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Ismail UN, Yahya N, Manan HA. Investigating functional connectivity related to stroke recovery: A systematic review. Brain Res 2024; 1840:149023. [PMID: 38815644 DOI: 10.1016/j.brainres.2024.149023] [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: 02/03/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/01/2024]
Abstract
INTRODUCTION Stroke recovery is a complex process influenced by various factors, including specific neural reorganization. The objective of this systematic review was to identify important functional connectivity (FC) changes in resting-state fMRI data that were often correlated with motor, emotional, and cognitive outcome improvement. METHOD A systematic search using PubMed and SCOPUS databases was conducted to identify relevant studies published between 2010 and 2023. RESULTS A total of 766 studies were identified, of which 20 studies (602 S individuals) met the inclusion criteria. Fourteen studies focussed on motor recovery while six on cognitive recovery. All studies reported interhemispheric FC to be strongly associated with motor and cognitive recovery. The preservation and changes of M1-M1 (eight incidences) and M1-SMA (nine incidences) FC were found to be strongly correlated with motor function improvement. For cognitive recovery, restoration and preservation of FC with and between default mode network (DMN)-related regions were important for the process. CONCLUSIONS This review identified specific patterns of FC that were consistently reported with recovery of motor and cognitive function. The findings may serve in refining future management strategies to enhance patient outcomes.
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Affiliation(s)
- Umi Nabilah Ismail
- Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56 000 Cheras, Kuala Lumpur, Malaysia
| | - Noorazrul Yahya
- Diagnostic Imaging & Radiotherapy Program, Centre of Diagnostic, Therapeutic and Investigative Sciences (CODTIS), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Hanani Abdul Manan
- Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56 000 Cheras, Kuala Lumpur, Malaysia; Department of Radiology and Intervention, Hospital Pakar Kanak-Kanak (Children Specialist Hospital), Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia.
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Georgiadis M, auf der Heiden F, Abbasi H, Ettema L, Nirschl J, Taghavi HM, Wakatsuki M, Liu A, Ho WHD, Carlson M, Doukas M, Koppes SA, Keereweer S, Sobel RA, Setsompop K, Liao C, Amunts K, Axer M, Zeineh M, Menzel M. Uncovering microstructural architecture from histology. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.26.586745. [PMID: 38585744 PMCID: PMC10996646 DOI: 10.1101/2024.03.26.586745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Microstructural tissue organization underlies the complex connectivity of the brain and controls properties of connective, muscle, and epithelial tissue. However, discerning microstructural architecture with high resolution for large fields of view remains prohibitive. We address this challenge with computational scattered light imaging (ComSLI), which exploits the anisotropic light scattering of aligned structures. Using a rotating lightsource and a high-resolution camera, ComSLI determines fiber architecture with micrometer resolution from histological sections across preparation and staining protocols. We show complex fiber architecture in brain and non-brain sections, including histological paraffin-embedded sections with various stains, and demonstrate its applicability on animal and human tissue, including disease cases with altered microstructure. ComSLI opens new avenues for investigating fiber architecture in new and archived sections across organisms, tissues, and diseases.
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Affiliation(s)
| | - Franca auf der Heiden
- Institute of Neuroscience and Medicine (INM-1), Forschungszentrum Jülich GmbH; 52425 Jülich, Germany
| | - Hamed Abbasi
- Department of Imaging Physics, Faculty of Applied Sciences, Delft University of Technology; 2628 CJ Delft, the Netherlands
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam; 3015 CN Rotterdam, the Netherlands
| | - Loes Ettema
- Department of Imaging Physics, Faculty of Applied Sciences, Delft University of Technology; 2628 CJ Delft, the Netherlands
| | - Jeffrey Nirschl
- Department of Pathology, Stanford University; Stanford, 94305, USA
| | | | - Moe Wakatsuki
- Department of Radiology, Stanford University; Stanford, 94305, USA
| | - Andy Liu
- Department of Radiology, Stanford University; Stanford, 94305, USA
| | | | - Mackenzie Carlson
- Department of Radiology, Stanford University; Stanford, 94305, USA
- Department of Neurology and Neurological Sciences, Stanford University; Stanford, 94305, USA
| | - Michail Doukas
- Department of Pathology, Erasmus MC, University Medical Center Rotterdam; 3015 CN Rotterdam, the Netherlands
| | - Sjors A. Koppes
- Department of Pathology, Erasmus MC, University Medical Center Rotterdam; 3015 CN Rotterdam, the Netherlands
| | - Stijn Keereweer
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam; 3015 CN Rotterdam, the Netherlands
| | - Raymond A. Sobel
- Department of Pathology, Stanford University; Stanford, 94305, USA
| | - Kawin Setsompop
- Department of Radiology, Stanford University; Stanford, 94305, USA
| | - Congyu Liao
- Department of Radiology, Stanford University; Stanford, 94305, USA
| | - Katrin Amunts
- Institute of Neuroscience and Medicine (INM-1), Forschungszentrum Jülich GmbH; 52425 Jülich, Germany
- C. and O. Vogt Institute for Brain Research, University Hospital Düsseldorf, Medical Faculty, University Düsseldorf, Germany
| | - Markus Axer
- Institute of Neuroscience and Medicine (INM-1), Forschungszentrum Jülich GmbH; 52425 Jülich, Germany
- Department of Physics, School of Mathematics and Natural Sciences, University of Wuppertal; 52119 Wuppertal, Germany
| | - Michael Zeineh
- Department of Radiology, Stanford University; Stanford, 94305, USA
| | - Miriam Menzel
- Institute of Neuroscience and Medicine (INM-1), Forschungszentrum Jülich GmbH; 52425 Jülich, Germany
- Department of Imaging Physics, Faculty of Applied Sciences, Delft University of Technology; 2628 CJ Delft, the Netherlands
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Zhang K, Ding L, Wang X, Zhuang J, Tong S, Jia J, Guo X. Evidence of mirror therapy for recruitment of ipsilateral motor pathways in stroke recovery: A resting fMRI study. Neurotherapeutics 2024; 21:e00320. [PMID: 38262102 DOI: 10.1016/j.neurot.2024.e00320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/25/2024] Open
Abstract
Mirror therapy (MT) has been proposed to promote motor recovery post-stroke through activation of mirror neuron system, recruitment of ipsilateral motor pathways, or/and increasing attention toward the affected limb. However, neuroimaging evidence for these mechanisms is still lacking. To uncover the underlying mechanisms, we designed a randomized controlled study and used a voxel-based whole-brain analysis of resting-state fMRI to explore the brain reorganizations induced by MT. Thirty-five stroke patients were randomized to an MT group (n = 16) and a conventional therapy (CT) group (n = 19) for a 4-week intervention. Before and after the intervention, the Fugl-Meyer Assessment Upper Limb subscale (FMA-UL) and resting-state fMRI were collected. A healthy cohort (n = 16) was established for fMRI comparison. The changes in fractional amplitude of low-frequency fluctuation (fALFF) and seed-based functional connectivity were analyzed to investigate the impact of intervention. Results showed that greater FMA-UL improvement in the MT group was associated with the compensatory increase of fALFF in the contralesional precentral gyrus (M1) region and the re-establishment of functional connectivity between the bilateral M1 regions, which facilitate motor signals transmission via the ipsilateral motor pathways from the ipsilesional M1, contralesional M1, to the affected limb. A step-wise linear regression model revealed these two brain reorganization patterns collaboratively contributed to FMA-UL improvement. In conclusion, MT achieved motor rehabilitation primarily by recruitment of the ipsilateral motor pathways. Trial Registration Information: http://www.chictr.org.cn. Unique Identifier. ChiCTR-INR-17013644, submitted on December 2, 2017.
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Affiliation(s)
- Kexu Zhang
- School of Biomedical Engineering, Shanghai Jiaotong University, Shanghai, China
| | - Li Ding
- Department of Rehabilitation Medicine, Huashan Hospital Fudan University, Shanghai, China
| | - Xu Wang
- School of Biomedical Engineering, Shanghai Jiaotong University, Shanghai, China
| | - Jinyang Zhuang
- Department of Rehabilitation Medicine, Huashan Hospital Fudan University, Shanghai, China
| | - Shanbao Tong
- School of Biomedical Engineering, Shanghai Jiaotong University, Shanghai, China
| | - Jie Jia
- Department of Rehabilitation Medicine, Huashan Hospital Fudan University, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital Fudan University, Shanghai, China; National Center for Neurological Disorders, Shanghai, China.
| | - Xiaoli Guo
- School of Biomedical Engineering, Shanghai Jiaotong University, Shanghai, China.
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Umarova RM, Gallucci L, Hakim A, Wiest R, Fischer U, Arnold M. Adaptation of the Concept of Brain Reserve for the Prediction of Stroke Outcome: Proxies, Neural Mechanisms, and Significance for Research. Brain Sci 2024; 14:77. [PMID: 38248292 PMCID: PMC10813468 DOI: 10.3390/brainsci14010077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/22/2023] [Accepted: 01/10/2024] [Indexed: 01/23/2024] Open
Abstract
The prediction of stroke outcome is challenging due to the high inter-individual variability in stroke patients. We recently suggested the adaptation of the concept of brain reserve (BR) to improve the prediction of stroke outcome. This concept was initially developed alongside the one for the cognitive reserve for neurodegeneration and forms a valuable theoretical framework to capture high inter-individual variability in stroke patients. In the present work, we suggest and discuss (i) BR-proxies-quantitative brain characteristics at the time stroke occurs (e.g., brain volume, hippocampus volume), and (ii) proxies of brain pathology reducing BR (e.g., brain atrophy, severity of white matter hyperintensities), parameters easily available from a routine MRI examination that might improve the prediction of stroke outcome. Though the influence of these parameters on stroke outcome has been partly reported individually, their independent and combined impact is yet to be determined. Conceptually, BR is a continuous measure determining the amount of brain structure available to mitigate and compensate for stroke damage, thus reflecting individual differences in neural resources and a capacity to maintain performance and recover after stroke. We suggest that stroke outcome might be defined as an interaction between BR at the time stroke occurs and lesion load. BR in stroke can potentially be influenced, e.g., by modifying cardiovascular risk factors. In addition to the potential power of the BR concept in a mechanistic understanding of inter-individual variability in stroke outcome and establishing individualized therapeutic approaches, it might help to strengthen the synergy of preventive measures in stroke, neurodegeneration, and healthy aging.
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Affiliation(s)
- Roza M. Umarova
- Department of Neurology, University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; (L.G.); (U.F.); (M.A.)
| | - Laura Gallucci
- Department of Neurology, University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; (L.G.); (U.F.); (M.A.)
| | - Arsany Hakim
- Department of Neuroradiology, University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; (A.H.); (R.W.)
| | - Roland Wiest
- Department of Neuroradiology, University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; (A.H.); (R.W.)
| | - Urs Fischer
- Department of Neurology, University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; (L.G.); (U.F.); (M.A.)
- Department of Neurology, University Hospital Basel, University of Basel, 4003 Basel, Switzerland
| | - Marcel Arnold
- Department of Neurology, University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; (L.G.); (U.F.); (M.A.)
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Sun F, Huang Y, Wang J, Hong W, Zhao Z. Research Progress in Diffusion Spectrum Imaging. Brain Sci 2023; 13:1497. [PMID: 37891866 PMCID: PMC10605731 DOI: 10.3390/brainsci13101497] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/14/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
Studies have demonstrated that many regions in the human brain include multidirectional fiber tracts, in which the diffusion of water molecules within image voxels does not follow a Gaussian distribution. Therefore, the conventional diffusion tensor imaging (DTI) that hypothesizes a single fiber orientation within a voxel is intrinsically incapable of revealing the complex microstructures of brain tissues. Diffusion spectrum imaging (DSI) employs a pulse sequence with different b-values along multiple gradient directions to sample the diffusion information of water molecules in the entire q-space and then quantitatively estimates the diffusion profile using a probability density function with a high angular resolution. Studies have suggested that DSI can reliably observe the multidirectional fibers within each voxel and allow fiber tracking along different directions, which can improve fiber reconstruction reflecting the true but complicated brain structures that were not observed in the previous DTI studies. Moreover, with increasing angular resolution, DSI is able to reveal new neuroimaging biomarkers used for disease diagnosis and the prediction of disorder progression. However, so far, this method has not been used widely in clinical studies, due to its overly long scanning time and difficult post-processing. Within this context, the current paper aims to conduct a comprehensive review of DSI research, including the fundamental principles, methodology, and application progress of DSI tractography. By summarizing the DSI studies in recent years, we propose potential solutions towards the existing problem in the methodology and applications of DSI technology as follows: (1) using compressed sensing to undersample data and to reconstruct the diffusion signal may be an efficient and promising method for reducing scanning time; (2) the probability density function includes more information than the orientation distribution function, and it should be extended in application studies; and (3) large-sample study is encouraged to confirm the reliability and reproducibility of findings in clinical diseases. These findings may help deepen the understanding of the DSI method and promote its development in clinical applications.
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Affiliation(s)
- Fenfen Sun
- Center for Brain, Mind and Education, Shaoxing University, Shaoxing 312000, China; (F.S.); (Y.H.); (J.W.)
| | - Yingwen Huang
- Center for Brain, Mind and Education, Shaoxing University, Shaoxing 312000, China; (F.S.); (Y.H.); (J.W.)
| | - Jingru Wang
- Center for Brain, Mind and Education, Shaoxing University, Shaoxing 312000, China; (F.S.); (Y.H.); (J.W.)
| | - Wenjun Hong
- Department of Rehabilitation Medicine, Afiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, China;
| | - Zhiyong Zhao
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou 310027, China
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