1
|
Kaufmann BC, Pastore-Wapp M, Bartolomeo P, Geiser N, Nyffeler T, Cazzoli D. Severity-Dependent Interhemispheric White Matter Connectivity Predicts Poststroke Neglect Recovery. J Neurosci 2024; 44:e1311232024. [PMID: 38565290 PMCID: PMC11112644 DOI: 10.1523/jneurosci.1311-23.2024] [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: 07/13/2023] [Revised: 12/15/2023] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
Left-sided spatial neglect is a very common and challenging issue after right-hemispheric stroke, which strongly and negatively affects daily living behavior and recovery of stroke survivors. The mechanisms underlying recovery of spatial neglect remain controversial, particularly regarding the involvement of the intact, contralesional hemisphere, with potential contributions ranging from maladaptive to compensatory. In the present prospective, observational study, we assessed neglect severity in 54 right-hemispheric stroke patients (32 male; 22 female) at admission to and discharge from inpatient neurorehabilitation. We demonstrate that the interaction of initial neglect severity and spared white matter (dis)connectivity resulting from individual lesions (as assessed by diffusion tensor imaging, DTI) explains a significant portion of the variability of poststroke neglect recovery. In mildly impaired patients, spared structural connectivity within the lesioned hemisphere is sufficient to attain good recovery. Conversely, in patients with severe impairment, successful recovery critically depends on structural connectivity within the intact hemisphere and between hemispheres. These distinct patterns, mediated by their respective white matter connections, may help to reconcile the dichotomous perspectives regarding the role of the contralesional hemisphere as exclusively compensatory or not. Instead, they suggest a unified viewpoint wherein the contralesional hemisphere can - but must not necessarily - assume a compensatory role. This would depend on initial impairment severity and on the available, spared structural connectivity. In the future, our findings could serve as a prognostic biomarker for neglect recovery and guide patient-tailored therapeutic approaches.
Collapse
Affiliation(s)
- Brigitte C Kaufmann
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris 75013, France
- Neurocenter, Luzerner Kantonsspital, Lucerne 6016, Switzerland
| | - Manuela Pastore-Wapp
- Neurocenter, Luzerner Kantonsspital, Lucerne 6016, Switzerland
- ARTORG Center for Biomedical Engineering Research, Gerontechnology and Rehabilitation Group, University of Bern, Bern 3010, Switzerland
| | - Paolo Bartolomeo
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris 75013, France
| | - Nora Geiser
- Neurocenter, Luzerner Kantonsspital, Lucerne 6016, Switzerland
- ARTORG Center for Biomedical Engineering Research, Gerontechnology and Rehabilitation Group, University of Bern, Bern 3010, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern 3012, Switzerland
| | - Thomas Nyffeler
- Neurocenter, Luzerner Kantonsspital, Lucerne 6016, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern 3012, Switzerland
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern 3010, Switzerland
| | - Dario Cazzoli
- Neurocenter, Luzerner Kantonsspital, Lucerne 6016, Switzerland
- ARTORG Center for Biomedical Engineering Research, Gerontechnology and Rehabilitation Group, University of Bern, Bern 3010, Switzerland
- Department of Psychology, University of Bern, Bern 3012, Switzerland
| |
Collapse
|
2
|
Mazzi C, Mele S, Bagattini C, Sanchez-Lopez J, Savazzi S. Coherent activity within and between hemispheres: cortico-cortical connectivity revealed by rTMS of the right posterior parietal cortex. Front Hum Neurosci 2024; 18:1362742. [PMID: 38516308 PMCID: PMC10954802 DOI: 10.3389/fnhum.2024.1362742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/23/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction Low frequency (1 Hz) repetitive transcranial stimulation (rTMS) applied over right posterior parietal cortex (rPPC) has been shown to reduce cortical excitability both of the stimulated area and of the interconnected contralateral homologous areas. In the present study, we investigated the whole pattern of intra- and inter-hemispheric cortico-cortical connectivity changes induced by rTMS over rPPC. Methods To do so, 14 healthy participants underwent resting state EEG recording before and after 30 min of rTMS at 1 Hz or sham stimulation over the rPPC (electrode position P6). Real stimulation was applied at 90% of motor threshold. Coherence values were computed on the electrodes nearby the stimulated site (i.e., P4, P8, and CP6) considering all possible inter- and intra-hemispheric combinations for the following frequency bands: delta (0.5-4 Hz), theta (4-8 Hz), alpha (8-12Hz), low beta (12-20 Hz), high beta (20-30 Hz), and gamma (30-50 Hz). Results and discussion Results revealed a significant increase in coherence in delta, theta, alpha and beta frequency bands between rPPC and the contralateral homologous sites. Moreover, an increase in coherence in theta, alpha, beta and gamma frequency bands was found between rPPC and right frontal sites, reflecting the activation of the fronto-parietal network within the right hemisphere. Summarizing, subthreshold rTMS over rPPC revealed cortico-cortical inter- and intra-hemispheric connectivity as measured by the increase in coherence among these areas. Moreover, the present results further confirm previous evidence indicating that the increase of coherence values is related to intra- and inter-hemispheric inhibitory effects of rTMS. These results can have implications for devising evidence-based rehabilitation protocols after stroke.
Collapse
Affiliation(s)
- Chiara Mazzi
- Perception and Awareness (PandA) Laboratory, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sonia Mele
- Perception and Awareness (PandA) Laboratory, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Chiara Bagattini
- Perception and Awareness (PandA) Laboratory, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Section of Neurosurgery, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Javier Sanchez-Lopez
- Escuela Nacional de Estudios Superiores Unidad Juriquilla, Universidad Nacional Autonoma de Mexico, Santiago de Querétaro, Mexico
| | - Silvia Savazzi
- Perception and Awareness (PandA) Laboratory, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| |
Collapse
|
3
|
Zigiotto L, Amorosino G, Saviola F, Jovicich J, Annicchiarico L, Rozzanigo U, Olivetti E, Avesani P, Sarubbo S. Spontaneous unilateral spatial neglect recovery after brain tumour resection: A multimodal diffusion and rs-fMRI case report. J Neuropsychol 2024; 18 Suppl 1:91-114. [PMID: 37431064 DOI: 10.1111/jnp.12339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/25/2023] [Indexed: 07/12/2023]
Abstract
Patients with unilateral spatial neglect (USN) are unable to explore or to report stimuli presented in the left personal and extra-personal space. USN is usually caused by lesion of the right parietal lobe: nowadays, it is also clear the key role of structural connections (the second and the third branch of the right Superior Longitudinal Fasciculus, respectively, SLF II and III) and functional networks (Dorsal and Ventral Attention Network, respectively, DAN and VAN) in USN. In this multimodal case report, we have merged those structural and functional information derived from a patient with a right parietal lobe tumour and USN before surgery. Functional, structural and neuropsychological data were also collected 6 months after surgery, when the USN was spontaneously recovered. Diffusion metrics and Functional Connectivity (FC) of the right SLF and DAN, before and after surgery, were compared with the same data of a patient with a tumour in a similar location, but without USN, and with a control sample. Results indicate an impairment in the right SLF III and a reduction of FC of the right DAN in patients with USN before surgery compared to controls; after surgery, when USN was recovered, patient's diffusion metrics and FC showed no differences compared to the controls. This single case and its multimodal approach reinforce the crucial role of the right SLF III and DAN in the development and recovery of egocentric and allocentric extra-personal USN, highlighting the need to preserve these structural and functional areas during brain surgery.
Collapse
Affiliation(s)
- Luca Zigiotto
- Department of Neurosurgery, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
- Structural and Functional Connectivity Lab Project, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
- Department of Psychology, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Gabriele Amorosino
- Neuroinformatics Laboratory (NILab), Bruno Kessler Foundation (FBK), Trento, Italy
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Francesca Saviola
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Jorge Jovicich
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Luciano Annicchiarico
- Department of Neurosurgery, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
- Structural and Functional Connectivity Lab Project, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Umberto Rozzanigo
- Department of Neuroradiology, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Emanuele Olivetti
- Neuroinformatics Laboratory (NILab), Bruno Kessler Foundation (FBK), Trento, Italy
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Paolo Avesani
- Neuroinformatics Laboratory (NILab), Bruno Kessler Foundation (FBK), Trento, Italy
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Silvio Sarubbo
- Department of Neurosurgery, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
- Structural and Functional Connectivity Lab Project, 'S. Chiara' Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| |
Collapse
|
4
|
Zampieri C, Leary JB, Shahim P, Damiano D, Ho PS, Pham DL, Chan L. Associations between white matter integrity and postural control in adults with traumatic brain injury. PLoS One 2023; 18:e0288727. [PMID: 38011096 PMCID: PMC10681193 DOI: 10.1371/journal.pone.0288727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/03/2023] [Indexed: 11/29/2023] Open
Abstract
Abnormalities of postural sway have been extensively reported in traumatic brain injury (TBI). However, the underlying neural correlates of balance disturbances in TBI remain to be elucidated. Studies in children with TBI have reported associations between the Sensory Organization Test (SOT) and measures of white matter (WM) integrity with diffusion tensor imaging (DTI) in brain areas responsible for multisensory integration. This study seeks to replicate those associations in adults as well as explore relationships between DTI and the Limits of Stability (LOS) Test. Fifty-six participants (43±17 years old) with a history of TBI were tested 30 days to 5 years post-TBI. This study confirmed results in children for associations between the SOT and the medial lemniscus as well as middle cerebellar peduncle, and revealed additional associations with the posterior thalamic radiation. Additionally, this study found significant correlations between abnormal LOS scores and impaired WM integrity in the cingulum, corpus callosum, corticopontine and corticospinal tracts, fronto-occipital fasciculi, longitudinal fasciculi, medial lemniscus, optic tracts and thalamic radiations. Our findings indicate the involvement of a broad range of WM tracts in the control of posture, and demonstrate the impact of TBI on balance via disruptions to WM integrity.
Collapse
Affiliation(s)
- Cris Zampieri
- Rehabilitation Medicine Department, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Jacob B. Leary
- Rehabilitation Medicine Department, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Pashtun Shahim
- Rehabilitation Medicine Department, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Diane Damiano
- Rehabilitation Medicine Department, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Pei-Shu Ho
- Rehabilitation Medicine Department, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Dzung L. Pham
- Center for Neuroscience and Regenerative Medicine, The Henry Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Leighton Chan
- Rehabilitation Medicine Department, National Institutes of Health, Bethesda, Maryland, United States of America
| |
Collapse
|
5
|
Sperber C, Gallucci L, Mirman D, Arnold M, Umarova RM. Stroke lesion size - Still a useful biomarker for stroke severity and outcome in times of high-dimensional models. Neuroimage Clin 2023; 40:103511. [PMID: 37741168 PMCID: PMC10520672 DOI: 10.1016/j.nicl.2023.103511] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/05/2023] [Accepted: 09/16/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND The volumetric size of a brain lesion is a frequently used stroke biomarker. It stands out among most imaging biomarkers for being a one-dimensional variable that is applicable in simple statistical models. In times of machine learning algorithms, the question arises of whether such a simple variable is still useful, or whether high-dimensional models on spatial lesion information are superior. METHODS We included 753 first-ever anterior circulation ischemic stroke patients (age 68.4±15.2 years; NIHSS at 24 h 4.4±5.1; modified Rankin Scale (mRS) at 3-months median[IQR] 1[0.75;3]) and traced lesions on diffusion-weighted MRI. In an out-of-sample model validation scheme, we predicted stroke severity as measured by NIHSS 24 h and functional stroke outcome as measured by mRS at 3 months either from spatial lesion features or lesion size. RESULTS For stroke severity, the best regression model based on lesion size performed significantly above chance (p < 0.0001) with R2 = 0.322, but models with spatial lesion features performed significantly better with R2 = 0.363 (t(752) = 2.889; p = 0.004). For stroke outcome, the best classification model based on lesion size again performed significantly above chance (p < 0.0001) with an accuracy of 62.8%, which was not different from the best model with spatial lesion features (62.6%, p = 0.80). With smaller training data sets of only 150 or 50 patients, the performance of high-dimensional models with spatial lesion features decreased up to the point of being equivalent or even inferior to models trained on lesion size. The combination of lesion size and spatial lesion features in one model did not improve predictions. CONCLUSIONS Lesion size is a decent biomarker for stroke outcome and severity that is slightly inferior to spatial lesion features but is particularly suited in studies with small samples. When low-dimensional models are desired, lesion size provides a viable proxy biomarker for spatial lesion features, whereas high-precision prediction models in personalised prognostic medicine should operate with high-dimensional spatial imaging features in large samples.
Collapse
Affiliation(s)
- Christoph Sperber
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
| | - Laura Gallucci
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Daniel Mirman
- Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Marcel Arnold
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Roza M Umarova
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| |
Collapse
|
6
|
Rosenzopf H, Klingbeil J, Wawrzyniak M, Röhrig L, Sperber C, Saur D, Karnath HO. Thalamocortical disconnection involved in pusher syndrome. Brain 2023; 146:3648-3661. [PMID: 36943319 DOI: 10.1093/brain/awad096] [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: 10/21/2022] [Revised: 02/13/2023] [Accepted: 03/02/2023] [Indexed: 03/23/2023] Open
Abstract
The presence of both isolated thalamic and isolated cortical lesions have been reported in the context of pusher syndrome-a disorder characterized by a disturbed perception of one's own upright body posture, following unilateral left- or right-sided stroke. In recent times, indirect quantification of functional and structural disconnection increases the knowledge derived from focal brain lesions by inferring subsequent brain network damage from the respective lesion. We applied both measures to a sample of 124 stroke patients to investigate brain disconnection in pusher syndrome. Our results suggest a hub-like function of the posterior and lateral portions of the thalamus in the perception of one's own postural upright. Lesion network symptom mapping investigating functional disconnection indicated cortical diaschisis in cerebellar, frontal, parietal and temporal areas in patients with thalamic lesions suffering from pusher syndrome, but there was no evidence for functional diaschisis in pusher patients with cortical stroke and no evidence for the convergence of thalamic and cortical lesions onto a common functional network. Structural disconnection mapping identified posterior thalamic disconnection to temporal, pre-, post- and paracentral regions. Fibre tracking between the thalamic and cortical pusher lesion hotspots indicated that in cortical lesions of patients with pusher syndrome, it is disconnectivity to the posterior thalamus caused by accompanying white matter damage, rather than the direct cortical lesions themselves, that lead to the emergence of pusher syndrome. Our analyses thus offer the first evidence for a direct thalamo-cortical (or cortico-thalamic) interconnection and, more importantly, shed light on the location of the respective thalamo-cortical disconnections. Pusher syndrome seems to be a consequence of direct damage or of disconnection of the posterior thalamus.
Collapse
Affiliation(s)
- Hannah Rosenzopf
- Center of Neurology, Division of Neuropsychology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Julian Klingbeil
- Neuroimaging Lab, Department of Neurology, University of Leipzig, 04103 Leipzig, Germany
| | - Max Wawrzyniak
- Neuroimaging Lab, Department of Neurology, University of Leipzig, 04103 Leipzig, Germany
| | - Lisa Röhrig
- Center of Neurology, Division of Neuropsychology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Christoph Sperber
- Center of Neurology, Division of Neuropsychology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Dorothee Saur
- Neuroimaging Lab, Department of Neurology, University of Leipzig, 04103 Leipzig, Germany
| | - Hans-Otto Karnath
- Center of Neurology, Division of Neuropsychology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
| |
Collapse
|
7
|
Sperber C, Gallucci L, Smaczny S, Umarova R. Bayesian lesion-deficit inference with Bayes factor mapping: Key advantages, limitations, and a toolbox. Neuroimage 2023; 271:120008. [PMID: 36914109 DOI: 10.1016/j.neuroimage.2023.120008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/15/2023] Open
Abstract
Statistical lesion-symptom mapping is largely dominated by frequentist approaches with null hypothesis significance testing. They are popular for mapping functional brain anatomy but are accompanied by some challenges and limitations. The typical analysis design and the structure of clinical lesion data are linked to the multiple comparison problem, an association problem, limitations to statistical power, and a lack of insights into evidence for the null hypothesis. Bayesian lesion deficit inference (BLDI) could be an improvement as it collects evidence for the null hypothesis, i.e. the absence of effects, and does not accumulate α-errors with repeated testing. We implemented BLDI by Bayes factor mapping with Bayesian t-tests and general linear models and evaluated its performance in comparison to frequentist lesion-symptom mapping with a permutation-based family-wise error correction. We mapped the voxel-wise neural correlates of simulated deficits in an in-silico-study with 300 stroke patients, and the voxel-wise and disconnection-wise neural correlates of phonemic verbal fluency and constructive ability in 137 stroke patients. Both the performance of frequentist and Bayesian lesion-deficit inference varied largely across analyses. In general, BLDI could find areas with evidence for the null hypothesis and was statistically more liberal in providing evidence for the alternative hypothesis, i.e. the identification of lesion-deficit associations. BLDI performed better in situations in which the frequentist method is typically strongly limited, for example with on average small lesions and in situations with low power, where BLDI also provided unprecedented transparency in terms of the informative value of the data. On the other hand, BLDI suffered more from the association problem, which led to a pronounced overshoot of lesion-deficit associations in analyses with high statistical power. We further implemented a new approach to lesion size control, adaptive lesion size control, that, in many situations, was able to counter the limitations imposed by the association problem, and increased true evidence both for the null and the alternative hypothesis. In summary, our results suggest that BLDI is a valuable addition to the method portfolio of lesion-deficit inference with some specific and exclusive advantages: it deals better with smaller lesions and low statistical power (i.e. small samples and effect sizes) and identifies regions with absent lesion-deficit associations. However, it is not superior to established frequentist approaches in all respects and therefore not to be seen as a general replacement. To make Bayesian lesion-deficit inference widely accessible, we published an R toolkit for the analysis of voxel-wise and disconnection-wise data.
Collapse
Affiliation(s)
- Christoph Sperber
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
| | - Laura Gallucci
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Stefan Smaczny
- Centre of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Roza Umarova
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| |
Collapse
|
8
|
Min Y, Liu C, Zuo L, Wang Y, Li Z. The Relationship between Altered Degree Centrality and Cognitive Function in Mild Subcortical Stroke: A Resting-State fMRI Study. Brain Res 2022; 1798:148125. [DOI: 10.1016/j.brainres.2022.148125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/28/2022] [Accepted: 10/10/2022] [Indexed: 11/02/2022]
|
9
|
Cha S, Jeong B, Choi M, Kwon S, Lee SH, Paik NJ, Kim WS, Han CE. White matter tracts involved in subcortical unilateral spatial neglect in subacute stroke. Front Neurol 2022; 13:992107. [PMID: 36247754 PMCID: PMC9561922 DOI: 10.3389/fneur.2022.992107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundUnilateral spatial neglect (USN) is common and associated with poor motor and cognitive outcomes as well as impaired quality of life following stroke. Traditionally, the neural substrates underlying USN have been thought to be cortical areas, such as the posterior parietal cortex. However, patients with stroke involving only subcortical structures may also present with USN. While only a few studies have reported on USN in subcortical stroke, the involvement of white matter tracts related to brain networks of visuospatial attention is one possible explanation for subcortical neglect. Therefore, this study aimed to investigate which specific white matter tracts are neural substrates for USN in patients with subcortical stroke.MethodsTwenty-two patients with subcortical stroke without cortical involvement who were admitted to the Department of Rehabilitation Medicine at Seoul National University Bundang Hospital were retrospectively enrolled. Nine subjects were subclassified into a “USN(+)” group, as they had at least two positive results on three tests (the Schenkenberg line bisection test, Albert's test, and house drawing test) and a score of 1 or higher on the Catherine Bergego scale. The remaining 13 subjects without abnormalities on those tests were subclassified into the “USN(–)” group. Stroke lesions on MRI were manually drawn using MRIcron software. Lesion overlapping and atlas-based analyses of MRI images were conducted. The correlation was analyzed between the overlapped lesion volumes with white matter tracts and the severity of USN (in the Albert test and the Catherine Bergego scale).ResultsLesions were more widespread in the USN(+) group than in the USN(–) group, although their locations in the right hemisphere were similar. The atlas-based analyses identified that the right cingulum in the cingulate cortex, the temporal projection of the superior longitudinal fasciculus, and the forceps minor significantly overlapped with the lesions in the USN(+) group than in the USN(–) group. The score of the Catherine Bergego scale correlated with the volume of the involved white matter tracts.ConclusionIn this study, white matter tracts associated with USN were identified in patients with subcortical stroke without any cortical involvement. Our study results, along with previous findings on subcortical USN, support that USN may result from damage to white matter pathways.
Collapse
Affiliation(s)
- Seungwoo Cha
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - ByeongChang Jeong
- Department of Electronics and Information Engineering, Korea University, Sejong, South Korea
- Interdisciplinary Graduate Program for Artificial Intelligence Smart Convergence Technology, Korea University, Sejong, South Korea
| | - Myungwon Choi
- Department of Electronics and Information Engineering, Korea University, Sejong, South Korea
| | - Sohyun Kwon
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Stephanie Hyeyoung Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Nam-Jong Paik
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
- Won-Seok Kim
| | - Cheol E. Han
- Department of Electronics and Information Engineering, Korea University, Sejong, South Korea
- Interdisciplinary Graduate Program for Artificial Intelligence Smart Convergence Technology, Korea University, Sejong, South Korea
- *Correspondence: Cheol E. Han
| |
Collapse
|
10
|
Sperber C, Griffis J, Kasties V. Indirect structural disconnection-symptom mapping. Brain Struct Funct 2022; 227:3129-3144. [PMID: 36048282 DOI: 10.1007/s00429-022-02559-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 08/24/2022] [Indexed: 01/01/2023]
Abstract
In vivo tracking of white matter fibres catalysed a modern perspective on the pivotal role of brain connectome disruption in neuropsychological deficits. However, the examination of white matter integrity in neurological patients by diffusion-weighted magnetic resonance imaging bears conceptual limitations and is not widely applicable, as it requires imaging-compatible patients and resources beyond the capabilities of many researchers. The indirect estimation of structural disconnection offers an elegant and economical alternative. For this approach, a patient's structural lesion information and normative connectome data are combined to estimate different measures of lesion-induced structural disconnection. Using one of several toolboxes, this method is relatively easy to implement and is even available to scientists without expertise in fibre tracking analyses. Nevertheless, the anatomo-behavioural statistical mapping of structural brain disconnection requires analysis steps that are not covered by these toolboxes. In this paper, we first review the current state of indirect lesion disconnection estimation, the different existing measures, and the available software. Second, we aim to fill the remaining methodological gap in statistical disconnection-symptom mapping by providing an overview and guide to disconnection data and the statistical mapping of their relationship to behavioural measurements using either univariate or multivariate statistical modelling. To assist in the practical implementation of statistical analyses, we have included software tutorials and analysis scripts.
Collapse
Affiliation(s)
- Christoph Sperber
- University of Tubingen: Eberhard Karls Universitat Tubingen, Tubingen, Germany.
| | - Joseph Griffis
- University of Tubingen: Eberhard Karls Universitat Tubingen, Tubingen, Germany
| | - Vanessa Kasties
- Centre of Neurology, Hertie-Institute for Clinical Brain Research, University of Tubingen, Tubingen, Germany
- Child Development Center, University Childrens Hospital Zurich, University of Zurich, Zurich, Switzerland
| |
Collapse
|
11
|
Rosenzopf H, Wiesen D, Basilakos A, Yourganov G, Bonilha L, Rorden C, Fridriksson J, Karnath HO, Sperber C. Mapping the human praxis network: an investigation of white matter disconnection in limb apraxia of gesture production. Brain Commun 2022; 4:fcac004. [PMID: 35169709 PMCID: PMC8833454 DOI: 10.1093/braincomms/fcac004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/19/2021] [Accepted: 01/07/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Left hemispheric cerebral stroke can cause apraxia, a motor-cognitive disorder characterised by deficits of higher-order motor skills such as the failure to accurately produce meaningful gestures. This disorder provides unique insights into the anatomical and cognitive architecture of the human praxis system. The present study aimed to map the structural brain network that is damaged in apraxia. We assessed the ability to perform meaningful gestures with the hand in 101 patients with chronic left hemisphere stroke. Structural white matter fibre damage was directly assessed by diffusion tensor imaging and fractional anisotropy mapping. We used multivariate topographical inference on tract-based fractional anisotropy topographies to identify white matter disconnection associated with apraxia. We found relevant pathological white matter alterations in a densely connected fronto-temporo-parietal network of short and long association fibres. Hence, the findings suggest that heterogeneous topographical results in previous lesion mapping studies might not only result from differences in study design, but also from the general methodological limitations of univariate topographical mapping in uncovering the structural praxis network. A striking role of middle and superior temporal lobe disconnection, including temporo-temporal short association fibres, was found, suggesting strong involvement of the temporal lobe in the praxis network. Further, the results stressed the importance of subcortical disconnections for the emergence of apractic symptoms. Our study provides a fine-grain view into the structural connectivity of the human praxis network and suggests a potential value of disconnection measures in the clinical prediction of behavioural post-stroke outcome.
Collapse
Affiliation(s)
- Hannah Rosenzopf
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Daniel Wiesen
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Alexandra Basilakos
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Grigori Yourganov
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | - Christopher Rorden
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Hans-Otto Karnath
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Christoph Sperber
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| |
Collapse
|
12
|
Adam R, Schaeffer DJ, Johnston K, Menon RS, Everling S. Structural alterations in cortical and thalamocortical white matter tracts after recovery from prefrontal cortex lesions in macaques. Neuroimage 2021; 232:117919. [PMID: 33652141 DOI: 10.1016/j.neuroimage.2021.117919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 01/04/2023] Open
Abstract
Unilateral damage to the frontoparietal network typically impairs saccade target selection within the contralesional visual hemifield. Severity of deficits and the degree of recovery have been associated with widespread network dysfunction, yet it is not clear how these behavioural and functional brain changes relate with the underlying structural white matter tracts. Here, we investigated whether recovery after unilateral prefrontal cortex (PFC) lesions was associated with changes in white matter microstructure across large-scale frontoparietal cortical and thalamocortical networks. Diffusion-weighted imaging was acquired in four male rhesus macaques at pre-lesion, week 1, and week 8-16 post-lesion when target selection deficits largely recovered. Probabilistic tractography was used to reconstruct cortical frontoparietal fiber tracts, including the superior longitudinal fasciculus (SLF) and transcallosal fibers connecting the PFC or posterior parietal cortex (PPC), as well as thalamocortical fiber tracts connecting the PFC and PPC to thalamic nuclei. We found that the two animals with small PFC lesions showed increased fractional anisotropy in both cortical and thalamocortical fiber tracts when behaviour had recovered. However, we found that fractional anisotropy decreased in cortical frontoparietal tracts after larger PFC lesions yet increased in some thalamocortical tracts at the time of behavioural recovery. These findings indicate that behavioural recovery after small PFC lesions may be supported by both cortical and subcortical areas, whereas larger PFC lesions may have induced widespread structural damage and hindered compensatory remodeling in the cortical frontoparietal network.
Collapse
Affiliation(s)
- Ramina Adam
- Graduate Program in Neuroscience, University of Western Ontario, London, Canada; Robarts Research Institute, University of Western Ontario, London, Canada; The Brain and Mind Institute, University of Western Ontario, London, Canada
| | - David J Schaeffer
- Department of Neurobiology, University of Pittsburgh, PA, United States
| | - Kevin Johnston
- The Brain and Mind Institute, University of Western Ontario, London, Canada; Department of Physiology and Pharmacology, University of Western Ontario, London, Canada
| | - Ravi S Menon
- Robarts Research Institute, University of Western Ontario, London, Canada; The Brain and Mind Institute, University of Western Ontario, London, Canada; Department of Medical Biophysics, University of Western Ontario, London, Canada
| | - Stefan Everling
- Graduate Program in Neuroscience, University of Western Ontario, London, Canada; Robarts Research Institute, University of Western Ontario, London, Canada; The Brain and Mind Institute, University of Western Ontario, London, Canada; Department of Physiology and Pharmacology, University of Western Ontario, London, Canada.
| |
Collapse
|
13
|
Russell-Giller S, Wu T, Spagna A, Dhamoon M, Hao Q, Fan J. Impact of unilateral stroke on right hemisphere superiority in executive control. Neuropsychologia 2020; 150:107693. [PMID: 33238172 DOI: 10.1016/j.neuropsychologia.2020.107693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 10/16/2020] [Accepted: 11/18/2020] [Indexed: 11/19/2022]
Abstract
In our previous study, we have demonstrated a right hemisphere superiority in executive control of attention, with the right hemisphere being more efficient in dealing with conflict for stimuli presented in the left visual field. However, the unique and synergetic contribution of the two hemispheres to this superiority effect is still elusive. Here, using the lateralized attention network test, we compared the flanker conflict effect for stimuli presented in the left and right visual fields in patients with an ischemic stroke in the right or left hemisphere as the unilateral lesion groups and in patients with a transient ischemic attack without an acute infarction as the control group. In contrast to the transient ischemic attack group, which demonstrated a right hemisphere superiority in conflict processing, there was no evidence for such an effect in both unilateral stroke groups. These results can be explained by our model proposing that there is bilateral hemispheric involvement for conflict processing for information received from the left visual field and unilateral hemispheric involvement for conflict processing for information received from the right visual field, resulting in more efficient processing for the left visual field, i.e., the right hemisphere superiority effect. When there is damage to either hemisphere, the responsibility of conflict processing will largely fall on the intact hemisphere, eliminating the right hemisphere superiority effect.
Collapse
Affiliation(s)
- Shira Russell-Giller
- Department of Psychology, Queens College, The City University of New York, Queens, NY, USA; Department of Psychology, The Graduate Center, The City University of New York, New York, NY, USA; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tingting Wu
- Department of Psychology, Queens College, The City University of New York, Queens, NY, USA
| | - Alfredo Spagna
- Department of Psychology, Columbia University in the City of New York, New York, NY, USA
| | - Mandip Dhamoon
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Qing Hao
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jin Fan
- Department of Psychology, Queens College, The City University of New York, Queens, NY, USA.
| |
Collapse
|
14
|
Mengotti P, Käsbauer AS, Fink GR, Vossel S. Lateralization, functional specialization, and dysfunction of attentional networks. Cortex 2020; 132:206-222. [PMID: 32998061 DOI: 10.1016/j.cortex.2020.08.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 04/20/2020] [Accepted: 08/31/2020] [Indexed: 12/11/2022]
Abstract
The present review covers the latest findings on the lateralization of the dorsal and ventral attention systems, their functional specialization, and their clinical relevance for stroke-induced attentional dysfunction. First, the original assumption of a bilateral dorsal system for top-down attention and a right-lateralized ventral system for stimulus-driven attention is critically reviewed. The evidence for the involvement of the left parietal cortex in attentional functions is discussed and findings on putative pathways linking the dorsal and ventral network are presented. In the second part of the review, we focus on the different attentional subsystems and their lateralization, discussing the differences between spatial, feature- and object-based attention, and motor attention. We also review studies based on predictive coding frameworks of attentional functions. Finally, in the third section, we provide an overview of the consequences of specific disruption within the attention networks after stroke. The role of the interhemispheric (im)balance is discussed, and the results of new promising therapeutic approaches employing brain stimulation techniques such as transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) are presented.
Collapse
Affiliation(s)
- Paola Mengotti
- Cognitive Neuroscience, Institute of Neuroscience & Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany.
| | - Anne-Sophie Käsbauer
- Cognitive Neuroscience, Institute of Neuroscience & Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany
| | - Gereon R Fink
- Cognitive Neuroscience, Institute of Neuroscience & Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany; Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Simone Vossel
- Cognitive Neuroscience, Institute of Neuroscience & Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany; Department of Psychology, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| |
Collapse
|
15
|
Sperber C, Clausen J, Benke T, Karnath HO. The anatomy of spatial neglect after posterior cerebral artery stroke. Brain Commun 2020; 2:fcaa163. [PMID: 33543137 PMCID: PMC7846084 DOI: 10.1093/braincomms/fcaa163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 08/10/2020] [Accepted: 09/04/2020] [Indexed: 11/14/2022] Open
Abstract
Spatial neglect is a common consequence of stroke in the territory of the right middle cerebral artery. Damage to a perisylvian fronto-temporo-parietal network has been demonstrated to underlie this disorder. Less common, stroke to the posterior cerebral artery territory may also lead to spatial neglect. This study aimed to uncover the anatomical underpinnings of spatial neglect after posterior cerebral artery infarction. A sample of 50 posterior cerebral artery infarct patients was screened for spatial neglect. Neural correlates of neglect were investigated both with voxel-based lesion behaviour mapping and with region-of-interest analyses. Brain damage neither to the splenium, nor to the parahippocampal gyrus, nor to the thalamus was predictive of spatial neglect. Only damage to the perisylvian fronto-temporo-parietal network of spatial neglect was significantly associated with neglect severity. We conclude that both posterior and middle cerebral artery stroke induce spatial neglect after damage to the same perisylvian brain network. The findings contradict previous theories that postulated neural correlates of spatial neglect specifically supplied by the posterior cerebral artery. In posterior cerebral artery stroke patients, affected parts of this network are located at the border zone between the posterior and middle cerebral artery territories. Inter-individual variability in the localization of the border between both artery territories appears to mediate the occurrence of spatial neglect after posterior cerebral artery stroke.
Collapse
Affiliation(s)
- Christoph Sperber
- Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, Centre of Neurology, University of Tübingen, 72076 Tübingen, Germany
| | - Jacob Clausen
- Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, Centre of Neurology, University of Tübingen, 72076 Tübingen, Germany
| | - Thomas Benke
- Department of Neurology, Medical University Innsbruck, A - 6020 Innsbruck, Austria
| | - Hans-Otto Karnath
- Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, Centre of Neurology, University of Tübingen, 72076 Tübingen, Germany
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
| |
Collapse
|
16
|
Toba MN, Zavaglia M, Malherbe C, Moreau T, Rastelli F, Kaglik A, Valabrègue R, Pradat-Diehl P, Hilgetag CC, Valero-Cabré A. Game theoretical mapping of white matter contributions to visuospatial attention in stroke patients with hemineglect. Hum Brain Mapp 2020; 41:2926-2950. [PMID: 32243676 PMCID: PMC7336155 DOI: 10.1002/hbm.24987] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 02/24/2020] [Accepted: 03/06/2020] [Indexed: 01/19/2023] Open
Abstract
White matter bundles linking gray matter nodes are key anatomical players to fully characterize associations between brain systems and cognitive functions. Here we used a multivariate lesion inference approach grounded in coalitional game theory (multiperturbation Shapley value analysis, MSA) to infer causal contributions of white matter bundles to visuospatial orienting of attention. Our work is based on the characterization of the lesion patterns of 25 right hemisphere stroke patients and the causal analysis of their impact on three neuropsychological tasks: line bisection, letter cancellation, and bells cancellation. We report that, out of the 11 white matter bundles included in our MSA coalitions, the optic radiations, the inferior fronto-occipital fasciculus and the anterior cingulum were the only tracts to display task-invariant contributions (positive, positive, and negative, respectively) to the tasks. We also report task-dependent influences for the branches of the superior longitudinal fasciculus and the posterior cingulum. By extending prior findings to white matter tracts linking key gray matter nodes, we further characterize from a network perspective the anatomical basis of visual and attentional orienting processes. The knowledge about interactions patterns mediated by white matter tracts linking cortical nodes of attention orienting networks, consolidated by further studies, may help develop and customize brain stimulation approaches for the rehabilitation of visuospatial neglect.
Collapse
Affiliation(s)
- Monica N Toba
- Cerebral Dynamics, Plasticity and Rehabilitation Team, Frontlab, Paris Brain Institute, ICM, Sorbonne Universités, UPMC Paris 06, Inserm UMR S 1127, CNRS UMR 7225, F-75013, & IHU-A-ICM, Paris, France.,Institute of Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,AP-HP, HxU Pitié-Salpêtrière-Charles-Foix, service de Médecine Physique et de Réadaptation & PHRC Régional NEGLECT, Paris, France.,Laboratory of Functional Neurosciences (EA 4559), University of Picardie Jules Verne, Amiens, France
| | - Melissa Zavaglia
- Institute of Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Jacobs University, Focus Area Health, Bremen, Germany
| | - Caroline Malherbe
- Institute of Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Neurology, Head and Neuro Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tristan Moreau
- Cerebral Dynamics, Plasticity and Rehabilitation Team, Frontlab, Paris Brain Institute, ICM, Sorbonne Universités, UPMC Paris 06, Inserm UMR S 1127, CNRS UMR 7225, F-75013, & IHU-A-ICM, Paris, France
| | - Federica Rastelli
- Cerebral Dynamics, Plasticity and Rehabilitation Team, Frontlab, Paris Brain Institute, ICM, Sorbonne Universités, UPMC Paris 06, Inserm UMR S 1127, CNRS UMR 7225, F-75013, & IHU-A-ICM, Paris, France.,AP-HP, HxU Pitié-Salpêtrière-Charles-Foix, service de Médecine Physique et de Réadaptation & PHRC Régional NEGLECT, Paris, France
| | - Anna Kaglik
- Cerebral Dynamics, Plasticity and Rehabilitation Team, Frontlab, Paris Brain Institute, ICM, Sorbonne Universités, UPMC Paris 06, Inserm UMR S 1127, CNRS UMR 7225, F-75013, & IHU-A-ICM, Paris, France.,AP-HP, HxU Pitié-Salpêtrière-Charles-Foix, service de Médecine Physique et de Réadaptation & PHRC Régional NEGLECT, Paris, France
| | - Romain Valabrègue
- Centre for NeuroImaging Research-CENIR, Paris Brain Institute, ICM, Sorbonne Universités, Inserm UMR S 1127, CNRS UMR 7225, F-75013, Paris, France
| | - Pascale Pradat-Diehl
- AP-HP, HxU Pitié-Salpêtrière-Charles-Foix, service de Médecine Physique et de Réadaptation & PHRC Régional NEGLECT, Paris, France.,GRC-UPMC n° 18-Handicap cognitif et réadaptation, Paris, France
| | - Claus C Hilgetag
- Institute of Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Health Sciences, Boston University, 635 Commonwealth Ave., Boston, Massachusetts, 02215, USA
| | - Antoni Valero-Cabré
- Cerebral Dynamics, Plasticity and Rehabilitation Team, Frontlab, Paris Brain Institute, ICM, Sorbonne Universités, UPMC Paris 06, Inserm UMR S 1127, CNRS UMR 7225, F-75013, & IHU-A-ICM, Paris, France.,AP-HP, HxU Pitié-Salpêtrière-Charles-Foix, service de Médecine Physique et de Réadaptation & PHRC Régional NEGLECT, Paris, France.,Laboratory for Cerebral Dynamics, Plasticity & Rehabilitation, Boston University School of Medicine, Boston, Massachusetts, 02118, USA
| |
Collapse
|
17
|
Pedrazzini E, Ptak R. The neuroanatomy of spatial awareness: a large-scale region-of-interest and voxel-based anatomical study. Brain Imaging Behav 2020; 14:615-626. [DOI: 10.1007/s11682-019-00213-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
18
|
Ye L, Cao L, Xie H, Shan G, Hu J, Du J, Song W. Visual processing features in patients with visual spatial neglect recovering from right-hemispheric stroke. Neurosci Lett 2019; 714:134528. [PMID: 31585212 DOI: 10.1016/j.neulet.2019.134528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 09/09/2019] [Accepted: 09/30/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Visual spatial neglect (VSN) is a disorder of spatial-temporal attention, often as a result of traumatic brain injury, including stroke. Accumulating evidence suggests that the recovery from VSN follows a very predictable pattern. In this study, we aimed to determine the specific electrophysiology readout that might have predictive value for recovery from VSN in the typical early events, including the recovery rate of visual processing, within the first four weeks of recovery. METHODS This was a prospective study of 18 right ischemic stroke patients with VSN who performed a visual cue-target task within 3 days after stroke. The patients were divided into two groups according to their outcome. We compared behavioral data, the amplitudes and latencies of ERP components(P1, N1, and P300) between patients with persistent-VSN (P-VSN) and those with rapid recovery-VSN (R-VSN). RESULTS The amplitudes and latencies of the P1 and N1 components were not significantly influenced by the validity of the cue-based expectancy (all p > 0.05). However, a longer mean P300 latency evoked an effective cue (p < 0.001), and there was a significant difference between the P-VSN and R-VSN groups when using the left target (left hemisphere, p = 0.014; right hemisphere, p = 0.027). The recovery rate found in our study (18.75% at four weeks after stroke) was lower than that of previously reported studies. CONCLUSIONS Our findings support the use of the event-related potential as a tool for investigating rapid recovery from VSN after stroke and suggest that other factors, such as an asymmetrical omission toward the contralateral side or impairment in the temporal processing capacity, might also be potential biomarkers of recovery.
Collapse
Affiliation(s)
- Linlin Ye
- Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Road, Beijing, 100053 China
| | - Lei Cao
- Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Road, Beijing, 100053 China
| | - Huanxin Xie
- Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Road, Beijing, 100053 China
| | - Guixiang Shan
- Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Road, Beijing, 100053 China
| | - Jie Hu
- Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Road, Beijing, 100053 China
| | - Jubao Du
- Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Road, Beijing, 100053 China
| | - Weiqun Song
- Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Road, Beijing, 100053 China.
| |
Collapse
|
19
|
Wiesen D, Sperber C, Yourganov G, Rorden C, Karnath HO. Using machine learning-based lesion behavior mapping to identify anatomical networks of cognitive dysfunction: Spatial neglect and attention. Neuroimage 2019; 201:116000. [PMID: 31295567 DOI: 10.1016/j.neuroimage.2019.07.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 07/02/2019] [Accepted: 07/04/2019] [Indexed: 12/12/2022] Open
Abstract
Previous lesion behavior studies primarily used univariate lesion behavior mapping techniques to map the anatomical basis of spatial neglect after right brain damage. These studies led to inconsistent results and lively controversies. Given these inconsistencies, the idea of a wide-spread network that might underlie spatial orientation and neglect has been pushed forward. In such case, univariate lesion behavior mapping methods might have been inherently limited in detecting the presumed network due to limited statistical power. By comparing various univariate analyses with multivariate lesion-mapping based on support vector regression, we aimed to validate the network hypothesis directly in a large sample of 203 newly recruited right brain damaged patients. If the exact same correction factors and parameter combinations (FDR correction and dTLVC for lesion size control) were used, both univariate as well as multivariate approaches uncovered the same complex network pattern underlying spatial neglect. At the cortical level, lesion location dominantly affected the temporal cortex and its borders into inferior parietal and occipital cortices. Beyond, frontal and subcortical gray matter regions as well as white matter tracts connecting these regions were affected. Our findings underline the importance of a right network in spatial exploration and attention and specifically in the emergence of the core symptoms of spatial neglect.
Collapse
Affiliation(s)
- Daniel Wiesen
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, 72076, Germany
| | - Christoph Sperber
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, 72076, Germany
| | - Grigori Yourganov
- Department of Psychology, University of South Carolina, Columbia, 29208, USA
| | - Christopher Rorden
- Department of Psychology, University of South Carolina, Columbia, 29208, USA
| | - Hans-Otto Karnath
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, 72076, Germany; Department of Psychology, University of South Carolina, Columbia, 29208, USA.
| |
Collapse
|
20
|
Cognitive reserve impacts on disability and cognitive deficits in acute stroke. J Neurol 2019; 266:2495-2504. [PMID: 31254064 DOI: 10.1007/s00415-019-09442-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 06/20/2019] [Accepted: 06/22/2019] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Although post-stroke cognitive deficit can significantly limit patient independence and social re-integration, clinical routine predictors for this condition are lacking. 'Cognitive reserve' limits the detrimental effects of slowly developing neurodegeneration. We aimed to determine whether comparable effects also exist in acute stroke. Using 'years of education' as a proxy, we investigated whether cognitive reserve beneficially influences cognitive performance and disability after stroke, whilst controlling for age and lesion size as measure of stroke pathology. METHODS Within the first week of ischemic right hemisphere stroke, 36 patients were assessed for alertness, working memory, executive functions, spatial neglect, global cognition and motor deficit at 4.9 ± 2.1 days post-stroke, in addition to routine clinical tests (NIH Stroke Scale, modified Rankin Scale on admission < 24 h post-stroke and at discharge 9.5 ± 4.7 days post-stroke). The impact of education was assessed using partial correlation analysis adjusted for lesion size, age, and the time interval between stroke and assessment. To validate our results, we compared groups with similar age and lesion load, but different education levels. RESULTS In the acute stroke phase, years of education predicted both severity of education independent (alertness) and education dependent (working memory, executive functions, global cognition) cognitive deficits and disability (modified Rankin Scale). Spatial neglect seemed to be independent. INTERPRETATION Proxies of cognitive reserve should be considered in stroke research as early as in the acute stroke phase. Cognitive reserve contributes to inter-individual variability in the initial severity of cognitive deficits and disability in acute stroke, and may suggest individualised rehabilitation strategies.
Collapse
|
21
|
Guggisberg AG, Koch PJ, Hummel FC, Buetefisch CM. Brain networks and their relevance for stroke rehabilitation. Clin Neurophysiol 2019; 130:1098-1124. [PMID: 31082786 DOI: 10.1016/j.clinph.2019.04.004] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 03/04/2019] [Accepted: 04/08/2019] [Indexed: 12/21/2022]
Abstract
Stroke has long been regarded as focal disease with circumscribed damage leading to neurological deficits. However, advances in methods for assessing the human brain and in statistics have enabled new tools for the examination of the consequences of stroke on brain structure and function. Thereby, it has become evident that stroke has impact on the entire brain and its network properties and can therefore be considered as a network disease. The present review first gives an overview of current methodological opportunities and pitfalls for assessing stroke-induced changes and reorganization in the human brain. We then summarize principles of plasticity after stroke that have emerged from the assessment of networks. Thereby, it is shown that neurological deficits do not only arise from focal tissue damage but also from local and remote changes in white-matter tracts and in neural interactions among wide-spread networks. Similarly, plasticity and clinical improvements are associated with specific compensatory structural and functional patterns of neural network interactions. Innovative treatment approaches have started to target such network patterns to enhance recovery. Network assessments to predict treatment response and to individualize rehabilitation is a promising way to enhance specific treatment effects and overall outcome after stroke.
Collapse
Affiliation(s)
- Adrian G Guggisberg
- Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospital Geneva, Switzerland.
| | - Philipp J Koch
- Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL), 1202 Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology Valais (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland
| | - Friedhelm C Hummel
- Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL), 1202 Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology Valais (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland; Department of Clinical Neuroscience, University Hospital Geneva, 1202 Geneva, Switzerland
| | - Cathrin M Buetefisch
- Depts of Neurology, Rehabilitation Medicine, Radiology, Emory University, Atlanta, GA, USA
| |
Collapse
|
22
|
Tu MC, Lo CP, Huang CF, Huang WH, Deng JF, Hsu YH. Visual Attention Performances and Related Cerebral Microstructural Integrity Among Subjects With Subjective Cognitive Decline and Mild Cognitive Impairment. Front Aging Neurosci 2018; 10:268. [PMID: 30245626 PMCID: PMC6137332 DOI: 10.3389/fnagi.2018.00268] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 08/21/2018] [Indexed: 01/09/2023] Open
Abstract
Objective: To compare visual attention performances and diffusion tensor imaging (DTI) between subjects with subjective cognitive decline (SCD) and mild cognitive impairment (MCI), and to discover neuronal substrates related to visual attention performances. Methods: Thirty-nine subjects with SCD and 15 with MCI, diagnosed following neuropsychological tests and conventional brain magnetic resonance imaging, were recruited. All subjects were further examined by the Conners Continuous Performance Test 3 (CPT3) and DTI including fractional anisotropy (FA) and mean diffusivity (MD), in which group comparisons and stepwise linear regression were made. Results: Subjects with MCI had a worse performance in all retrieval indices of verbal/nonverbal memory tests than those with SCD in the context of comparable general cognition and demographic status. In the CPT3, subjects with MCI had a significant longer hit reaction time (HRT) by univariate but not multivariate comparisons. Further analysis suggested that a longer HRT across all interstimuli intervals and at the point of fourth to sixth blocks were noted among MCI subjects. In DTI evaluations, FA value within the left forceps major was the only hotspot with significant between-group differences after the Bonferroni correction of FA and MD values. On the basis that HRT had significant inverse correlations with FA value within the genu of the corpus callosum and left forceps minor, regression analysis was conducted, showing HRT was best predicted by the FA value within the left forceps minor. Area under receiver operative characteristic curve was 0.70; the optimum cut-off for HRT was 515.8 ms, with a sensitivity of 85% but specificity of 47%. Conclusions: Our report suggested that impaired sustained attention and vigilance to be an early cognitive marker in differentiating MCI from SCD, where MCI subjects had a longer HRT across all interstimuli intervals and more profoundly in later blocks. FA measures appeared to be more sensitive DTI parameters than MD values in detecting microstructural changes between SCD and MCI. The role of the anterior interhemispheric fibers in sustained attention implementation during visual signal detection task was highlighted.
Collapse
Affiliation(s)
- Min-Chien Tu
- Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chung-Ping Lo
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Radiology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Ching-Feng Huang
- Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Wen-Hui Huang
- Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Jie Fu Deng
- Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Yen-Hsuan Hsu
- Department of Psychology, National Chung Cheng University, Chiayi, Taiwan.,Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, Chiayi, Taiwan
| |
Collapse
|
23
|
Giglhuber K, Maurer S, Zimmer C, Meyer B, Krieg SM. Mapping visuospatial attention: the greyscales task in combination with repetitive navigated transcranial magnetic stimulation. BMC Neurosci 2018; 19:40. [PMID: 29996777 PMCID: PMC6042394 DOI: 10.1186/s12868-018-0440-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 07/04/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Visuospatial attention is executed by the frontoparietal cortical areas of the brain. Damage to these areas can result in visual neglect. We therefore aimed to assess a combination of the greyscales task and repetitive navigated transcranial magnetic stimulation (rTMS) to identify cortical regions involved in visuospatial attention processes. This pilot study was designed to evaluate an approach in a cohort of healthy volunteers, with the future aim of using this technique to map brain tumor patients before surgery. Ten healthy, right-handed subjects underwent rTMS mapping of 52 cortical spots in both hemispheres. The greyscales task was presented tachistoscopically and was time-locked to rTMS pulses. The task pictures showed pairs of horizontal rectangles shaded continuously from black at one end to white at the other, mirror-reversed. On each picture the subject was asked to report which of the two greyscales appeared darker overall. The responses were categorized into "leftward" and "rightward," depending on whether the subject had chosen the rectangle with the darker end on the left or the right. rTMS applied to cortical areas involved in visuospatial attention is supposed to affect lateral shifts in spatial bias. These shifts result in an altered performance on the greyscales task compared to the baseline performance without rTMS stimulation. RESULTS In baseline conditions, 9/10 subjects showed classic pseudoneglect to the left. Leftward effects also occurred more often in mapping conditions. Yet, calculated rightward deviations were strikingly greater in magnitude (p < 0.0001). Overall, the right hemisphere was found to be more suggestible than the left hemisphere. Both rightward and leftward deviation scores were higher for the rTMS of this brain side (p < 0.0001). Right hemispheric distributions accord well with current models of visuospatial attention (Corbetta et al. Nat Neurosci 8(11):1603-1610, 2005). We observed leftward deviations triggered by rTMS within superior frontal and posterior parietal areas and rightward deviations within inferior frontal areas and the temporoparietal junction (TPJ). CONCLUSION The greyscales task, in combination with rTMS, yields encouraging results in the examination of the visuospatial attention function. Future clinical implications should be evaluated.
Collapse
Affiliation(s)
- Katrin Giglhuber
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Stefanie Maurer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Claus Zimmer
- Section of Neuroradiology, Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. .,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| |
Collapse
|
24
|
Martín-Arévalo E, Schintu S, Farnè A, Pisella L, Reilly KT. Adaptation to Leftward Shifting Prisms Alters Motor Interhemispheric Inhibition. Cereb Cortex 2018; 28:528-537. [PMID: 27993820 PMCID: PMC6248503 DOI: 10.1093/cercor/bhw386] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 11/15/2016] [Accepted: 11/17/2016] [Indexed: 11/14/2022] Open
Abstract
Adaptation to rightward shifting prisms (rightward prism adaptation, RPA) ameliorates neglect symptoms in patients while adaptation to leftward shifting prisms (leftward prism adaptation, LPA) induces neglect-like behaviors in healthy subjects. It has been hypothesized that prism adaptation (PA) modulates interhemispheric balance between the parietal cortices by inhibiting the posterior parietal cortex (PPC) contralateral to the prismatic deviation, but PA's effects on interhemispheric inhibition (IHI) have not been directly investigated. Since there are hyper-excitable connections between the PPC and primary motor cortex (M1) in the left hemisphere of neglect patients, we reasoned that LPA might mimic right hemisphere lesions by reducing parietal IHI, hyper-exciting the left PPC and PPC-M1 connections, and in turn altering IHI at the motor level. Namely, we hypothesized that LPA would increase IHI from the left to the right M1. We examined changes in left-to-right and right-to-left IHI between the 2 M1s using the ipsilateral silent period (iSP) (Meyer et al. 1995) before and after either LPA or RPA. The iSP was significantly longer after LPA but only from left-to-right and it did not change at all after RPA. This is the first physiological demonstration that LPA alters IHI in the healthy brain.
Collapse
Affiliation(s)
- Elisa Martín-Arévalo
- ImpAct team, Lyon Neuroscience Research Center, INSERM
U1028, CRNS-UMR5292, 16 Ave. Doyen Lépine, 69676 Bron
Cedex, France
- Lyon 1 University, F-69373 Lyon, France
| | - Selene Schintu
- ImpAct team, Lyon Neuroscience Research Center, INSERM
U1028, CRNS-UMR5292, 16 Ave. Doyen Lépine, 69676 Bron
Cedex, France
- Lyon 1 University, F-69373 Lyon, France
- Behavioral Neurology Unit, National Institute of
Neurological Disorders and Stroke, National Institutes of Health,
10 Center Bethesda, MD, USA
| | - Alessandro Farnè
- ImpAct team, Lyon Neuroscience Research Center, INSERM
U1028, CRNS-UMR5292, 16 Ave. Doyen Lépine, 69676 Bron
Cedex, France
- Lyon 1 University, F-69373 Lyon, France
- Hospices Civils de Lyon, Neuro-immersion & Mouvement
et Handicap, F-69676 Lyon, France
| | - Laure Pisella
- ImpAct team, Lyon Neuroscience Research Center, INSERM
U1028, CRNS-UMR5292, 16 Ave. Doyen Lépine, 69676 Bron
Cedex, France
- Lyon 1 University, F-69373 Lyon, France
| | - Karen T Reilly
- ImpAct team, Lyon Neuroscience Research Center, INSERM
U1028, CRNS-UMR5292, 16 Ave. Doyen Lépine, 69676 Bron
Cedex, France
- Lyon 1 University, F-69373 Lyon, France
| |
Collapse
|
25
|
Evoking visual neglect-like deficits in healthy volunteers - an investigation by repetitive navigated transcranial magnetic stimulation. Brain Imaging Behav 2018; 11:17-29. [PMID: 26781482 DOI: 10.1007/s11682-016-9506-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In clinical practice, repetitive navigated transcranial magnetic stimulation (rTMS) is of particular interest for non-invasive mapping of cortical language areas. Yet, rTMS studies try to detect further cortical functions. Damage to the underlying network of visuospatial attention function can result in visual neglect-a severe neurological deficit and influencing factor for a significantly reduced functional outcome. This investigation aims to evaluate the use of rTMS for evoking visual neglect in healthy volunteers and the potential of specifically locating cortical areas that can be assigned for the function of visuospatial attention. Ten healthy, right-handed subjects underwent rTMS visual neglect mapping. Repetitive trains of 5 Hz and 10 pulses were applied to 52 pre-defined cortical spots on each hemisphere; each cortical spot was stimulated 10 times. Visuospatial attention was tested time-locked to rTMS pulses by a landmark task. Task pictures were displayed tachistoscopically for 50 ms. The subjects' performance was analyzed by video, and errors were referenced to cortical spots. We observed visual neglect-like deficits during the stimulation of both hemispheres. Errors were categorized into leftward, rightward, and no response errors. Rightward errors occurred significantly more often during stimulation of the right hemisphere than during stimulation of the left hemisphere (mean rightward error rate (ER) 1.6 ± 1.3 % vs. 1.0 ± 1.0 %, p = 0.0141). Within the left hemisphere, we observed predominantly leftward errors rather than rightward errors (mean leftward ER 2.0 ± 1.3 % vs. rightward ER 1.0 ± 1.0 %; p = 0.0005). Visual neglect can be elicited non-invasively by rTMS, and cortical areas eloquent for visuospatial attention can be detected. Yet, the correlation of this approach with clinical findings has to be shown in upcoming steps.
Collapse
|
26
|
Adapting the concepts of brain and cognitive reserve to post-stroke cognitive deficits: Implications for understanding neglect. Cortex 2017; 97:327-338. [DOI: 10.1016/j.cortex.2016.12.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 08/03/2016] [Accepted: 12/04/2016] [Indexed: 01/17/2023]
|
27
|
Abstract
The lateralization of visuospatial attention has been well investigated and demonstrated to be primarily resulting from unbalanced interaction between interhemispheric fronto-parietal networks in previous studies. Many recent studies of top-down attention have reported the neural signatures of its effects within visual cortex and identified its causal basis. However, the relationship between top-down networks and asymmetric visuospatial attention has not been well studied. In the current study, we aimed to explore the relationship between top-down connectivity and asymmetric visuospatial ability by using repetitive transcranial magnetic stimulation (rTMS) and resting-state functional connectivity (RSFC) analyses. We used rTMS and RSFC to model the virtual lesion to assess the behavioral performances in visuospatial attention shifting and to identify the behavior-related top-down functional connectivities, respectively. Furthermore, we also investigated the top-down connectivity in neglect patients to validate the RSFC findings. RSFC analyses in healthy subjects and neglect patients consistently revealed that asymmetric visuospatial ability and visuospatial neglect were closely related to the bias of top-down functional connectivity between posterior superior parietal lobule (SPL) and V1. Our findings indicate that stronger top-down connectivity has stronger dominance on its corresponding visual field. We argue that an asymmetric top-down network may represent a possible neurophysiological substrate for the ongoing functional asymmetry of visuospatial attention, and its interhemispheric unbalanced interaction could contribute to the clinical manifestations of visuospatial neglect.
Collapse
|
28
|
Umarova RM, Beume L, Reisert M, Kaller CP, Klöppel S, Mader I, Glauche V, Kiselev VG, Catani M, Weiller C. Distinct white matter alterations following severe stroke. Neurology 2017; 88:1546-1555. [DOI: 10.1212/wnl.0000000000003843] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 01/23/2017] [Indexed: 01/28/2023] Open
Abstract
Objective:To distinguish white matter remodeling directly induced by stroke lesion from that evoked by remote network dysfunction, using spatial neglect as a model.Methods:We examined 24 visual neglect/extinction patients and 17 control patients combining comprehensive analyses of diffusion tensor metrics and global fiber tracking with neuropsychological testing in the acute (6.3 ± 0.5 days poststroke) and chronic (134 ± 7 days poststroke) stroke phases.Results:Compared to stroke controls, patients with spatial neglect/extinction displayed longitudinal white matter alterations with 2 defining signatures: (1) perilesional degenerative changes characterized by congruently reduced fractional anisotropy and increased radial diffusivity (RD), axial diffusivity, and mean diffusivity, all suggestive of direct axonal damage by lesion and therefore nonspecific for impaired attention network and (2) transneuronal changes characterized by an increased RD in contralesional frontoparietal and bilateral occipital connections, suggestive of primary periaxonal involvement; these changes were distinctly related to the degree of unrecovered neglect symptoms in chronic stroke, hence emerging as network-specific alterations.Conclusions:The present data show how stroke entails global alterations of lesion-spared network architecture over time. Sufficiently large lesions of widely interconnected association cortex induce distinct, large-scale structural reorganization in domain-specific network connections. Besides their relevance to unrecovered domain-specific symptoms, these effects might also explain mechanisms of domain-general deficits in stroke patients, pointing to potential targets for therapeutic intervention.
Collapse
|
29
|
Let thy left brain know what thy right brain doeth: Inter-hemispheric compensation of functional deficits after brain damage. Neuropsychologia 2016; 93:407-412. [DOI: 10.1016/j.neuropsychologia.2016.06.016] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 05/06/2016] [Accepted: 06/12/2016] [Indexed: 12/18/2022]
|
30
|
Chen P, Caulfield MD, Hartman AJ, O’Rourke J, Toglia J. Assessing viewer-centered and stimulus-centered spatial bias: The 3s spreadsheet test version 1. APPLIED NEUROPSYCHOLOGY-ADULT 2016; 24:532-539. [DOI: 10.1080/23279095.2016.1220382] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Peii Chen
- Kessler Foundation, West Orange, New Jersey, USA
- Department of Physical Medicine and Rehabilitation, Rutgers University, Newark, New Jersey, USA
| | - Meghan D. Caulfield
- Kessler Foundation, West Orange, New Jersey, USA
- Department of Psychology, Lafayette College, Easton, Pennsylvania, USA
| | - Ashley J. Hartman
- Department of Rehabilitation and Regenerative Medicine, Columbia University, New York, New York, USA
| | - Jacqueline O’Rourke
- School of Health and Natural Sciences, Mercy College, Dobbs Ferry, New York, USA
| | - Joan Toglia
- School of Health and Natural Sciences, Mercy College, Dobbs Ferry, New York, USA
| |
Collapse
|
31
|
Umarova RM, Nitschke K, Kaller CP, Klöppel S, Beume L, Mader I, Martin M, Hennig J, Weiller C. Predictors and signatures of recovery from neglect in acute stroke. Ann Neurol 2016; 79:673-86. [DOI: 10.1002/ana.24614] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 12/30/2015] [Accepted: 02/08/2016] [Indexed: 01/11/2023]
Affiliation(s)
- Roza M. Umarova
- Department of Neurology; University Medical Center Freiburg; Freiburg Germany
- Freiburg Brain Imaging; University Medical Center Freiburg; Freiburg Germany
- BrainLinks-BrainTools Cluster of Excellence; University of Freiburg; Freiburg Germany
| | - Kai Nitschke
- Department of Neurology; University Medical Center Freiburg; Freiburg Germany
- Freiburg Brain Imaging; University Medical Center Freiburg; Freiburg Germany
- BrainLinks-BrainTools Cluster of Excellence; University of Freiburg; Freiburg Germany
| | - Christoph P. Kaller
- Department of Neurology; University Medical Center Freiburg; Freiburg Germany
- Freiburg Brain Imaging; University Medical Center Freiburg; Freiburg Germany
- BrainLinks-BrainTools Cluster of Excellence; University of Freiburg; Freiburg Germany
| | - Stefan Klöppel
- Department of Neurology; University Medical Center Freiburg; Freiburg Germany
- Freiburg Brain Imaging; University Medical Center Freiburg; Freiburg Germany
- BrainLinks-BrainTools Cluster of Excellence; University of Freiburg; Freiburg Germany
- Department of Psychiatry; University Medical Center Freiburg; Freiburg Germany
| | - Lena Beume
- Department of Neurology; University Medical Center Freiburg; Freiburg Germany
- Freiburg Brain Imaging; University Medical Center Freiburg; Freiburg Germany
- BrainLinks-BrainTools Cluster of Excellence; University of Freiburg; Freiburg Germany
| | - Irina Mader
- Freiburg Brain Imaging; University Medical Center Freiburg; Freiburg Germany
- Department of Neuroradiology; University Medical Center Freiburg; Freiburg Germany
| | - Markus Martin
- Department of Neurology; University Medical Center Freiburg; Freiburg Germany
- Freiburg Brain Imaging; University Medical Center Freiburg; Freiburg Germany
- BrainLinks-BrainTools Cluster of Excellence; University of Freiburg; Freiburg Germany
| | - Jürgen Hennig
- Freiburg Brain Imaging; University Medical Center Freiburg; Freiburg Germany
- BrainLinks-BrainTools Cluster of Excellence; University of Freiburg; Freiburg Germany
- Medical Physics, Department of Radiology; University Medical Center Freiburg; Freiburg Germany
| | - Cornelius Weiller
- Department of Neurology; University Medical Center Freiburg; Freiburg Germany
- Freiburg Brain Imaging; University Medical Center Freiburg; Freiburg Germany
- BrainLinks-BrainTools Cluster of Excellence; University of Freiburg; Freiburg Germany
| |
Collapse
|
32
|
Lim JS, Kang DW. Stroke Connectome and Its Implications for Cognitive and Behavioral Sequela of Stroke. J Stroke 2015; 17:256-67. [PMID: 26437992 PMCID: PMC4635721 DOI: 10.5853/jos.2015.17.3.256] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 09/10/2015] [Accepted: 09/17/2015] [Indexed: 12/21/2022] Open
Abstract
Systems-based approaches to neuroscience, using network analysis and the human connectome, have been adopted by many researchers by virtue of recent progress in neuroimaging and computational technologies. Various neurological disorders have been evaluated from a network perspective, including stroke, Alzheimer’s disease, Parkinson’s disease, and traumatic brain injury. Until now, dynamic processes after stroke and during recovery were investigated through multimodal neuroimaging techniques. Many studies have shown disruptions in structural and functional connectivity, including in large-scale neural networks, in patients with stroke sequela such as motor weakness, aphasia, hemianopia, neglect, and general cognitive dysfunction. A connectome-based approach might shed light on the underlying mechanisms of stroke sequela and the recovery process, and could identify candidates for individualized rehabilitation programs. In this review, we briefly outline the basic concepts of structural and functional connectivity, and the connectome. Then, we explore current evidence regarding how stroke lesions cause changes in connectivity and network architecture parameters. Finally, the clinical implications of perspectives on the connectome are discussed in relation to the cognitive and behavioral sequela of stroke.
Collapse
Affiliation(s)
- Jae-Sung Lim
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Wha Kang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
33
|
|
34
|
Charras P, Herbet G, Deverdun J, de Champfleur NM, Duffau H, Bartolomeo P, Bonnetblanc F. Functional reorganization of the attentional networks in low-grade glioma patients: A longitudinal study. Cortex 2015; 63:27-41. [DOI: 10.1016/j.cortex.2014.08.010] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 06/27/2014] [Accepted: 08/15/2014] [Indexed: 11/29/2022]
|
35
|
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: 155] [Impact Index Per Article: 17.2] [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.
Collapse
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
| |
Collapse
|