; Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
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Baldassarre A, Ramsey L, Rengachary J, Zinn K, Siegel JS, Metcalf NV, Strube MJ, Snyder AZ, Corbetta M, Shulman GL. Dissociated functional connectivity profiles for motor and attention deficits in acute right-hemisphere stroke. Brain 2016; 139:2024-38. [PMID: 27225794 DOI: 10.1093/brain/aww107] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 03/24/2016] [Indexed: 12/31/2022] Open
Abstract
Strokes often cause multiple behavioural deficits that are correlated at the population level. Here, we show that motor and attention deficits are selectively associated with abnormal patterns of resting state functional connectivity in the dorsal attention and motor networks. We measured attention and motor deficits in 44 right hemisphere-damaged patients with a first-time stroke at 1-2 weeks post-onset. The motor battery included tests that evaluated deficits in both upper and lower extremities. The attention battery assessed both spatial and non-spatial attention deficits. Summary measures for motor and attention deficits were identified through principal component analyses on the raw behavioural scores. Functional connectivity in structurally normal cortex was estimated based on the temporal correlation of blood oxygenation level-dependent signals measured at rest with functional magnetic resonance imaging. Any correlation between motor and attention deficits and between functional connectivity in the dorsal attention network and motor networks that might spuriously affect the relationship between each deficit and functional connectivity was statistically removed. We report a double dissociation between abnormal functional connectivity patterns and attention and motor deficits, respectively. Attention deficits were significantly more correlated with abnormal interhemispheric functional connectivity within the dorsal attention network than motor networks, while motor deficits were significantly more correlated with abnormal interhemispheric functional connectivity patterns within the motor networks than dorsal attention network. These findings indicate that functional connectivity patterns in structurally normal cortex following a stroke link abnormal physiology in brain networks to the corresponding behavioural deficits.
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Affiliation(s)
- Antonello Baldassarre
- 1 Department of Neurology, Washington University in St. Louis School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA 2 Department of Neuroscience, Imaging, and Clinical Sciences, University of Chieti, via dei Vestini 33, 66013, Chieti, Italy 3 Institute for Advanced Biomedical Technologies, University of Chieti G. d'Annunzio, via dei Vestini 33, 66013, Chieti, Italy
| | - Lenny Ramsey
- 1 Department of Neurology, Washington University in St. Louis School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Jennifer Rengachary
- 1 Department of Neurology, Washington University in St. Louis School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Kristi Zinn
- 1 Department of Neurology, Washington University in St. Louis School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Joshua S Siegel
- 1 Department of Neurology, Washington University in St. Louis School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Nicholas V Metcalf
- 1 Department of Neurology, Washington University in St. Louis School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Michael J Strube
- 4 Department of Psychology, Washington University in St. Louis, 1 Brooking Dr., St Louis, MO, USA
| | - Abraham Z Snyder
- 5 Department of Radiology, Washington University in Saint Louis School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Maurizio Corbetta
- 1 Department of Neurology, Washington University in St. Louis School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA 5 Department of Radiology, Washington University in Saint Louis School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA 6 Department of Neuroscience, University of Padua, Via Giustiniani, 5 35128, Padova, Italy 7 Department of Anatomy and Neurobiology, Washington University in St. Louis, School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA 8 Department of Bioengineering, Washington University in St. Louis, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Gordon L Shulman
- 1 Department of Neurology, Washington University in St. Louis School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
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Wang L, Zhang J, Zhang Y, Yan R, Liu H, Qiu M. Conditional Granger Causality Analysis of Effective Connectivity during Motor Imagery and Motor Execution in Stroke Patients. BIOMED RESEARCH INTERNATIONAL 2016; 2016:3870863. [PMID: 27200373 PMCID: PMC4854998 DOI: 10.1155/2016/3870863] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 03/01/2016] [Accepted: 03/10/2016] [Indexed: 11/17/2022]
Abstract
Aims. Motor imagery has emerged as a promising technique for the improvement of motor function following stroke, but the mechanism of functional network reorganization in patients during this process remains unclear. The aim of this study is to evaluate the cortical motor network patterns of effective connectivity in stroke patients. Methods. Ten stroke patients with right hand hemiplegia and ten normal control subjects were recruited. We applied conditional Granger causality analysis (CGCA) to explore and compare the functional connectivity between motor execution and motor imagery. Results. Compared with the normal controls, the patient group showed lower effective connectivity to the primary motor cortex (M1), the premotor cortex (PMC), and the supplementary motor area (SMA) in the damaged hemisphere but stronger effective connectivity to the ipsilesional PMC and M1 in the intact hemisphere during motor execution. There were tighter connections in the cortical motor network in the patients than in the controls during motor imagery, and the patients showed more effective connectivity in the intact hemisphere. Conclusions. The increase in effective connectivity suggests that motor imagery enhances core corticocortical interactions, promotes internal interaction in damaged hemispheres in stroke patients, and may facilitate recovery of motor function.
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Affiliation(s)
- Li Wang
- Department of Medical Image, College of Biomedical Engineering, Third Military Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing 400038, China
| | - Jingna Zhang
- Department of Medical Image, College of Biomedical Engineering, Third Military Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing 400038, China
| | - Ye Zhang
- Department of Medical Image, College of Biomedical Engineering, Third Military Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing 400038, China
| | - Rubing Yan
- Department of Rehabilitation, Southwest Hospital, Third Military Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing 400038, China
| | - Hongliang Liu
- Department of Rehabilitation, Southwest Hospital, Third Military Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing 400038, China
| | - Mingguo Qiu
- Department of Medical Image, College of Biomedical Engineering, Third Military Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing 400038, China
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Tang C, Zhao Z, Chen C, Zheng X, Sun F, Zhang X, Tian J, Fan M, Wu Y, Jia J. Decreased Functional Connectivity of Homotopic Brain Regions in Chronic Stroke Patients: A Resting State fMRI Study. PLoS One 2016; 11:e0152875. [PMID: 27074031 PMCID: PMC4830618 DOI: 10.1371/journal.pone.0152875] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 03/21/2016] [Indexed: 02/07/2023] Open
Abstract
The recovery of motor functions is accompanied by brain reorganization, and identifying the inter-hemispheric interaction post stroke will conduce to more targeted treatments. However, the alterations of bi-hemispheric coordination pattern between homologous areas in the whole brain for chronic stroke patients were still unclear. The present study focuses on the functional connectivity (FC) of mirror regions of the whole brain to investigate the inter-hemispheric interaction using a new fMRI method named voxel-mirrored homotopic connectivity (VMHC). Thirty left subcortical chronic stroke patients with pure motor deficits and 37 well-matched healthy controls (HCs) underwent resting-state fMRI scans. We employed a VMHC analysis to determine the brain areas showed significant differences between groups in FC between homologous regions, and we explored the relationships between the mean VMHC of each survived area and clinical tests within patient group using Pearson correlation. In addition, the brain areas showed significant correlations between the mean VMHC and clinical tests were defined as the seed regions for whole brain FC analysis. Relative to HCs, patients group displayed lower VMHC in the precentral gyrus, postcentral gyrus, inferior frontal gyrus, middle temporal gyrus, calcarine gyrus, thalamus, cerebellum anterior lobe, and cerebellum posterior lobe (CPL). Moreover, the VMHC of CPL was positively correlated with the Fugl-Meyer Score of hand (FMA-H), while a negative correlation between illness duration and the VMHC of this region was also detected. Furthermore, we found that when compared with HCs, the right CPL exhibited reduced FC with the left precentral gyrus, inferior frontal gyrus, inferior parietal lobule, middle temporal gyrus, thalamus and hippocampus. Our results suggest that the functional coordination across hemispheres is impaired in chronic stroke patients, and increased VMHC of the CPL is significantly associated with higher FMA-H scores. These findings may be helpful in understanding the mechanism of hand deficit after stroke, and the CPL may serve as a target region for hand rehabilitation following stroke.
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Affiliation(s)
- Chaozheng Tang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhiyong Zhao
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
| | - Chuang Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiaohui Zheng
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
| | - Fenfen Sun
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Xiaoli Zhang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jing Tian
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Mingxia Fan
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
| | - Yi Wu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jie Jia
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Department of Rehabilitation Medicine, Jingan District Center Hospital, Shanghai, China
- * E-mail:
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tDCS and Robotics on Upper Limb Stroke Rehabilitation: Effect Modification by Stroke Duration and Type of Stroke. BIOMED RESEARCH INTERNATIONAL 2016; 2016:5068127. [PMID: 27123448 PMCID: PMC4830702 DOI: 10.1155/2016/5068127] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 01/18/2016] [Accepted: 03/06/2016] [Indexed: 11/18/2022]
Abstract
Objective. The aim of this exploratory pilot study is to test the effects of bilateral tDCS combined with upper extremity robot-assisted therapy (RAT) on stroke survivors. Methods. We enrolled 23 subjects who were allocated to 2 groups: RAT + real tDCS and RAT + sham-tDCS. Each patient underwent 10 sessions (5 sessions/week) over two weeks. Outcome measures were collected before and after treatment: (i) Fugl-Meyer Assessment-Upper Extremity (FMA-UE), (ii) Box and Block Test (BBT), and (iii) Motor Activity Log (MAL). Results. Both groups reported a significant improvement in FMA-UE score after treatment (p < 0.01). No significant between-groups differences were found in motor function. However, when the analysis was adjusted for stroke type and duration, a significant interaction effect (p < 0.05) was detected, showing that stroke duration (acute versus chronic) and type (cortical versus subcortical) modify the effect of tDCS and robotics on motor function. Patients with chronic and subcortical stroke benefited more from the treatments than patients with acute and cortical stroke, who presented very small changes. Conclusion. The additional use of bilateral tDCS to RAT seems to have a significant beneficial effect depending on the duration and type of stroke. These results should be verified by additional confirmatory studies.
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Increased resting state connectivity between ipsilesional motor cortex and contralesional premotor cortex after transcranial direct current stimulation with physical therapy. Sci Rep 2016; 6:23271. [PMID: 26980052 PMCID: PMC4793190 DOI: 10.1038/srep23271] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 03/03/2016] [Indexed: 11/16/2022] Open
Abstract
Non-invasive stimulation of the brain using transcranial direct current stimulation (tDCS) during motor rehabilitation can improve the recovery of movements in individuals with stroke. However, the neural substrates that underlie the clinical improvements are not well understood. In this proof-of-principle open-label pilot study, five individuals with stroke received 10 sessions of tDCS while undergoing usual care physical/occupational therapy for the arm and hand. Motor impairment as indexed by the Upper Extremity Fugl Meyer assessment was significantly reduced after the intervention. Resting state fMRI connectivity increased between ipsilesional motor cortex and contralesional premotor cortex after the intervention. These findings provide preliminary evidence that the neural underpinnings of tDCS coupled with rehabilitation exercises, may be mediated by interactions between motor and premotor cortex. The latter, of which has been shown to play an important role in the recovery of movements post-stroke. Our data suggest premotor cortex could be tested as a target region for non-invasive brain-stimulation to enhance connectivity between regions that might be beneficial for stroke motor recovery.
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Li Y, Wang D, Zhang H, Wang Y, Wu P, Zhang H, Yang Y, Huang W. Changes of Brain Connectivity in the Primary Motor Cortex After Subcortical Stroke: A Multimodal Magnetic Resonance Imaging Study. Medicine (Baltimore) 2016; 95:e2579. [PMID: 26871777 PMCID: PMC4753872 DOI: 10.1097/md.0000000000002579] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 12/24/2015] [Accepted: 12/29/2015] [Indexed: 12/11/2022] Open
Abstract
The authors investigated the changes in connectivity networks of the bilateral primary motor cortex (M1) of subcortical stroke patients using a multimodal neuroimaging approach with antiplatelet therapy. Nineteen patients were scanned at 2 time points: before and 1 month after the treatment. The authors assessed the resting-state functional connectivity (FC) and probabilistic fiber tracking of left and right M1 of every patient, and then compared these results to the 15 healthy controls. The authors also evaluated the correlations between the neuroimaging results and clinical scores.Compared with the controls, the patients showed a significant decrease of FC in the contralateral motor cortex before treatment, and the disrupted FC was restored after treatment. The fiber tracking results in the controls indicated that the body of the corpus callosum should be the main pathway connecting the M1 and contralateral hemispheres. All patients exhibited reduced probability of structural connectivity within this pathway before treatment and which was restored after treatment. Significant correlations were also found in these patients between the connectivity results and clinical scores, which might imply that the connectivity of M1 can be used to evaluate the motor skills in stroke patients.These findings can help elucidate the neural mechanisms responsible for the brain connectivity recovery after stroke.
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Affiliation(s)
- Yongxin Li
- From the Institute of Clinical Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou (YL, YW, YY, HZ, WH); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong (DW); Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen (HZ); and The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China (PW)
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Koch P, Schulz R, Hummel FC. Structural connectivity analyses in motor recovery research after stroke. Ann Clin Transl Neurol 2016; 3:233-44. [PMID: 27042683 PMCID: PMC4774263 DOI: 10.1002/acn3.278] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 11/19/2015] [Accepted: 11/20/2015] [Indexed: 01/10/2023] Open
Abstract
Structural connectivity analyses by means of diffusion‐weighted imaging have substantially advanced the understanding of stroke‐related network alterations and their implications for motor recovery processes and residual motor function. Analyses of the corticospinal tract, alternate corticofugal pathways as well as intrahemispheric and interhemispheric corticocortical connections have not only been related to residual motor function in cross‐sectional studies, but have also been evaluated to predict functional recovery after stroke in longitudinal studies. This review will consist of an update on the available literature about structural connectivity analyses after ischemic motor stroke, followed by an outlook of possible future directions of research and applications.
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Affiliation(s)
- Philipp Koch
- Brain Imaging and Neuro Stimulation (BINS) Laboratory Department of Neurology University Medical Center Hamburg-Eppendorf Martini str. 52 20246 Hamburg Germany
| | - Robert Schulz
- Brain Imaging and Neuro Stimulation (BINS) Laboratory Department of Neurology University Medical Center Hamburg-Eppendorf Martini str. 52 20246 Hamburg Germany
| | - Friedhelm C Hummel
- Brain Imaging and Neuro Stimulation (BINS) Laboratory Department of Neurology University Medical Center Hamburg-Eppendorf Martini str. 52 20246 Hamburg Germany
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64
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Fan YT, Wu CY, Liu HL, Lin KC, Wai YY, Chen YL. Neuroplastic changes in resting-state functional connectivity after stroke rehabilitation. Front Hum Neurosci 2015; 9:546. [PMID: 26557065 PMCID: PMC4617387 DOI: 10.3389/fnhum.2015.00546] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 09/17/2015] [Indexed: 01/19/2023] Open
Abstract
Most neuroimaging research in stroke rehabilitation mainly focuses on the neural mechanisms underlying the natural history of post-stroke recovery. However, connectivity mapping from resting-state fMRI is well suited for different neurological conditions and provides a promising method to explore plastic changes for treatment-induced recovery from stroke. We examined the changes in resting-state functional connectivity (RS-FC) of the ipsilesional primary motor cortex (M1) in 10 post-acute stroke patients before and immediately after 4 weeks of robot-assisted bilateral arm therapy (RBAT). Motor performance, functional use of the affected arm, and daily function improved in all participants. Reduced interhemispheric RS-FC between the ipsilesional and contralesional M1 (M1-M1) and the contralesional-lateralized connections were noted before treatment. In contrast, greater M1-M1 functional connectivity and disturbed resting-state networks were observed after RBAT relative to pre-treatment. Increased changes in M1-M1 RS-FC after RBAT were coupled with better motor and functional improvements. Mediation analysis showed the pre-to-post difference in M1-M1 RS-FC was a significant mediator for the relationship between motor and functional recovery. These results show neuroplastic changes and functional recoveries induced by RBAT in post-acute stroke survivors and suggest that interhemispheric functional connectivity in the motor cortex may be a neurobiological marker for recovery after stroke rehabilitation.
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Affiliation(s)
- Yang-Teng Fan
- School of Occupational Therapy, College of Medicine, National Taiwan University and Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Taipei, Taiwan
| | - Ching-Yi Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University Taoyuan, Taiwan ; Healthy Aging Research Center, Chang Gung University Taoyuan, Taiwan
| | - Ho-Ling Liu
- Department of Imaging Physics, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center Houston, TX, USA ; Department of Medical Imaging and Radiological Sciences, Chang Gung University Taoyuan, Taiwan
| | - Keh-Chung Lin
- School of Occupational Therapy, College of Medicine, National Taiwan University and Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Taipei, Taiwan ; Department of Physical Medicine and Rehabilitation, Division of Occupational Therapy, National Taiwan University Hospital Taipei, Taiwan
| | - Yau-Yau Wai
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital Keelung, Taiwan ; MRI Center, Chang Gung Memorial Hospital Taoyuan, Taiwan
| | - Yao-Liang Chen
- MRI Center, Chang Gung Memorial Hospital Taoyuan, Taiwan
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Dijkhuizen RM, Zaharchuk G, Otte WM. Assessment and modulation of resting-state neural networks after stroke. Curr Opin Neurol 2015; 27:637-43. [PMID: 25333606 DOI: 10.1097/wco.0000000000000150] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE OF REVIEW Stroke is a major cause of disability; however, most patients experience spontaneous partial recovery of functions in subacute to chronic phases. Poststroke loss and recovery of functions have been increasingly correlated with brain-wide alterations in the connectivity of neural networks, which is described in this review. Elucidation of the mechanisms of functional brain remodeling could reveal targets and strategies for more effective neurorehabilitation. RECENT FINDINGS Data from recent resting-state functional MRI, electroencephalography, magnetoencephalography, and optical imaging studies in patients and animal models have demonstrated that loss of function after stroke is closely associated with disrupted connectivity in large-scale networks beyond the lesion territory. Restoration of functional connectivity in the surviving networks appears to be critical for functional recovery, and this may be promoted with specific therapeutic strategies, such as robot-assisted training and noninvasive brain stimulation. The adaptability of functional networks relies on the structural integrity of neuronal pathways, but the relationship between the two remains incompletely understood. Furthermore, disturbed neurovascular coupling after stroke can confound hemodynamically based measurements of functional connectivity. SUMMARY Identification of key network processes in adaptive brain plasticity can aid in the prediction of functional outcome and the development of therapeutic interventions to support and promote recovery after stroke.
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Affiliation(s)
- Rick M Dijkhuizen
- aBiomedical MR Imaging and Spectroscopy Group, Image Sciences Institute, University Medical Center Utrecht, Utrecht, the Netherlands bDepartment of Radiology, Stanford University School of Medicine, Stanford, California, USA cDepartment of Pediatric Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
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66
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The microstructural status of the corpus callosum is associated with the degree of motor function and neurological deficit in stroke patients. PLoS One 2015; 10:e0122615. [PMID: 25875333 PMCID: PMC4398463 DOI: 10.1371/journal.pone.0122615] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 02/23/2015] [Indexed: 11/19/2022] Open
Abstract
Human neuroimaging studies and animal models have suggested that white matter damage from ischemic stroke leads to the functional and structural reorganization of perilesional and remote brain regions. However, the quantitative relationship between the transcallosal tract integrity and clinical motor performance score after stroke remains unexplored. The current study employed a tract-based spatial statistics (TBSS) analysis on diffusion tensor imaging (DTI) to investigate the relationship between white matter diffusivity changes and the clinical scores in stroke patients. Probabilistic fiber tracking was also used to identify structural connectivity patterns in the patients. Thirteen ischemic stroke patients and fifteen healthy control subjects participated in this study. TBSS analyses showed that the corpus callosum (CC) and bilateral corticospinal tracts (CST) in the stroke patients exhibited significantly decreased fractional anisotropy and increased axial and radial diffusivity compared with those of the controls. Correlation analyses revealed that the motor and neurological deficit scores in the stroke patients were associated with the value of diffusivity indices in the CC. Compared with the healthy control group, probabilistic fiber tracking analyses revealed that significant changes in the inter-hemispheric fiber connections between the left and right motor cortex in the stroke patients were primarily located in the genu and body of the CC, left anterior thalamic radiation and inferior fronto-occipital fasciculus, bilateral CST, anterior/superior corona radiate, cingulum and superior longitudinal fasciculus, strongly suggesting that ischemic induces inter-hemispheric network disturbances and disrupts the white matter fibers connecting motor regions. In conclusion, the results of the present study show that DTI-derived measures in the CC can be used to predict the severity of motor skill and neurological deficit in stroke patients. Changes in structural connectivity pattern tracking between the left and right motor areas, particularly in the body of the CC, might reflect functional reorganization and behavioral deficit.
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67
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New AB, Robin DA, Parkinson AL, Duffy JR, McNeil MR, Piguet O, Hornberger M, Price CJ, Eickhoff SB, Ballard KJ. Altered resting-state network connectivity in stroke patients with and without apraxia of speech. NEUROIMAGE-CLINICAL 2015; 8:429-39. [PMID: 26106568 PMCID: PMC4473263 DOI: 10.1016/j.nicl.2015.03.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/16/2015] [Accepted: 03/18/2015] [Indexed: 12/22/2022]
Abstract
Motor speech disorders, including apraxia of speech (AOS), account for over 50% of the communication disorders following stroke. Given its prevalence and impact, and the need to understand its neural mechanisms, we used resting state functional MRI to examine functional connectivity within a network of regions previously hypothesized as being associated with AOS (bilateral anterior insula (aINS), inferior frontal gyrus (IFG), and ventral premotor cortex (PM)) in a group of 32 left hemisphere stroke patients and 18 healthy, age-matched controls. Two expert clinicians rated severity of AOS, dysarthria and nonverbal oral apraxia of the patients. Fifteen individuals were categorized as AOS and 17 were AOS-absent. Comparison of connectivity in patients with and without AOS demonstrated that AOS patients had reduced connectivity between bilateral PM, and this reduction correlated with the severity of AOS impairment. In addition, AOS patients had negative connectivity between the left PM and right aINS and this effect decreased with increasing severity of non-verbal oral apraxia. These results highlight left PM involvement in AOS, begin to differentiate its neural mechanisms from those of other motor impairments following stroke, and help inform us of the neural mechanisms driving differences in speech motor planning and programming impairment following stroke.
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Affiliation(s)
- Anneliese B New
- Research Imaging Institute, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Donald A Robin
- Research Imaging Institute, University of Texas Health Science Center San Antonio, San Antonio, TX, USA ; Department of Neurology, University of Texas Health Science Center San Antonio, San Antonio, TX, USA ; Joint Program in Biomedical Engineering, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA ; Honors College, University of Texas, San Antonio, TX, USA
| | - Amy L Parkinson
- Research Imaging Institute, University of Texas Health Science Center San Antonio, San Antonio, TX, USA ; Department of Neurology, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | | | - Malcom R McNeil
- University of Pittsburgh and Veterans Administration, Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Olivier Piguet
- Neuroscience Research Australia and University of New South Wales, Randwick, NSW,Australia
| | - Michael Hornberger
- Neuroscience Research Australia and University of New South Wales, Randwick, NSW,Australia
| | - Cathy J Price
- Wellcome Trust Centre for Neuroimaging, University College London, London, UK
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine (INM-1), Research Center Julich, Julich, Germany ; Department of Clinical Neuroscience and Medical Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Kirrie J Ballard
- Neuroscience Research Australia and University of New South Wales, Randwick, NSW,Australia ; Faculty of Health Sciences, The University of Sydney, Sydney, Australia
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68
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Viswanath H, Velasquez KM, Thompson-Lake DGY, Savjani R, Carter AQ, Eagleman D, Baldwin PR, De La Garza R, Salas R. Alterations in interhemispheric functional and anatomical connectivity are associated with tobacco smoking in humans. Front Hum Neurosci 2015; 9:116. [PMID: 25805986 PMCID: PMC4353249 DOI: 10.3389/fnhum.2015.00116] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 02/16/2015] [Indexed: 01/28/2023] Open
Abstract
Abnormal interhemispheric functional connectivity correlates with several neurologic and psychiatric conditions, including depression, obsessive-compulsive disorder, schizophrenia, and stroke. Abnormal interhemispheric functional connectivity also correlates with abuse of cannabis and cocaine. In the current report, we evaluated whether tobacco abuse (i.e., cigarette smoking) is associated with altered interhemispheric connectivity. To that end, we examined resting state functional connectivity (RSFC) using magnetic resonance imaging (MRI) in short term tobacco deprived and smoking as usual tobacco smokers, and in non-smoker controls. Additionally, we compared diffusion tensor imaging (DTI) in the same subjects to study differences in white matter. The data reveal a significant increase in interhemispheric functional connectivity in sated tobacco smokers when compared to controls. This difference was larger in frontal regions, and was positively correlated with the average number of cigarettes smoked per day. In addition, we found a negative correlation between the number of DTI streamlines in the genual corpus callosum and the number of cigarettes smoked per day. Taken together, our results implicate changes in interhemispheric functional and anatomical connectivity in current cigarette smokers.
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Affiliation(s)
- Humsini Viswanath
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine Houston, TX, USA
| | - Kenia M Velasquez
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine Houston, TX, USA
| | | | - Ricky Savjani
- Department of Neuroscience, Baylor College of Medicine Houston, TX, USA
| | - Asasia Q Carter
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine Houston, TX, USA
| | - David Eagleman
- Department of Neuroscience, Baylor College of Medicine Houston, TX, USA
| | - Philip R Baldwin
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine Houston, TX, USA
| | - Richard De La Garza
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine Houston, TX, USA ; Department of Neuroscience, Baylor College of Medicine Houston, TX, USA
| | - Ramiro Salas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine Houston, TX, USA
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69
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Liu J, Qin W, Zhang J, Zhang X, Yu C. Enhanced interhemispheric functional connectivity compensates for anatomical connection damages in subcortical stroke. Stroke 2015; 46:1045-51. [PMID: 25721013 DOI: 10.1161/strokeaha.114.007044] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Motor recovery after stroke has been shown to be correlated with both the fractional anisotropy (FA) of the affected corticospinal tract (CST) and the interhemispheric resting-state functional connectivity (rsFC) of the primary motor cortex (M1). However, the role of the restoration or enhancement of the M1-M1 rsFC in motor recovery remains largely unknown. We aimed to clarify this issue by investigating the correlations between the M1-M1 rsFC and the integrity of the M1-M1 anatomic connection and the affected CST in chronic subcortical stroke patients with good motor outcomes. METHODS Twenty patients and 16 healthy controls underwent multimodal magnetic resonance imaging examinations. Diffusion tensor imaging was used to reconstruct the M1-M1 anatomic connection and bilateral CSTs. White matter integrity of these tracts was assessed using FA. Resting-state functional magnetic resonance imaging was used to calculate M1-M1 rsFC. Group differences in these measures were compared. Correlations between M1-M1 rsFC and FA of the M1-M1 anatomic connection and the affected CST were analyzed in patients with stroke. RESULTS Compared with healthy controls, patients with stroke exhibited significantly reduced FA in the affected CST and the M1-M1 anatomic connection and a significantly increased M1-M1 rsFC. The FA values of the affected CST were positively correlated with the M1-M1 anatomic connection, and these FA values were negatively correlated with the M1-M1 rsFC in these patients. CONCLUSIONS Our findings suggest that the M1-M1 anatomic connection impairment is secondary to CST damage, and the M1-M1 rsFC enhancement may reflect compensatory or reactive neural plasticity in stroke patients with CST impairment.
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Affiliation(s)
- Jingchun Liu
- From the Departments of Radiology and Tianjin Key Laboratory of Functional Imaging (J.L., W.Q., J.Z., C.Y.), Tianjin Medical University General Hospital, Tianjin, China; and Department of Medical Imaging, School of Medical Imaging, Tianjin Medical University, Tianjin, China (X.Z.)
| | - Wen Qin
- From the Departments of Radiology and Tianjin Key Laboratory of Functional Imaging (J.L., W.Q., J.Z., C.Y.), Tianjin Medical University General Hospital, Tianjin, China; and Department of Medical Imaging, School of Medical Imaging, Tianjin Medical University, Tianjin, China (X.Z.)
| | - Jing Zhang
- From the Departments of Radiology and Tianjin Key Laboratory of Functional Imaging (J.L., W.Q., J.Z., C.Y.), Tianjin Medical University General Hospital, Tianjin, China; and Department of Medical Imaging, School of Medical Imaging, Tianjin Medical University, Tianjin, China (X.Z.)
| | - Xuejun Zhang
- From the Departments of Radiology and Tianjin Key Laboratory of Functional Imaging (J.L., W.Q., J.Z., C.Y.), Tianjin Medical University General Hospital, Tianjin, China; and Department of Medical Imaging, School of Medical Imaging, Tianjin Medical University, Tianjin, China (X.Z.).
| | - Chunshui Yu
- From the Departments of Radiology and Tianjin Key Laboratory of Functional Imaging (J.L., W.Q., J.Z., C.Y.), Tianjin Medical University General Hospital, Tianjin, China; and Department of Medical Imaging, School of Medical Imaging, Tianjin Medical University, Tianjin, China (X.Z.).
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70
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Silasi G, Murphy TH. Stroke and the connectome: how connectivity guides therapeutic intervention. Neuron 2015; 83:1354-68. [PMID: 25233317 DOI: 10.1016/j.neuron.2014.08.052] [Citation(s) in RCA: 140] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2014] [Indexed: 11/30/2022]
Abstract
Connections between neurons are affected within 3 min of stroke onset by massive ischemic depolarization and then delayed cell death. Some connections can recover with prompt reperfusion; others associated with the dying infarct do not. Disruption in functional connectivity is due to direct tissue loss and indirect disconnections of remote areas known as diaschisis. Stroke is devastating, yet given the brain's redundant design, collateral surviving networks and their connections are well-positioned to compensate. Our perspective is that new treatments for stroke may involve a rational functional and structural connections-based approach. Surviving, affected, and at-risk networks can be identified and targeted with scenario-specific treatments. Strategies for recovery may include functional inhibition of the intact hemisphere, rerouting of connections, or setpoint-mediated network plasticity. These approaches may be guided by brain imaging and enabled by patient- and injury-specific brain stimulation, rehabilitation, and potential molecule-based strategies to enable new connections.
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Affiliation(s)
- Gergely Silasi
- Department of Psychiatry, Kinsmen Laboratory of Neurological Research, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; Brain Research Centre, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Timothy H Murphy
- Department of Psychiatry, Kinsmen Laboratory of Neurological Research, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; Brain Research Centre, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
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Lunven M, Thiebaut De Schotten M, Bourlon C, Duret C, Migliaccio R, Rode G, Bartolomeo P. White matter lesional predictors of chronic visual neglect: a longitudinal study. ACTA ACUST UNITED AC 2015; 138:746-60. [PMID: 25609686 DOI: 10.1093/brain/awu389] [Citation(s) in RCA: 159] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Chronic visual neglect prevents brain-damaged patients from returning to an independent and active life. Detecting predictors of persistent neglect as early as possible after the stroke is therefore crucial to plan the relevant interventions. Neglect signs do not only depend on focal brain lesions, but also on dysfunction of large-scale brain networks connected by white matter bundles. We explored the relationship between markers of axonal degeneration occurring after the stroke and visual neglect chronicity. A group of 45 patients with unilateral strokes in the right hemisphere underwent cognitive testing for neglect twice, first at the subacute phase (<3 months after onset) and then at the chronic phase (>1 year). For each patient, magnetic resonance imaging including diffusion sequences was performed at least 4 months after the stroke. After masking each patient's lesion, we used tract-based spatial statistics to obtain a voxel-wise statistical analysis of the fractional anisotropy data. Twenty-seven patients had signs of visual neglect at initial testing. Only 10 of these patients had recovered from neglect at follow-up. When compared with patients without neglect, the group including all subacute neglect patients had decreased fractional anisotropy in the second (II) and third (III) branches of the right superior longitudinal fasciculus, as well as in the splenium of the corpus callosum. The subgroup of chronic patients showed reduced fractional anisotropy in a portion the splenium, the forceps major, which provides interhemispheric communication between regions of the occipital lobe and of the superior parietal lobules. The severity of neglect correlated with fractional anisotropy values in superior longitudinal fasciculus II/III for subacute patients and in its caudal portion for chronic patients. Our results confirm a key role of fronto-parietal disconnection in the emergence and chronic persistence of neglect, and demonstrate an implication of caudal interhemispheric disconnection in chronic neglect. Splenial disconnection may prevent fronto-parietal networks in the left hemisphere from resolving the activity imbalance with their right hemisphere counterparts, thus leading to persistent neglect.
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Affiliation(s)
- Marine Lunven
- 1 INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), F-75013 Paris, France 2 Service de Médecine Physique et Réadaptation, Unité de Rééducation Neurologique CRF 'Les Trois Soleils' Boissise le Roi, France 3 Inserm UMR_S 1028, CNRS UMR 5292, ImpAct, centre des neurosciences de Lyon, université Lyon-1, 16, avenue Lépine 69676 Bron, France
| | - Michel Thiebaut De Schotten
- 1 INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), F-75013 Paris, France 4 Natbrainlab, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, UK
| | - Clémence Bourlon
- 2 Service de Médecine Physique et Réadaptation, Unité de Rééducation Neurologique CRF 'Les Trois Soleils' Boissise le Roi, France
| | - Christophe Duret
- 2 Service de Médecine Physique et Réadaptation, Unité de Rééducation Neurologique CRF 'Les Trois Soleils' Boissise le Roi, France
| | - Raffaella Migliaccio
- 1 INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), F-75013 Paris, France 5 AP-HP, Department of Neurology, IFR 70, Salpêtrière Hospital, Paris, France
| | - Gilles Rode
- 3 Inserm UMR_S 1028, CNRS UMR 5292, ImpAct, centre des neurosciences de Lyon, université Lyon-1, 16, avenue Lépine 69676 Bron, France 6 Service de médecine physique et réadaptation neurologique, hospital Henry-Gabrielle, hospice civils de Lyon, 20, route de Vourles, Saint-Genis-Laval, France
| | - Paolo Bartolomeo
- 1 INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), F-75013 Paris, France 5 AP-HP, Department of Neurology, IFR 70, Salpêtrière Hospital, Paris, France 7 Department of Psychology, Catholic University, Milan, Italy
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Thiel A, Vahdat S. Structural and resting-state brain connectivity of motor networks after stroke. Stroke 2014; 46:296-301. [PMID: 25477218 DOI: 10.1161/strokeaha.114.006307] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Alexander Thiel
- From the Department of Neurology and Neurosurgery (A.T.) and Department of Psychology (S.V.), McGill University, Montreal, Canada; Department of Neuroscience, Jewish General Hospital, Lady Davis Institute for Medical Research, Montreal, Canada (A.T.); and Functional Neuroimaging Unit, Department of Neuroscience, University of Montreal, Montreal, Canada (S.V.).
| | - Shahabeddin Vahdat
- From the Department of Neurology and Neurosurgery (A.T.) and Department of Psychology (S.V.), McGill University, Montreal, Canada; Department of Neuroscience, Jewish General Hospital, Lady Davis Institute for Medical Research, Montreal, Canada (A.T.); and Functional Neuroimaging Unit, Department of Neuroscience, University of Montreal, Montreal, Canada (S.V.)
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Veldsman M, Cumming T, Brodtmann A. Beyond BOLD: optimizing functional imaging in stroke populations. Hum Brain Mapp 2014; 36:1620-36. [PMID: 25469481 DOI: 10.1002/hbm.22711] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 11/14/2014] [Accepted: 11/25/2014] [Indexed: 12/11/2022] Open
Abstract
Blood oxygenation level-dependent (BOLD) signal changes are often assumed to directly reflect neural activity changes. Yet the real relationship is indirect, reliant on numerous assumptions, and subject to several sources of noise. Deviations from the core assumptions of BOLD contrast functional magnetic resonance imaging (fMRI), and their implications, have been well characterized in healthy populations, but are frequently neglected in stroke populations. In addition to conspicuous local structural and vascular changes after stroke, there are many less obvious challenges in the imaging of stroke populations. Perilesional ischemic changes, remodeling in regions distant to lesion sites, and diffuse perfusion changes all complicate interpretation of BOLD signal changes in standard fMRI protocols. Most stroke patients are also older than the young populations on which assumptions of neurovascular coupling and the typical analysis pipelines are based. We present a review of the evidence to show that the basic assumption of neurovascular coupling on which BOLD-fMRI relies does not capture the complex changes arising from stroke, both pathological and recovery related. As a result, estimating neural activity using the canonical hemodynamic response function is inappropriate in a number of contexts. We review methods designed to better estimate neural activity in stroke populations. One promising alternative to event-related fMRI is a resting-state-derived functional connectivity approach. Resting-state fMRI is well suited to stroke populations because it makes no performance demands on patients and is capable of revealing network-based pathology beyond the lesion site.
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Affiliation(s)
- Michele Veldsman
- The Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
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Interplay between intra- and interhemispheric remodeling of neural networks as a substrate of functional recovery after stroke: Adaptive versus maladaptive reorganization. Neuroscience 2014; 283:178-201. [DOI: 10.1016/j.neuroscience.2014.06.066] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 06/27/2014] [Accepted: 06/27/2014] [Indexed: 11/18/2022]
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75
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Reynolds AM, Peters DM, Vendemia JMC, Smith LP, Sweet RC, Baylis GC, Krotish D, Fritz SL. Neuronal injury in the motor cortex after chronic stroke and lower limb motor impairment: a voxel-based lesion symptom mapping study. Neural Regen Res 2014; 9:766-72. [PMID: 25206888 PMCID: PMC4146271 DOI: 10.4103/1673-5374.131589] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2014] [Indexed: 01/08/2023] Open
Abstract
Many studies have examined motor impairments using voxel-based lesion symptom mapping, but few are reported regarding the corresponding relationship between cerebral cortex injury and lower limb motor impairment analyzed using this technique. This study correlated neuronal injury in the cerebral cortex of 16 patients with chronic stroke based on a voxel-based lesion symptom mapping analysis. Neuronal injury in the corona radiata, caudate nucleus and putamen of patients with chronic stroke could predict walking speed. The behavioral measure scores were consistent with motor deficits expected after damage to the cortical motor system due to stroke. These findings suggest that voxel-based lesion symptom mapping may provide a more accurate prognosis of motor recovery from chronic stroke according to neuronal injury in cerebral motor cortex.
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Affiliation(s)
- Alexandria M Reynolds
- Department of Psychology, Barnwell College, University of South Carolina, Columbia, SC, USA
| | - Denise M Peters
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | | | - Lenwood P Smith
- Neurosurgery Center, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Raymond C Sweet
- Neurosurgery Center, University of South Carolina School of Medicine, Columbia, SC, USA
| | | | - Debra Krotish
- University of South Carolina School of Medicine, Columbia, SC, USA
| | - Stacy L Fritz
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
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76
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Song J, Young BM, Nigogosyan Z, Walton LM, Nair VA, Grogan SW, Tyler ME, Farrar-Edwards D, Caldera KE, Sattin JA, Williams JC, Prabhakaran V. Characterizing relationships of DTI, fMRI, and motor recovery in stroke rehabilitation utilizing brain-computer interface technology. FRONTIERS IN NEUROENGINEERING 2014; 7:31. [PMID: 25120466 PMCID: PMC4114288 DOI: 10.3389/fneng.2014.00031] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 07/08/2014] [Indexed: 11/13/2022]
Abstract
The relationship of the structural integrity of white matter tracts and cortical activity to motor functional outcomes in stroke patients is of particular interest in understanding mechanisms of brain structural and functional changes while recovering from stroke. This study aims to probe these underlying mechanisms using diffusion tensor imaging (DTI) and fMRI measures. We examined the structural integrity of the posterior limb of the internal capsule (PLIC) using DTI and corticomotor activity using motor-task fMRI in stroke patients who completed up to 15 sessions of rehabilitation therapy using Brain-Computer Interface (BCI) technology. We hypothesized that (1) the structural integrity of PLIC and corticomotor activity are affected by stroke; (2) changes in structural integrity and corticomotor activity following BCI intervention are related to motor recovery; (3) there is a potential relationship between structural integrity and corticomotor activity. We found that (1) the ipsilesional PLIC showed significantly decreased fractional anisotropy (FA) values when compared to the contralesional PLIC; (2) lower ipsilesional PLIC-FA values were significantly associated with worse motor outcomes (i.e., ipsilesional PLIC-FA and motor outcomes were positively correlated.); (3) lower ipsilesional PLIC-FA values were significantly associated with greater ipsilesional corticomotor activity during impaired-finger-tapping-task fMRI (i.e., ipsilesional PLIC-FA and ipsilesional corticomotor activity were negatively correlated), with an overall bilateral pattern of corticomotor activity observed; and (4) baseline FA values predicted motor recovery assessed after BCI intervention. These findings suggest that (1) greater vs. lesser microstructural integrity of the ipsilesional PLIC may contribute toward better vs. poor motor recovery respectively in the stroke-affected limb and demand lesser vs. greater cortical activity respectively from the ipsilesional motor cortex; and that (2) PLIC-FA is a promising biomarker in tracking and predicting motor functional recovery in stroke patients receiving BCI intervention.
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Affiliation(s)
- Jie Song
- Department of Radiology, University of Wisconsin - Madison Madison, WI, USA ; Department of Biomedical Engineering, University of Wisconsin - Madison Madison, WI, USA
| | - Brittany M Young
- Department of Radiology, University of Wisconsin - Madison Madison, WI, USA ; Medical Scientist Training Program, University of Wisconsin School of Medicine and Public Health - Madison Madison, WI, USA ; Neuroscience Training Program, University of Wisconsin School of Medicine and Public Health - Madison Madison, WI, USA
| | - Zack Nigogosyan
- Department of Radiology, University of Wisconsin - Madison Madison, WI, USA
| | - Leo M Walton
- Department of Biomedical Engineering, University of Wisconsin - Madison Madison, WI, USA ; Neuroscience Training Program, University of Wisconsin School of Medicine and Public Health - Madison Madison, WI, USA
| | - Veena A Nair
- Department of Radiology, University of Wisconsin - Madison Madison, WI, USA
| | - Scott W Grogan
- Department of Radiology, University of Wisconsin - Madison Madison, WI, USA
| | - Mitchell E Tyler
- Department of Biomedical Engineering, University of Wisconsin - Madison Madison, WI, USA ; Departments of Orthopedics and Rehabilitation, University of Wisconsin - Madison Madison, WI, USA
| | - Dorothy Farrar-Edwards
- Department of Kinesiology, University of Wisconsin - Madison Madison, WI, USA ; Department of Medicine, University of Wisconsin - Madison Madison, WI, USA ; Department of Neurology, University of Wisconsin - Madison Madison, WI, USA
| | - Kristin E Caldera
- Departments of Orthopedics and Rehabilitation, University of Wisconsin - Madison Madison, WI, USA
| | - Justin A Sattin
- Department of Neurology, University of Wisconsin - Madison Madison, WI, USA
| | - Justin C Williams
- Department of Biomedical Engineering, University of Wisconsin - Madison Madison, WI, USA ; Neuroscience Training Program, University of Wisconsin School of Medicine and Public Health - Madison Madison, WI, USA ; Department of Neurosurgery, University of Wisconsin - Madison Madison, WI, USA
| | - Vivek Prabhakaran
- Department of Radiology, University of Wisconsin - Madison Madison, WI, USA ; Medical Scientist Training Program, University of Wisconsin School of Medicine and Public Health - Madison Madison, WI, USA ; Neuroscience Training Program, University of Wisconsin School of Medicine and Public Health - Madison Madison, WI, USA ; Department of Neurology, University of Wisconsin - Madison Madison, WI, USA ; Department of Psychiatry, University of Wisconsin - Madison Madison, WI, USA ; Department of Psychology, University of Wisconsin - Madison Madison, WI, USA
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77
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Young BM, Nigogosyan Z, Remsik A, Walton LM, Song J, Nair VA, Grogan SW, Tyler ME, Edwards DF, Caldera K, Sattin JA, Williams JC, Prabhakaran V. Changes in functional connectivity correlate with behavioral gains in stroke patients after therapy using a brain-computer interface device. FRONTIERS IN NEUROENGINEERING 2014; 7:25. [PMID: 25071547 PMCID: PMC4086321 DOI: 10.3389/fneng.2014.00025] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 06/19/2014] [Indexed: 11/26/2022]
Abstract
Brain-computer interface (BCI) technology is being incorporated into new stroke rehabilitation devices, but little is known about brain changes associated with its use. We collected anatomical and functional MRI of nine stroke patients with persistent upper extremity motor impairment before, during, and after therapy using a BCI system. Subjects were asked to perform finger tapping of the impaired hand during fMRI. Action Research Arm Test (ARAT), 9-Hole Peg Test (9-HPT), and Stroke Impact Scale (SIS) domains of Hand Function (HF) and Activities of Daily Living (ADL) were also assessed. Group-level analyses examined changes in whole-brain task-based functional connectivity (FC) to seed regions in the motor network observed during and after BCI therapy. Whole-brain FC analyses seeded in each thalamus showed FC increases from baseline at mid-therapy and post-therapy (p < 0.05). Changes in FC between seeds at both the network and the connection levels were examined for correlations with changes in behavioral measures. Average motor network FC was increased post-therapy, and changes in average network FC correlated (p < 0.05) with changes in performance on ARAT (R2 = 0.21), 9-HPT (R2 = 0.41), SIS HF (R2 = 0.27), and SIS ADL (R2 = 0.40). Multiple individual connections within the motor network were found to correlate in change from baseline with changes in behavioral measures. Many of these connections involved the thalamus, with change in each of four behavioral measures significantly correlating with change from baseline FC of at least one thalamic connection. These preliminary results show changes in FC that occur with the administration of rehabilitative therapy using a BCI system. The correlations noted between changes in FC measures and changes in behavioral outcomes indicate that both adaptive and maladaptive changes in FC may develop with this therapy and also suggest a brain-behavior relationship that may be stimulated by the neuromodulatory component of BCI therapy.
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Affiliation(s)
- Brittany Mei Young
- Department of Radiology, University of Wisconsin - Madison Madison, WI, USA ; Medical Scientist Training Program, University of Wisconsin - Madison Madison, WI, USA ; Neuroscience Training Program, University of Wisconsin - Madison Madison, WI, USA
| | - Zack Nigogosyan
- Department of Radiology, University of Wisconsin - Madison Madison, WI, USA
| | - Alexander Remsik
- Department of Radiology, University of Wisconsin - Madison Madison, WI, USA
| | - Léo M Walton
- Neuroscience Training Program, University of Wisconsin - Madison Madison, WI, USA ; Department of Biomedical Engineering, University of Wisconsin - Madison Madison, WI, USA
| | - Jie Song
- Department of Radiology, University of Wisconsin - Madison Madison, WI, USA ; Department of Biomedical Engineering, University of Wisconsin - Madison Madison, WI, USA
| | - Veena A Nair
- Department of Radiology, University of Wisconsin - Madison Madison, WI, USA
| | - Scott W Grogan
- Department of Radiology, University of Wisconsin - Madison Madison, WI, USA
| | - Mitchell E Tyler
- Department of Biomedical Engineering, University of Wisconsin - Madison Madison, WI, USA
| | - Dorothy Farrar Edwards
- Departments of Kinesiology and Medicine, University of Wisconsin - Madison Madison, WI, USA
| | - Kristin Caldera
- Department of Orthopedics and Rehabilitation, University of Wisconsin - Madison Madison, WI, USA
| | - Justin A Sattin
- Department of Neurology, University of Wisconsin - Madison Madison, WI, USA
| | - Justin C Williams
- Neuroscience Training Program, University of Wisconsin - Madison Madison, WI, USA ; Department of Biomedical Engineering, University of Wisconsin - Madison Madison, WI, USA ; Department of Neurosurgery, University of Wisconsin - Madison Madison, WI, USA
| | - Vivek Prabhakaran
- Department of Radiology, University of Wisconsin - Madison Madison, WI, USA ; Medical Scientist Training Program, University of Wisconsin - Madison Madison, WI, USA ; Neuroscience Training Program, University of Wisconsin - Madison Madison, WI, USA ; Department of Neurology, University of Wisconsin - Madison Madison, WI, USA ; Departments of Psychology and Psychiatry, University of Wisconsin - Madison Madison, WI, USA
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Acupuncture Induces Time-Dependent Remodelling Brain Network on the Stable Somatosensory First-Ever Stroke Patients: Combining Diffusion Tensor and Functional MR Imaging. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:740480. [PMID: 25101136 PMCID: PMC4101930 DOI: 10.1155/2014/740480] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 05/08/2014] [Indexed: 01/13/2023]
Abstract
Different treatment interventions induce distinct remodelling of network architecture of entire motor system. Acupuncture has been proved to be of a promising efficacy in motor recovery. However, it is still unclear whether the reorganization of motor-related brain network underlying acupuncture is related with time since stroke and severity of deficit at baseline. The aim of study was to characterize the relation between motor-related brain organization following acupuncture and white matter microstructural changes at an interval of two weeks. We demonstrated that acupuncture induced differential reorganization of motor-related network for stroke patients as time-lapse since stroke. At the baseline, acupuncture can induce the increased functional connectivity between the left primary motor cortex (M1) and the right M1, premotor cortex, supplementary motor area (SMA), thalamus, and cerebellum. After two-week recovery, the increased functional connectivity of the left M1 was more widely distributed and primarily located in the insula, cerebellum, basal ganglia, and SMA. Furthermore, a significant negative relation existed between the FA value in the left M1 at the baseline scanning and node centrality of this region following acupuncture for both baseline and two-week recovery. Our findings may shed a new insight on understanding the reorganization of motor-related theory underlying motor impairments after brain lesions in stroke patients.
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