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Zhang Z. Resting-state functional abnormalities in ischemic stroke: a meta-analysis of fMRI studies. Brain Imaging Behav 2024:10.1007/s11682-024-00919-1. [PMID: 39245741 DOI: 10.1007/s11682-024-00919-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2024] [Indexed: 09/10/2024]
Abstract
Ischemic stroke is a leading neurological cause of severe disabilities and death in the world and has a major negative impact on patients' quality of life. However, the neural mechanism of spontaneous fluctuating neuronal activity remains unclear. This meta-analysis explored brain activity during resting state in patients with ischemic stroke including 22 studies of regional homogeneity, amplitude of low-frequency fluctuation, and fractional amplitude of low-frequency fluctuation (692 patients with ischemic stroke, 620 healthy controls, age range 35-80 years, 41% female, 175 foci). Results showed decreased regional activity in the bilateral caudate and thalamus and increased regional activity in the left superior occipital gyrus and left default mode network (precuneus/posterior cingulate cortex). Meta-analysis of the amplitude of low-frequency fluctuation studies showed that increased activity in the left inferior frontal gyrus was reduced across the progression from acute to chronic phases. These findings may indicate that disruption of the subcortical areas and default mode network could be one of the core functional abnormalities in ischemic stroke. Altered brain activity in the inferior frontal gyrus could be the imaging indicator of brain recovery/plasticity after stroke damage, which offers potential insight into developing prediction models and therapeutic strategies for ischemic stroke rehabilitation and recovery.
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Affiliation(s)
- Zheng Zhang
- Department of Neurology, Yale University, 333 Cedar Street, New Haven, CT, 06520, USA.
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2
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Katsurayama M, Silva LS, de Campos BM, Avelar WM, Cendes F, Yasuda CL. Disruption of Resting-State Functional Connectivity in Acute Ischemic Stroke: Comparisons Between Right and Left Hemispheric Insults. Brain Topogr 2024; 37:881-888. [PMID: 38302770 DOI: 10.1007/s10548-024-01033-7] [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: 10/29/2022] [Accepted: 01/01/2024] [Indexed: 02/03/2024]
Abstract
Few resting-state functional magnetic resonance imaging (RS-fMRI) studies evaluated the impact of acute ischemic changes on cerebral functional connectivity (FC) and its relationship with functional outcomes after acute ischemic stroke (AIS), considering the side of lesions. To characterize alterations of FC of patients with AIS by analyzing 12 large-scale brain networks (NWs) with RS-fMRI. Additionally, we evaluated the impact of the side (right (RH) or left (LH) hemisphere) of insult on the disruption of brain NWs. 38 patients diagnosed with AIS (17 RH and 21 LH) who performed 3T MRI scans up to 72 h after stroke were compared to 44 healthy controls. Images were processed and analyzed with the software toolbox UF2C with SPM12. For the first level, we generated individual matrices based on the time series extraction from 70 regions of interest (ROIs) from 12 functional NWs, constructing Pearson's cross-correlation; the second-level analysis included an analysis of covariance (ANCOVA) to investigate differences between groups. The statistical significance was determined with p < 0.05, after correction for multiple comparisons with false discovery rate (FDR) correction. Overall, individuals with LH insults developed poorer clinical outcomes after six months. A widespread pattern of lower FC was observed in the presence of LH insults, while a contralateral pattern of increased FC was identified in the group with RH insults. Our findings suggest that LH stroke causes a severe and widespread pattern of reduction of brain networks' FC, presumably related to the impairment in their long-term recovery.
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Affiliation(s)
- Marilise Katsurayama
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil
| | - Lucas Scárdua Silva
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil
| | - Brunno Machado de Campos
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil
| | - Wagner Mauad Avelar
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil
| | - Fernando Cendes
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil
| | - Clarissa Lin Yasuda
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil.
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Fruhwirth V, Berger L, Gattringer T, Fandler-Höfler S, Kneihsl M, Eppinger S, Ropele S, Fink A, Deutschmann H, Reishofer G, Enzinger C, Pinter D. White matter integrity and functional connectivity of the default mode network in acute stroke are associated with cognitive outcome three months post-stroke. J Neurol Sci 2024; 462:123071. [PMID: 38850772 DOI: 10.1016/j.jns.2024.123071] [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: 03/21/2024] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Knowledge about factors that are associated with post-stroke cognitive outcome is important to identify patients with high risk for impairment. We therefore investigated the associations of white matter integrity and functional connectivity (FC) within the brain's default-mode network (DMN) in acute stroke patients with cognitive outcome three months post-stroke. METHODS Patients aged between 18 and 85 years with an acute symptomatic MRI-proven unilateral ischemic middle cerebral artery infarction, who had received reperfusion therapy, were invited to participate in this longitudinal study. All patients underwent brain MRI within 24-72 h after symptom onset, and participated in a neuropsychological assessment three months post-stroke. We performed hierarchical regression analyses to explore the incremental value of baseline white matter integrity and FC beyond demographic, clinical, and macrostructural information for cognitive outcome. RESULTS The study cohort comprised 34 patients (mean age: 64 ± 12 years, 35% female). The initial median National Institutes of Health Stroke Scale (NIHSS) score was 10, and significantly improved three months post-stroke to a median NIHSS = 1 (p < .001). Nonetheless, 50% of patients showed cognitive impairment three months post-stroke. FC of the non-lesioned anterior cingulate cortex of the affected hemisphere explained 15% of incremental variance for processing speed (p = .007), and fractional anisotropy of the non-lesioned cingulum of the affected hemisphere explained 13% of incremental variance for cognitive flexibility (p = .033). CONCLUSIONS White matter integrity and functional MRI markers of the DMN in acute stroke explain incremental variance for post-stroke cognitive outcome beyond demographic, clinical, and macrostructural information.
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Affiliation(s)
- Viktoria Fruhwirth
- Department of Neurology, Medical University of Graz, Graz, Austria; Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria; Institute of Psychology, Department of Biological Psychology, University of Graz, Graz, Austria
| | - Lisa Berger
- Institute of Psychology, Department of Neuropsychology - Neuroimaging, University of Graz, Graz, Austria
| | - Thomas Gattringer
- Department of Neurology, Medical University of Graz, Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | | | - Markus Kneihsl
- Department of Neurology, Medical University of Graz, Graz, Austria
| | | | - Stefan Ropele
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Andreas Fink
- Institute of Psychology, Department of Biological Psychology, University of Graz, Graz, Austria
| | - Hannes Deutschmann
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Gernot Reishofer
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Christian Enzinger
- Department of Neurology, Medical University of Graz, Graz, Austria; Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Daniela Pinter
- Department of Neurology, Medical University of Graz, Graz, Austria; Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria.
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Dahms C, Noll A, Wagner F, Schmidt A, Brodoehl S, Klingner CM. Connecting the dots: Motor and default mode network crossroads in post-stroke motor learning deficits. Neuroimage Clin 2024; 42:103601. [PMID: 38579595 PMCID: PMC11004993 DOI: 10.1016/j.nicl.2024.103601] [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: 08/31/2023] [Revised: 03/20/2024] [Accepted: 04/01/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Strokes frequently result in long-term motor deficits, imposing significant personal and economic burdens. However, our understanding of the underlying neural mechanisms governing motor learning in stroke survivors remains limited - a fact that poses significant challenges to the development and optimisation of therapeutic strategies. OBJECTIVE This study investigates the diversity in motor learning aptitude and its associated neurological mechanisms. We hypothesised that stroke patients exhibit compromised overall motor learning capacity, which is associated with altered activity and connectivity patterns in the motor- and default-mode-network in the brain. METHODS We assessed a cohort of 40 chronic-stage, mildly impaired stroke survivors and 39 age-matched healthy controls using functional Magnetic Resonance Imaging (fMRI) and connectivity analyses. We focused on neural activity and connectivity patterns during an unilateral motor sequence learning task performed with the unimpaired or non-dominant hand. Primary outcome measures included task-induced changes in neural activity and network connectivity. RESULTS Compared to controls, stroke patients showed significantly reduced motor learning capacity, associated with diminished cerebral lateralization. Task induced activity modulation was reduced in the motor network but increased in the default mode network. The modulated activation strength was associated with an opposing trend in task-induced functional connectivity, with increased connectivity in the motor network and decreased connectivity in the DMN. CONCLUSIONS Stroke patients demonstrate altered neural activity and connectivity patterns during motor learning with their unaffected hand, potentially contributing to globally impaired motor learning skills. The reduced ability to lateralize cerebral activation, along with the enhanced connectivity between the right and left motor cortices in these patients, may signify maladaptive neural processes that impede motor adaptation, possibly affecting long-term rehabilitation post-stroke. The contrasting pattern of activity modulation and connectivity alteration in the default mode network suggests a nuanced role of this network in post-stroke motor learning. These insights could have significant implications for the development of customised rehabilitation strategies for stroke patients.
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Affiliation(s)
- Christiane Dahms
- Department of Neurology, Jena University Hospital, Germany; Biomagnetic Center, Jena University Hospital, Germany.
| | - Alexander Noll
- Department of Neurology, Jena University Hospital, Germany; Biomagnetic Center, Jena University Hospital, Germany
| | - Franziska Wagner
- Department of Neurology, Jena University Hospital, Germany; Biomagnetic Center, Jena University Hospital, Germany
| | - Alexander Schmidt
- Department of Neurology, Jena University Hospital, Germany; Biomagnetic Center, Jena University Hospital, Germany
| | - Stefan Brodoehl
- Department of Neurology, Jena University Hospital, Germany; Biomagnetic Center, Jena University Hospital, Germany
| | - Carsten M Klingner
- Department of Neurology, Jena University Hospital, Germany; Biomagnetic Center, Jena University Hospital, Germany
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5
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Brownsett SLE, Carey LM, Copland D, Walsh A, Sihvonen AJ. Structural brain networks correlating with poststroke cognition. Hum Brain Mapp 2024; 45:e26665. [PMID: 38520376 PMCID: PMC10960554 DOI: 10.1002/hbm.26665] [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: 12/20/2023] [Revised: 03/03/2024] [Accepted: 03/08/2024] [Indexed: 03/25/2024] Open
Abstract
Cognitive deficits are a common and debilitating consequence of stroke, yet our understanding of the structural neurobiological biomarkers predicting recovery of cognition after stroke remains limited. In this longitudinal observational study, we set out to investigate the effect of both focal lesions and structural connectivity on poststroke cognition. Sixty-two patients with stroke underwent advanced brain imaging and cognitive assessment, utilizing the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE), at 3-month and 12-month poststroke. We first evaluated the relationship between lesions and cognition at 3 months using voxel-based lesion-symptom mapping. Next, a novel correlational tractography approach, using multi-shell diffusion-weighted magnetic resonance imaging (MRI) data collected at both time points, was used to evaluate the relationship between the white matter connectome and cognition cross-sectionally at 3 months, and longitudinally (12 minus 3 months). Lesion-symptom mapping did not yield significant findings. In turn, correlational tractography analyses revealed positive associations between both MoCA and MMSE scores and bilateral cingulum and the corpus callosum, both cross-sectionally at the 3-month stage, and longitudinally. These results demonstrate that rather than focal neural structures, a consistent structural connectome underpins the performance of two frequently used cognitive screening tools, the MoCA and the MMSE, in people after stroke. This finding should encourage clinicians and researchers to not only suspect cognitive decline when lesions affect these tracts, but also to refine their investigation of novel approaches to differentially diagnosing pathology associated with cognitive decline, regardless of the aetiology.
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Affiliation(s)
- Sonia L. E. Brownsett
- Centre of Research Excellence in Aphasia Recovery and RehabilitationLa Trobe UniversityMelbourneVictoriaAustralia
- Queensland Aphasia Research CentreSurgical, Treatment and Rehabilitation Service, University of QueenslandBrisbaneQueenslandAustralia
- School of Health and Rehabilitation SciencesUniversity of QueenslandBrisbaneQueenslandAustralia
| | - Leeanne M. Carey
- Occupational Therapy, School of Allied Health Human Services and SportLa Trobe UniversityMelbourneVictoriaAustralia
- Neurorehabilitation and Recovery GroupThe FloreyMelbourneVictoriaAustralia
| | - David Copland
- Centre of Research Excellence in Aphasia Recovery and RehabilitationLa Trobe UniversityMelbourneVictoriaAustralia
- Queensland Aphasia Research CentreSurgical, Treatment and Rehabilitation Service, University of QueenslandBrisbaneQueenslandAustralia
- School of Health and Rehabilitation SciencesUniversity of QueenslandBrisbaneQueenslandAustralia
| | - Alistair Walsh
- Occupational Therapy, School of Allied Health Human Services and SportLa Trobe UniversityMelbourneVictoriaAustralia
- Neurorehabilitation and Recovery GroupThe FloreyMelbourneVictoriaAustralia
| | - Aleksi J. Sihvonen
- Centre of Research Excellence in Aphasia Recovery and RehabilitationLa Trobe UniversityMelbourneVictoriaAustralia
- Queensland Aphasia Research CentreSurgical, Treatment and Rehabilitation Service, University of QueenslandBrisbaneQueenslandAustralia
- School of Health and Rehabilitation SciencesUniversity of QueenslandBrisbaneQueenslandAustralia
- Centre of Excellence in Music, Mind, Body and Brain, Cognitive Brain Research Unit (CBRU)University of HelsinkiHelsinkiFinland
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Șerban CA, Barborică A, Roceanu AM, Mîndruță IR, Ciurea J, Stancu M, Pâslaru AC, Zăgrean AM, Zăgrean L, Moldovan M. Towards an electroencephalographic measure of awareness based on the reactivity of oscillatory macrostates to hearing a subject's own name. Eur J Neurosci 2024; 59:771-785. [PMID: 37675619 DOI: 10.1111/ejn.16138] [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: 10/12/2022] [Revised: 08/09/2023] [Accepted: 08/16/2023] [Indexed: 09/08/2023]
Abstract
We proposed that the brain's electrical activity is composed of a sequence of alternating states with repeating topographic spectral distributions on scalp electroencephalogram (EEG), referred to as oscillatory macrostates. The macrostate showing the largest decrease in the probability of occurrence, measured as a percentage (reactivity), during sensory stimulation was labelled as the default EEG macrostate (DEM). This study aimed to assess the influence of awareness on DEM reactivity (DER). We included 11 middle cerebral artery ischaemic stroke patients with impaired awareness having a median Glasgow Coma Scale (GCS) of 6/15 and a group of 11 matched healthy controls. EEG recordings were carried out during auditory 1 min stimulation epochs repeating either the subject's own name (SON) or the SON in reverse (rSON). The DEM was identified across three SON epochs alternating with three rSON epochs. Compared with the patients, the DEM of controls contained more posterior theta activity reflecting source dipoles that could be mapped in the posterior cingulate cortex. The DER was measured from the 1 min quiet baseline preceding each stimulation epoch. The difference in mean DER between the SON and rSON epochs was measured by the salient EEG reactivity (SER) theoretically ranging from -100% to 100%. The SER was 12.4 ± 2.7% (Mean ± standard error of the mean) in controls and only 1.3 ± 1.9% in the patient group (P < 0.01). The patient SER decreased with the Glasgow Coma Scale. Our data suggest that awareness increases DER to SON as measured by SER.
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Affiliation(s)
- Cosmin-Andrei Șerban
- Physics Department, University of Bucharest, Bucharest, Romania
- Termobit Prod SRL, Bucharest, Romania
- FHC Inc, Bowdoin, Maine, USA
| | - Andrei Barborică
- Physics Department, University of Bucharest, Bucharest, Romania
- Termobit Prod SRL, Bucharest, Romania
- FHC Inc, Bowdoin, Maine, USA
| | | | | | - Jan Ciurea
- Department of Neurosurgery, Bagdasar-Arseni Emergency Hospital, Bucharest, Romania
| | - Mihai Stancu
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Division of Neurobiology, Faculty of Biology, Ludwig Maximilian University, Munich, Germany
| | - Alexandru C Pâslaru
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ana-Maria Zăgrean
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Leon Zăgrean
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Mihai Moldovan
- Termobit Prod SRL, Bucharest, Romania
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark
- Clinical Neurophysiology and Neurology, Rigshospitalet, Copenhagen, Denmark
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Xu M, Qian L, Wang S, Cai H, Sun Y, Thakor N, Qi X, Sun Y. Brain network analysis reveals convergent and divergent aberrations between mild stroke patients with cortical and subcortical infarcts during cognitive task performing. Front Aging Neurosci 2023; 15:1193292. [PMID: 37484690 PMCID: PMC10358837 DOI: 10.3389/fnagi.2023.1193292] [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: 03/24/2023] [Accepted: 06/09/2023] [Indexed: 07/25/2023] Open
Abstract
Although consistent evidence has revealed that cognitive impairment is a common sequela in patients with mild stroke, few studies have focused on it, nor the impact of lesion location on cognitive function. Evidence on the neural mechanisms underlying the effects of mild stroke and lesion location on cognitive function is limited. This prompted us to conduct a comprehensive and quantitative study of functional brain network properties in mild stroke patients with different lesion locations. Specifically, an empirical approach was introduced in the present work to explore the impact of mild stroke-induced cognitive alterations on functional brain network reorganization during cognitive tasks (i.e., visual and auditory oddball). Electroencephalogram functional connectivity was estimated from three groups (i.e., 40 patients with cortical infarctions, 48 patients with subcortical infarctions, and 50 healthy controls). Using graph theoretical analysis, we quantitatively investigated the topological reorganization of functional brain networks at both global and nodal levels. Results showed that both patient groups had significantly worse behavioral performance on both tasks, with significantly longer reaction times and reduced response accuracy. Furthermore, decreased global and local efficiency were found in both patient groups, indicating a mild stroke-related disruption in information processing efficiency that is independent of lesion location. Regarding the nodal level, both divergent and convergent node strength distribution patterns were revealed between both patient groups, implying that mild stroke with different lesion locations would lead to complex regional alterations during visual and auditory information processing, while certain robust cognitive processes were independent of lesion location. These findings provide some of the first quantitative insights into the complex neural mechanisms of mild stroke-induced cognitive impairment and extend our understanding of underlying alterations in cognition-related brain networks induced by different lesion locations, which may help to promote post-stroke management and rehabilitation.
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Affiliation(s)
- Mengru Xu
- Key Laboratory for Biomedical Engineering of Ministry of Education of China, Department of Biomedical Engineering, Zhejiang University, Hangzhou, China
| | - Linze Qian
- Key Laboratory for Biomedical Engineering of Ministry of Education of China, Department of Biomedical Engineering, Zhejiang University, Hangzhou, China
| | - Sujie Wang
- Key Laboratory for Biomedical Engineering of Ministry of Education of China, Department of Biomedical Engineering, Zhejiang University, Hangzhou, China
| | - Huaying Cai
- Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yi Sun
- Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Nitish Thakor
- Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
| | - Xuchen Qi
- Department of Neurosurgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Neurosurgery, Shaoxing People's Hospital, Shaoxing, China
| | - Yu Sun
- Key Laboratory for Biomedical Engineering of Ministry of Education of China, Department of Biomedical Engineering, Zhejiang University, Hangzhou, China
- Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- State Key Laboratory of Brain-Machine Intelligence, Zhejiang University, Hangzhou, China
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8
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Zhang X, Zhang G, Wang Y, Huang H, Li H, Li M, Yang C, Li M, Chen H, Jing B, Lin S. Alteration of default mode network: association with executive dysfunction in frontal glioma patients. J Neurosurg 2023; 138:1512-1521. [PMID: 36242576 DOI: 10.3171/2022.8.jns22591] [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: 03/13/2022] [Accepted: 08/15/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Patients with frontal gliomas often experience executive dysfunction (EF-D) before surgery, and the changes in brain plasticity underlying this effect remain obscure. In this study, the authors aimed to assess whole-brain structural and functional alterations by using structural MRI and resting-state functional MRI (rs-fMRI) in frontal glioma patients with or without EF-D. METHODS Fifty-seven patients with frontal gliomas were admitted prospectively to the authors' institution and assigned to one of two groups: 1) the normal executive function (EF-N) group and 2) the EF-D group, based on patient results for the Trail Making Test, Part B and Stroop Color-Word Test, Part C. Twenty-nine baseline-matched healthy controls were also recruited. All participants underwent multimodal MRI examination. Cortical surface thickness, surface-based resting-state activity (fractional amplitude of low-frequency fluctuation [fALFF] and regional homogeneity [ReHo]), and edge-based network functional connectivity (FC) were measured with FreeSurfer and fMRIPrep. The correlation between altered MRI parameters and executive function (EF) was assessed using Pearson correlation and receiver operating characteristic (ROC) analysis. RESULTS Demographic characteristics (sex, age, and education level) and clinical characteristics (location, volume, grade of tumor, and preoperative epilepsy) were not significantly different between the groups, but the Karnofsky Performance Scale score was worse in the EF-D group. There was no significant difference in cortical surface thickness between the EF-D and EF-N groups. In both low-grade and high-grade glioma patients the fALFF value (permutation test + threshold-free cluster enhancement, p value after family-wise error correction < 0.05) and ReHo value (t-test, p < 0.001) of the left precuneus cortex in the EF-D group were greater than those in the EF-N group, which were negatively correlated with EF (p < 0.05) and enabled prediction of EF (area under the ROC curve 0.826 for fALFF and 0.855 for ReHo, p < 0.001). Compared with the EF-N group, the FCs between the default mode network (DMN) from DMN node to DMN node (DMN-DMN) and from the DMN to the central executive network (DMN-CEN) in the EF-D group were increased significantly (network-based statistics corrected p < 0.05) and negatively correlated with EF (Pearson correlation, p < 0.05). CONCLUSIONS Apart from local disruption, the abnormally activated DMN in the resting state is related to EF-D in frontal glioma patients. DMN activity should be considered during preoperative planning and postoperative neurorehabilitation for frontal glioma patients to preserve EF. Clinical trial registration no.: NCT03087838 (ClinicalTrials.gov).
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Affiliation(s)
- Xiaokang Zhang
- 1Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing Tiantan Hospital, Capital Medical University
- 3Beijing Key Laboratory of Brain Tumor, Beijing Tiantan Hospital, Capital Medical University
| | - Guobin Zhang
- 1Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing Tiantan Hospital, Capital Medical University
- 4Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University
| | - Yonggang Wang
- 1Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing Tiantan Hospital, Capital Medical University
- 4Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University
| | | | - Haoyi Li
- 1Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing Tiantan Hospital, Capital Medical University
- 3Beijing Key Laboratory of Brain Tumor, Beijing Tiantan Hospital, Capital Medical University
| | - Mingxiao Li
- 1Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing Tiantan Hospital, Capital Medical University
- 3Beijing Key Laboratory of Brain Tumor, Beijing Tiantan Hospital, Capital Medical University
| | - Chuanwei Yang
- 1Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing Tiantan Hospital, Capital Medical University
- 3Beijing Key Laboratory of Brain Tumor, Beijing Tiantan Hospital, Capital Medical University
| | - Ming Li
- 1Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing Tiantan Hospital, Capital Medical University
- 3Beijing Key Laboratory of Brain Tumor, Beijing Tiantan Hospital, Capital Medical University
| | - Hongyan Chen
- 6Department of Radiology, Beijing Tiantan Hospital, Capital Medical University; and
| | - Bin Jing
- 7School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Song Lin
- 1Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing Tiantan Hospital, Capital Medical University
- 4Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University
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9
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Li Y, Yu Z, Zhou X, Wu P, Chen J. Aberrant interhemispheric functional reciprocities of the default mode network and motor network in subcortical ischemic stroke patients with motor impairment: A longitudinal study. Front Neurol 2022; 13:996621. [PMID: 36267883 PMCID: PMC9577250 DOI: 10.3389/fneur.2022.996621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of the present study was to explore the longitudinal changes in functional homotopy in the default mode network (DMN) and motor network and its relationships with clinical characteristics in patients with stroke. Methods Resting-state functional magnetic resonance imaging was performed in stroke patients with subcortical ischemic lesions and healthy controls. The voxel-mirrored homotopic connectivity (VMHC) method was used to examine the differences in functional homotopy in patients with stroke between the two time points. Support vector machine (SVM) and correlation analyses were also applied to investigate whether the detected significant changes in VMHC were the specific feature in patients with stroke. Results The patients with stroke had significantly lower VMHC in the DMN and motor-related regions than the controls, including in the precuneus, parahippocampus, precentral gyrus, supplementary motor area, and middle frontal gyrus. Longitudinal analysis revealed that the impaired VMHC of the superior precuneus showed a significant increase at the second time point, which was no longer significantly different from the controls. Between the two time points, the changes in VMHC in the superior precuneus were significantly correlated with the changes in clinical scores. SVM analysis revealed that the VMHC of the superior precuneus could be used to correctly identify the patients with stroke from the controls with a statistically significant accuracy of 81.25% (P ≤ 0.003). Conclusions Our findings indicated that the increased VMHC in the superior precuneus could be regarded as the neuroimaging manifestation of functional recovery. The significant correlation and the discriminative power in classification results might provide novel evidence to understand the neural mechanisms responsible for brain reorganization after stroke.
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Affiliation(s)
- Yongxin Li
- School of Traditional Chinese Medicine, Formula-Pattern Research Center, Jinan University, Guangzhou, China
- *Correspondence: Yongxin Li
| | - Zeyun Yu
- Acupuncture and Tuina School/Tird Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xuan Zhou
- School of Traditional Chinese Medicine, Formula-Pattern Research Center, Jinan University, Guangzhou, China
| | - Ping Wu
- Acupuncture and Tuina School/Tird Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Ping Wu
| | - Jiaxu Chen
- School of Traditional Chinese Medicine, Formula-Pattern Research Center, Jinan University, Guangzhou, China
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10
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Li Y, Yu Z, Wu P, Chen J. Ability of an altered functional coupling between resting-state networks to predict behavioral outcomes in subcortical ischemic stroke: A longitudinal study. Front Aging Neurosci 2022; 14:933567. [PMID: 36185473 PMCID: PMC9520312 DOI: 10.3389/fnagi.2022.933567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/16/2022] [Indexed: 11/22/2022] Open
Abstract
Stroke can be viewed as an acute disruption of an individual's connectome caused by a focal or widespread loss of blood flow. Although individuals exhibit connectivity changes in multiple functional networks after stroke, the neural mechanisms that underlie the longitudinal reorganization of the connectivity patterns are still unclear. The study aimed to determine whether brain network connectivity patterns after stroke can predict longitudinal behavioral outcomes. Nineteen patients with stroke with subcortical lesions underwent two sessions of resting-state functional magnetic resonance imaging scanning at a 1-month interval. By independent component analysis, the functional connectivity within and between multiple brain networks (including the default mode network, the dorsal attention network, the limbic network, the visual network, and the frontoparietal network) was disrupted after stroke and partial recovery at the second time point. Additionally, regression analyses revealed that the connectivity between the limbic and dorsal attention networks at the first time point showed sufficient reliability in predicting the clinical scores (Fugl-Meyer Assessment and Neurological Deficit Scores) at the second time point. The overall findings suggest that functional coupling between the dorsal attention and limbic networks after stroke can be regarded as a biomarker to predict longitudinal clinical outcomes in motor function and the degree of neurological functional deficit. Overall, the present study provided a novel opportunity to improve prognostic ability after subcortical strokes.
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Affiliation(s)
- Yongxin Li
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Zeyun Yu
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ping Wu
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiaxu Chen
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
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11
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The distinct disrupted plasticity in structural and functional network in mild stroke with basal ganglia region infarcts. Brain Imaging Behav 2022; 16:2199-2219. [DOI: 10.1007/s11682-022-00689-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 12/20/2022]
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12
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Miao G, Rao B, Wang S, Fang P, Chen Z, Chen L, Zhang X, Zheng J, Xu H, Liao W. Decreased Functional Connectivities of Low-Degree Level Rich Club Organization and Caudate in Post-stroke Cognitive Impairment Based on Resting-State fMRI and Radiomics Features. Front Neurosci 2022; 15:796530. [PMID: 35250435 PMCID: PMC8890030 DOI: 10.3389/fnins.2021.796530] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 12/31/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundStroke is an important cause of cognitive impairment. Rich club organization, a highly interconnected network brain core region, is closely related to cognition. We hypothesized that the disturbance of rich club organization exists in patients with post-stroke cognitive impairment (PSCI).MethodsWe collected data on resting-state functional magnetic resonance imaging (rs-fMRI) with 21 healthy controls (HC), 16 hemorrhagic stroke (hPSCI), and 21 infarct stroke (iPSCI). 3D shape features and first-order statistics of stroke lesions were extracted using 3D slicer software. Additionally, we assessed cognitive function using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE).ResultsNormalized rich club coefficients were higher in hPSCI and iPSCI than HC at low-degree k-levels (k = 1–8 in iPSCI, k = 2–8 in hPSCI). Feeder and local connections were significantly decreased in PSCI patients versus HC, mainly distributed in salience network (SN), default-mode network (DMN), cerebellum network (CN), and orbitofrontal cortex (ORB), especially involving the right and left caudate with changed nodal efficiency. The feeder and local connections of significantly between-group difference were positively related to MMSE and MoCA scores, primarily distributed in the sensorimotor network (SMN) and visual network (VN) in hPSCI, SN, and DMN in iPSCI. Additionally, decreased local connections and low-degree ϕnorm(k) were correlated to 3D shape features and first-order statistics of stroke lesions.ConclusionThis study reveals the disrupted low-degree level rich club organization and relatively preserved functional core network in PSCI patients. Decreased feeder and local connections in cognition-related networks (DMN, SN, CN, and ORB), particularly involving the caudate nucleus, may offer insight into pathological mechanism of PSCI patients. The shape and signal features of stroke lesions may provide an essential clue for the damage of functional connectivity and the whole brain networks.
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Affiliation(s)
- Guofu Miao
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Bo Rao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Sirui Wang
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Pinyan Fang
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Radiology, TEDA International Cardiovascular Hospital, Tianjin, China
| | - Zhuo Chen
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Linglong Chen
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xin Zhang
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jun Zheng
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
- *Correspondence: Haibo Xu,
| | - Weijing Liao
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Weijing Liao,
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13
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Poststroke Cognitive Impairment Research Progress on Application of Brain-Computer Interface. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9935192. [PMID: 35252458 PMCID: PMC8896931 DOI: 10.1155/2022/9935192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 12/20/2021] [Accepted: 12/23/2021] [Indexed: 12/19/2022]
Abstract
Brain-computer interfaces (BCIs), a new type of rehabilitation technology, pick up nerve cell signals, identify and classify their activities, and convert them into computer-recognized instructions. This technique has been widely used in the rehabilitation of stroke patients in recent years and appears to promote motor function recovery after stroke. At present, the application of BCI in poststroke cognitive impairment is increasing, which is a common complication that also affects the rehabilitation process. This paper reviews the promise and potential drawbacks of using BCI to treat poststroke cognitive impairment, providing a solid theoretical basis for the application of BCI in this area.
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14
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Jaywant A, DelPonte L, Kanellopoulos D, O'Dell MW, Gunning FM. The Structural and Functional Neuroanatomy of Post-Stroke Depression and Executive Dysfunction: A Review of Neuroimaging Findings and Implications for Treatment. J Geriatr Psychiatry Neurol 2022; 35:3-11. [PMID: 33073704 DOI: 10.1177/0891988720968270] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Post-stroke depression and executive dysfunction co-occur and are highly debilitating. Few treatments alleviate both depression and executive dysfunction after stroke. Understanding the brain network changes underlying post-stroke depression with executive dysfunction can inform the development of targeted and efficacious treatment. In this review, we synthesize neuroimaging findings in post-stroke depression and post-stroke executive dysfunction and highlight the network commonalities that may underlie this comorbidity. Structural and functional alterations in the cognitive control network, salience network, and default mode network are associated with depression and executive dysfunction after stroke. Specifically, post-stroke depression and executive dysfunction are both linked to changes in intrinsic functional connectivity within resting state networks, functional over-connectivity between the default mode and salience/cognitive control networks, and reduced cross-hemispheric frontoparietal functional connectivity. Cognitive training and noninvasive brain stimulation targeted at these brain network abnormalities and specific clinical phenotypes may help advance treatment for post-stroke depression with executive dysfunction.
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Affiliation(s)
- Abhishek Jaywant
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA.,Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, NY, USA.,NewYork-Presbyterian Hospital, New York, NY, USA
| | - Larissa DelPonte
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - Dora Kanellopoulos
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA.,NewYork-Presbyterian Hospital, New York, NY, USA.,Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY, USA
| | - Michael W O'Dell
- Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, NY, USA.,NewYork-Presbyterian Hospital, New York, NY, USA
| | - Faith M Gunning
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA.,NewYork-Presbyterian Hospital, New York, NY, USA.,Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY, USA
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15
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Serban CA, Barborica A, Roceanu AM, Mindruta I, Ciurea J, Pâslaru AC, Zăgrean AM, Zăgrean L, Moldovan M. A method to assess the default EEG macrostate and its reactivity to stimulation. Clin Neurophysiol 2021; 134:50-64. [PMID: 34973517 DOI: 10.1016/j.clinph.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 08/23/2021] [Accepted: 12/04/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The default mode network (DMN) is deactivated by stimulation. We aimed to assess the DMN reactivity impairment by routine EEG recordings in stroke patients with impaired consciousness. METHODS Binocular light flashes were delivered at 1 Hz in 1-minute epochs, following a 1-minute baseline (PRE). The EEG was decomposed in a series of binary oscillatory macrostates by topographic spectral clustering. The most deactivated macrostate was labeled the default EEG macrostate (DEM). Its reactivity (DER) was quantified as the decrease in DEM occurrence probability during stimulation. A normalized DER index (DERI) was calculated as DER/PRE. The measures were compared between 14 healthy controls and 32 comatose patients under EEG monitoring following an acute stroke. RESULTS The DEM was mapped to the posterior DMN hubs. In the patients, these DEM source dipoles were 3-4 times less frequent and were associated with an increased theta activity. Even in a reduced 6-channel montage, a DER below 6.26% corresponding to a DERI below 0.25 could discriminate the patients with sensitivity and specificity well above 80%. CONCLUSION The method detected the DMN impairment in post-stroke coma patients. SIGNIFICANCE The DEM and its reactivity to stimulation could be useful to monitor the DMN function at bedside.
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Affiliation(s)
- Cosmin-Andrei Serban
- Physics Department, University of Bucharest, Romania; Termobit Prod SRL, Bucharest, Romania; FHC Inc, Bowdoin, ME, USA.
| | - Andrei Barborica
- Physics Department, University of Bucharest, Romania; Termobit Prod SRL, Bucharest, Romania; FHC Inc, Bowdoin, ME, USA.
| | | | - Ioana Mindruta
- Neurology Department, University Emergency Hospital, Bucharest, Romania.
| | - Jan Ciurea
- Department of Neurosurgery, Bagdasar-Arseni Emergency Hospital, Bucharest, Romania.
| | - Alexandru C Pâslaru
- Division of Physiology and Neuroscience, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Ana-Maria Zăgrean
- Division of Physiology and Neuroscience, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Leon Zăgrean
- Division of Physiology and Neuroscience, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Mihai Moldovan
- Termobit Prod SRL, Bucharest, Romania; Division of Physiology and Neuroscience, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; Neuroscience, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark.
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16
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von Deneen KM. Correlations between cognitive function and gray matter alterations in patients with acute lacunar stroke. BRAIN SCIENCE ADVANCES 2021. [DOI: 10.26599/bsa.2021.9050012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Researchers emphasized acute lacunar stroke (ALS) patients suffer from poor social/physical outcomes, cognitive decline, and decreased quality of life. We hypothesized brain abnormalities may occur in ALS during this particular stage and may be associated with cognitive deficits upon evaluation. We investigated structural abnormalities in ALS using magnetic resonance imaging and voxel-based morphometry conducted on 28 healthy controls (HC) and 29 patients with ALS and proximal anterior circulation occlusion within 12 hours of symptom onset. Mini-Mental State Examination (MMSE) scores were used to evaluate cognitive dysfunction. Decreased gray matter (GM) in ALS vs. HC was predominantly in the superior frontal gyrus, inferior frontal gyrus, insula, superior temporal gyrus (STG), heschl gyrus, middle temporal gyrus (MTG), posterior cingulate cortex (PCC), hippocampus (HIP), and others. Positive correlation was found between GM density and MMSE scores in STG ( r = 0.59, p = 0.0007), MTG ( r = 0.46, p = 0.01), PCC ( r = 0.42, p = 0.02), HIP ( r = 0.4, p = 0.03), and medial prefrontal cortex ( r = 0.5, p = 0.005). This study provided further information on pathophysiological/morphological mechanisms related to cognitive impairment in ALS and is the basis for further studies in aging-related diseases.
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Affiliation(s)
- Karen M. von Deneen
- School of Life Science and Technology, Xidian University, Xi’an 710126, Shaanxi, China
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17
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Lim JS, Lee JJ, Woo CW. Post-Stroke Cognitive Impairment: Pathophysiological Insights into Brain Disconnectome from Advanced Neuroimaging Analysis Techniques. J Stroke 2021; 23:297-311. [PMID: 34649376 PMCID: PMC8521255 DOI: 10.5853/jos.2021.02376] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 09/17/2021] [Indexed: 12/24/2022] Open
Abstract
The neurological symptoms of stroke have traditionally provided the foundation for functional mapping of the brain. However, there are many unresolved aspects in our understanding of cerebral activity, especially regarding high-level cognitive functions. This review provides a comprehensive look at the pathophysiology of post-stroke cognitive impairment in light of recent findings from advanced imaging techniques. Combining network neuroscience and clinical neurology, our research focuses on how changes in brain networks correlate with post-stroke cognitive prognosis. More specifically, we first discuss the general consequences of stroke lesions due to damage of canonical resting-state large-scale networks or changes in the composition of the entire brain. We also review emerging methods, such as lesion-network mapping and gradient analysis, used to study the aforementioned events caused by stroke lesions. Lastly, we examine other patient vulnerabilities, such as superimposed amyloid pathology and blood-brain barrier leakage, which potentially lead to different outcomes for the brain network compositions even in the presence of similar stroke lesions. This knowledge will allow a better understanding of the pathophysiology of post-stroke cognitive impairment and provide a theoretical basis for the development of new treatments, such as neuromodulation.
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Affiliation(s)
- Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Joong Lee
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Korea.,Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea
| | - Choong-Wan Woo
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Korea.,Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea.,Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Korea
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18
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Maniar YM, Peck KK, Jenabi M, Gene M, Holodny AI. Functional MRI Shows Altered Deactivation and a Corresponding Decrease in Functional Connectivity of the Default Mode Network in Patients with Gliomas. AJNR Am J Neuroradiol 2021; 42:1505-1512. [PMID: 33985945 DOI: 10.3174/ajnr.a7138] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 02/19/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE The default mode network normally decreases in activity during externally directed tasks. Although default mode network connectivity is disrupted in numerous brain pathologies, default mode network deactivation has not been studied in patients with brain tumors. We investigated default mode network deactivation with language task-based fMRI by measuring the anticorrelation of a critical default mode network node, the posterior cingulate cortex, in patients with gliomas and controls; furthermore, we examined default mode network functional connectivity in these patients with task-based and resting-state fMRI. MATERIALS AND METHODS In 10 healthy controls and 30 patients with gliomas, the posterior cingulate cortex was identified on task-based fMRI and was used as an ROI to create connectivity maps from task-based and resting-state fMRI data. We compared the average correlation in each default mode network region between patients and controls for each correlation map and stratified patients by tumor location, hemisphere, and grade. RESULTS Patients with gliomas (P = .001) and, in particular, patients with tumors near the posterior default mode network (P < .001) showed less posterior cingulate cortex anticorrelation in task-based fMRI than controls. Patients with both left- and right-hemisphere tumors, as well as those with grade IV tumors, showed significantly lower posterior cingulate cortex anticorrelation than controls (P = .02, .03, and <.001, respectively). Functional connectivity in each default mode network region was not significantly different between task-based and resting-state maps. CONCLUSIONS Task-based fMRI showed impaired deactivation of the default mode network in patients with gliomas. The functional connectivity of the default mode network in both task-based and resting-state fMRI in patients with gliomas using the posterior cingulate cortex identified in task-based fMRI as an ROI for seed-based correlation analysis has strong overlap.
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Affiliation(s)
- Y M Maniar
- From the Department of Radiology (Y.M.M., K.K.P., M.J., M.G., A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - K K Peck
- From the Department of Radiology (Y.M.M., K.K.P., M.J., M.G., A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medical Physics (K.K.P.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - M Jenabi
- From the Department of Radiology (Y.M.M., K.K.P., M.J., M.G., A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - M Gene
- From the Department of Radiology (Y.M.M., K.K.P., M.J., M.G., A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - A I Holodny
- From the Department of Radiology (Y.M.M., K.K.P., M.J., M.G., A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology (A.I.H.), Weill Medical College of Cornell University, New York, New York
- Department of Neuroscience (A.I.H.), Weill-Cornell Graduate School of the Medical Sciences, New York, New York
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19
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Jobson DD, Hase Y, Clarkson AN, Kalaria RN. The role of the medial prefrontal cortex in cognition, ageing and dementia. Brain Commun 2021; 3:fcab125. [PMID: 34222873 PMCID: PMC8249104 DOI: 10.1093/braincomms/fcab125] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 04/08/2021] [Accepted: 04/14/2021] [Indexed: 01/18/2023] Open
Abstract
Humans require a plethora of higher cognitive skills to perform executive functions, such as reasoning, planning, language and social interactions, which are regulated predominantly by the prefrontal cortex. The prefrontal cortex comprises the lateral, medial and orbitofrontal regions. In higher primates, the lateral prefrontal cortex is further separated into the respective dorsal and ventral subregions. However, all these regions have variably been implicated in several fronto-subcortical circuits. Dysfunction of these circuits has been highlighted in vascular and other neurocognitive disorders. Recent advances suggest the medial prefrontal cortex plays an important regulatory role in numerous cognitive functions, including attention, inhibitory control, habit formation and working, spatial or long-term memory. The medial prefrontal cortex appears highly interconnected with subcortical regions (thalamus, amygdala and hippocampus) and exerts top-down executive control over various cognitive domains and stimuli. Much of our knowledge comes from rodent models using precise lesions and electrophysiology readouts from specific medial prefrontal cortex locations. Although, anatomical disparities of the rodent medial prefrontal cortex compared to the primate homologue are apparent, current rodent models have effectively implicated the medial prefrontal cortex as a neural substrate of cognitive decline within ageing and dementia. Human brain connectivity-based neuroimaging has demonstrated that large-scale medial prefrontal cortex networks, such as the default mode network, are equally important for cognition. However, there is little consensus on how medial prefrontal cortex functional connectivity specifically changes during brain pathological states. In context with previous work in rodents and non-human primates, we attempt to convey a consensus on the current understanding of the role of predominantly the medial prefrontal cortex and its functional connectivity measured by resting-state functional MRI in ageing associated disorders, including prodromal dementia states, Alzheimer's disease, post-ischaemic stroke, Parkinsonism and frontotemporal dementia. Previous cross-sectional studies suggest that medial prefrontal cortex functional connectivity abnormalities are consistently found in the default mode network across both ageing and neurocognitive disorders such as Alzheimer's disease and vascular cognitive impairment. Distinct disease-specific patterns of medial prefrontal cortex functional connectivity alterations within specific large-scale networks appear to consistently feature in the default mode network, whilst detrimental connectivity alterations are associated with cognitive impairments independently from structural pathological aberrations, such as grey matter atrophy. These disease-specific patterns of medial prefrontal cortex functional connectivity also precede structural pathological changes and may be driven by ageing-related vascular mechanisms. The default mode network supports utility as a potential biomarker and therapeutic target for dementia-associated conditions. Yet, these associations still require validation in longitudinal studies using larger sample sizes.
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Affiliation(s)
- Dan D Jobson
- Translational and Clinical Research Institute,
Newcastle University, Campus for Ageing & Vitality,
Newcastle upon Tyne NE4 5PL, UK
| | - Yoshiki Hase
- Translational and Clinical Research Institute,
Newcastle University, Campus for Ageing & Vitality,
Newcastle upon Tyne NE4 5PL, UK
| | - Andrew N Clarkson
- Department of Anatomy, Brain Health Research Centre
and Brain Research New Zealand, University of Otago, Dunedin 9054,
New Zealand
| | - Rajesh N Kalaria
- Translational and Clinical Research Institute,
Newcastle University, Campus for Ageing & Vitality,
Newcastle upon Tyne NE4 5PL, UK
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20
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Geva S, Schneider LM, Roberts S, Green DW, Price CJ. The Effect of Focal Damage to the Right Medial Posterior Cerebellum on Word and Sentence Comprehension and Production. Front Hum Neurosci 2021; 15:664650. [PMID: 34093152 PMCID: PMC8172582 DOI: 10.3389/fnhum.2021.664650] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/19/2021] [Indexed: 11/13/2022] Open
Abstract
Functional imaging studies of neurologically intact adults have demonstrated that the right posterior cerebellum is activated during verb generation, semantic processing, sentence processing, and verbal fluency. Studies of patients with cerebellar damage converge to show that the cerebellum supports sentence processing and verbal fluency. However, to date there are no patient studies that investigated the specific importance of the right posterior cerebellum in language processing, because: (i) case studies presented patients with lesions affecting the anterior cerebellum (with or without damage to the posterior cerebellum), and (ii) group studies combined patients with lesions to different cerebellar regions, without specifically reporting the effects of right posterior cerebellar damage. Here we investigated whether damage to the right posterior cerebellum is critical for sentence processing and verbal fluency in four patients with focal stroke damage to different parts of the right posterior cerebellum (all involving Crus II, and lobules VII and VIII). We examined detailed lesion location by going beyond common anatomical definitions of cerebellar anatomy (i.e., according to lobules or vascular territory), and employed a recently proposed functional parcellation of the cerebellum. All four patients experienced language difficulties that persisted for at least a month after stroke but three performed in the normal range within a year. In contrast, one patient with more damage to lobule IX than the other patients had profound long-lasting impairments in the comprehension and repetition of sentences, and the production of spoken sentences during picture description. Spoken and written word comprehension and visual recognition memory were also impaired, however, verbal fluency was within the normal range, together with object naming, visual perception and verbal short-term memory. This is the first study to show that focal damage to the right posterior cerebellum leads to language difficulties after stroke; and that processing impairments persisted in the case with most damage to lobule IX. We discuss these results in relation to current theories of cerebellar contribution to language processing. Overall, our study highlights the need for longitudinal studies of language function in patients with focal damage to different cerebellar regions, with functional imaging to understand the mechanisms that support recovery.
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Affiliation(s)
- Sharon Geva
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
| | - Letitia M Schneider
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom.,Department of Cognition, Emotion and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Sophie Roberts
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
| | - David W Green
- Department of Experimental Psychology, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Cathy J Price
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
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21
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van Meenen LCC, van Stigt MN, Siegers A, Smeekes MD, van Grondelle JAF, Geuzebroek G, Marquering HA, Majoie CBLM, Roos YBWEM, Koelman JHTM, Potters WV, Coutinho JM. Detection of Large Vessel Occlusion Stroke in the Prehospital Setting: Electroencephalography as a Potential Triage Instrument. Stroke 2021; 52:e347-e355. [PMID: 33940955 DOI: 10.1161/strokeaha.120.033053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A reliable and fast instrument for prehospital detection of large vessel occlusion (LVO) stroke would be a game-changer in stroke care, because it would enable direct transportation of LVO stroke patients to the nearest comprehensive stroke center for endovascular treatment. This strategy would substantially improve treatment times and thus clinical outcomes of patients. Here, we outline our view on the requirements of an effective prehospital LVO detection method, namely: high diagnostic accuracy; fast application and interpretation; user-friendliness; compactness; and low costs. We argue that existing methods for prehospital LVO detection, including clinical scales, mobile stroke units and transcranial Doppler, do not fulfill all criteria, hindering broad implementation of these methods. Instead, electroencephalography may be suitable for prehospital LVO detection since in-hospital studies have shown that quantification of hypoxia-induced changes in the electroencephalography signal have good diagnostic accuracy for LVO stroke. Although performing electroencephalography measurements in the prehospital setting comes with challenges, solutions for fast and simple application of this method are available. Currently, the feasibility and diagnostic accuracy of electroencephalography in the prehospital setting are being investigated in clinical trials.
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Affiliation(s)
- Laura C C van Meenen
- Department of Neurology (L.C.C.v.M., Y.B.W.E.M.R., W.V.P., J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Maritta N van Stigt
- Department of Clinical Neurophysiology (M.N.v.S., J.H.T.M.K., W.V.P.), Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Arjen Siegers
- Ambulance Amsterdam, Amsterdam, the Netherlands (A.S., J.A.F.v.G., G.G.)
| | - Martin D Smeekes
- Emergency Medical Services North-Holland North, Alkmaar, the Netherlands (M.D.S.)
| | | | - Geertje Geuzebroek
- Ambulance Amsterdam, Amsterdam, the Netherlands (A.S., J.A.F.v.G., G.G.)
| | - Henk A Marquering
- Department of Biomedical Engineering and Physics (H.A.M.), Amsterdam UMC, University of Amsterdam, the Netherlands.,Department of Radiology and Nuclear Medicine (H.A.M., C.B.L.M.M.), Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Charles B L M Majoie
- Department of Radiology and Nuclear Medicine (H.A.M., C.B.L.M.M.), Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Yvo B W E M Roos
- Department of Neurology (L.C.C.v.M., Y.B.W.E.M.R., W.V.P., J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Johannes H T M Koelman
- Department of Clinical Neurophysiology (M.N.v.S., J.H.T.M.K., W.V.P.), Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Wouter V Potters
- Department of Neurology (L.C.C.v.M., Y.B.W.E.M.R., W.V.P., J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands.,Department of Clinical Neurophysiology (M.N.v.S., J.H.T.M.K., W.V.P.), Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Jonathan M Coutinho
- Department of Neurology (L.C.C.v.M., Y.B.W.E.M.R., W.V.P., J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands
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22
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Kraeutner SN, Rubino C, Rinat S, Lakhani B, Borich MR, Wadden KP, Boyd LA. Resting State Connectivity Is Modulated by Motor Learning in Individuals After Stroke. Neurorehabil Neural Repair 2021; 35:513-524. [PMID: 33825574 PMCID: PMC8135242 DOI: 10.1177/15459683211006713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective Activity patterns across brain regions that can be characterized at rest (ie, resting-state functional connectivity [rsFC]) are disrupted after stroke and linked to impairments in motor function. While changes in rsFC are associated with motor recovery, it is not clear how rsFC is modulated by skilled motor practice used to promote recovery. The current study examined how rsFC is modulated by skilled motor practice after stroke and how changes in rsFC are linked to motor learning. Methods Two groups of participants (individuals with stroke and age-matched controls) engaged in 4 weeks of skilled motor practice of a complex, gamified reaching task. Clinical assessments of motor function and impairment, and brain activity (via functional magnetic resonance imaging) were obtained before and after training. Results While no differences in rsFC were observed in the control group, increased connectivity was observed in the sensorimotor network, linked to learning in the stroke group. Relative to healthy controls, a decrease in network efficiency was observed in the stroke group following training. Conclusions Findings indicate that rsFC patterns related to learning observed after stroke reflect a shift toward a compensatory network configuration characterized by decreased network efficiency.
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Affiliation(s)
| | - Cristina Rubino
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Shie Rinat
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Bimal Lakhani
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Katie P Wadden
- Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Lara A Boyd
- University of British Columbia, Vancouver, British Columbia, Canada
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23
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Lopes R, Bournonville C, Kuchcinski G, Dondaine T, Mendyk AM, Viard R, Pruvo JP, Hénon H, Georgakis MK, Duering M, Dichgans M, Cordonnier C, Leclerc X, Bordet R. Prediction of Long-term Cognitive Function After Minor Stroke Using Functional Connectivity. Neurology 2021; 96:e1167-e1179. [PMID: 33402437 DOI: 10.1212/wnl.0000000000011452] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 09/02/2020] [Accepted: 10/12/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether functional MRI connectivity can predict long-term cognitive function 36 months after minor stroke. METHODS Seventy-two participants with first-ever stroke were included at baseline and followed up for 36 months. A ridge regression machine learning algorithm was developed and used to predict cognitive scores 36 months poststroke on the basis of the functional networks measured using MRI at 6 months (referred to here as the poststroke cognitive impairment [PSCI] network). The prediction accuracy was evaluated in 4 domains (memory, attention/executive, language, and visuospatial functions) and compared with clinical data and other functional networks. The models' statistical significance was probed with permutation tests. The potential involvement of cortical atrophy was assessed 6 months poststroke. A second, independent dataset (n = 40) was used to validate the results and assess their generalizability. RESULTS Based on the PSCI network, a machine learning model was able to predict memory, attention, visuospatial functions, and language functions 36 months poststroke (r 2: 0.67, 0.73, 0.55, and 0.48, respectively). The PSCI-based model was at least as accurate as models based on other functional networks or clinical data. Specific patterns were demonstrated for the 4 cognitive domains, with involvement of the left superior frontal cortex for memory, attention, and visuospatial functions. The cortical thickness 6 months poststroke was not correlated with cognitive function 36 months poststroke. The independent validation dataset gave similar results. CONCLUSIONS A machine learning model based on the PSCI network can predict long-term cognitive outcome after stroke.
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Affiliation(s)
- Renaud Lopes
- From U1172-LilNCog-Lille Neuroscience & Cognition (R.L., C.B., G.K., T.D., A.-M.M., J.-P.P., H.H., C.C., X.L., R.B.) and Institut Pasteur de Lille, US 41-UMS 2014-PLBS, CNRS (R.L., C.B., G.K., R.V., J.-P.P., X.L.), CHU Lille, Inserm, Université de Lille, France; and Institute for Stroke and Dementia Research (M.K.G., M. Duering, M. Dichgans), LMU Munich University Hospital, Germany.
| | - Clément Bournonville
- From U1172-LilNCog-Lille Neuroscience & Cognition (R.L., C.B., G.K., T.D., A.-M.M., J.-P.P., H.H., C.C., X.L., R.B.) and Institut Pasteur de Lille, US 41-UMS 2014-PLBS, CNRS (R.L., C.B., G.K., R.V., J.-P.P., X.L.), CHU Lille, Inserm, Université de Lille, France; and Institute for Stroke and Dementia Research (M.K.G., M. Duering, M. Dichgans), LMU Munich University Hospital, Germany
| | - Grégory Kuchcinski
- From U1172-LilNCog-Lille Neuroscience & Cognition (R.L., C.B., G.K., T.D., A.-M.M., J.-P.P., H.H., C.C., X.L., R.B.) and Institut Pasteur de Lille, US 41-UMS 2014-PLBS, CNRS (R.L., C.B., G.K., R.V., J.-P.P., X.L.), CHU Lille, Inserm, Université de Lille, France; and Institute for Stroke and Dementia Research (M.K.G., M. Duering, M. Dichgans), LMU Munich University Hospital, Germany
| | - Thibaut Dondaine
- From U1172-LilNCog-Lille Neuroscience & Cognition (R.L., C.B., G.K., T.D., A.-M.M., J.-P.P., H.H., C.C., X.L., R.B.) and Institut Pasteur de Lille, US 41-UMS 2014-PLBS, CNRS (R.L., C.B., G.K., R.V., J.-P.P., X.L.), CHU Lille, Inserm, Université de Lille, France; and Institute for Stroke and Dementia Research (M.K.G., M. Duering, M. Dichgans), LMU Munich University Hospital, Germany
| | - Anne-Marie Mendyk
- From U1172-LilNCog-Lille Neuroscience & Cognition (R.L., C.B., G.K., T.D., A.-M.M., J.-P.P., H.H., C.C., X.L., R.B.) and Institut Pasteur de Lille, US 41-UMS 2014-PLBS, CNRS (R.L., C.B., G.K., R.V., J.-P.P., X.L.), CHU Lille, Inserm, Université de Lille, France; and Institute for Stroke and Dementia Research (M.K.G., M. Duering, M. Dichgans), LMU Munich University Hospital, Germany
| | - Romain Viard
- From U1172-LilNCog-Lille Neuroscience & Cognition (R.L., C.B., G.K., T.D., A.-M.M., J.-P.P., H.H., C.C., X.L., R.B.) and Institut Pasteur de Lille, US 41-UMS 2014-PLBS, CNRS (R.L., C.B., G.K., R.V., J.-P.P., X.L.), CHU Lille, Inserm, Université de Lille, France; and Institute for Stroke and Dementia Research (M.K.G., M. Duering, M. Dichgans), LMU Munich University Hospital, Germany
| | - Jean-Pierre Pruvo
- From U1172-LilNCog-Lille Neuroscience & Cognition (R.L., C.B., G.K., T.D., A.-M.M., J.-P.P., H.H., C.C., X.L., R.B.) and Institut Pasteur de Lille, US 41-UMS 2014-PLBS, CNRS (R.L., C.B., G.K., R.V., J.-P.P., X.L.), CHU Lille, Inserm, Université de Lille, France; and Institute for Stroke and Dementia Research (M.K.G., M. Duering, M. Dichgans), LMU Munich University Hospital, Germany
| | - Hilde Hénon
- From U1172-LilNCog-Lille Neuroscience & Cognition (R.L., C.B., G.K., T.D., A.-M.M., J.-P.P., H.H., C.C., X.L., R.B.) and Institut Pasteur de Lille, US 41-UMS 2014-PLBS, CNRS (R.L., C.B., G.K., R.V., J.-P.P., X.L.), CHU Lille, Inserm, Université de Lille, France; and Institute for Stroke and Dementia Research (M.K.G., M. Duering, M. Dichgans), LMU Munich University Hospital, Germany
| | - Marios K Georgakis
- From U1172-LilNCog-Lille Neuroscience & Cognition (R.L., C.B., G.K., T.D., A.-M.M., J.-P.P., H.H., C.C., X.L., R.B.) and Institut Pasteur de Lille, US 41-UMS 2014-PLBS, CNRS (R.L., C.B., G.K., R.V., J.-P.P., X.L.), CHU Lille, Inserm, Université de Lille, France; and Institute for Stroke and Dementia Research (M.K.G., M. Duering, M. Dichgans), LMU Munich University Hospital, Germany
| | - Marco Duering
- From U1172-LilNCog-Lille Neuroscience & Cognition (R.L., C.B., G.K., T.D., A.-M.M., J.-P.P., H.H., C.C., X.L., R.B.) and Institut Pasteur de Lille, US 41-UMS 2014-PLBS, CNRS (R.L., C.B., G.K., R.V., J.-P.P., X.L.), CHU Lille, Inserm, Université de Lille, France; and Institute for Stroke and Dementia Research (M.K.G., M. Duering, M. Dichgans), LMU Munich University Hospital, Germany
| | - Martin Dichgans
- From U1172-LilNCog-Lille Neuroscience & Cognition (R.L., C.B., G.K., T.D., A.-M.M., J.-P.P., H.H., C.C., X.L., R.B.) and Institut Pasteur de Lille, US 41-UMS 2014-PLBS, CNRS (R.L., C.B., G.K., R.V., J.-P.P., X.L.), CHU Lille, Inserm, Université de Lille, France; and Institute for Stroke and Dementia Research (M.K.G., M. Duering, M. Dichgans), LMU Munich University Hospital, Germany
| | - Charlotte Cordonnier
- From U1172-LilNCog-Lille Neuroscience & Cognition (R.L., C.B., G.K., T.D., A.-M.M., J.-P.P., H.H., C.C., X.L., R.B.) and Institut Pasteur de Lille, US 41-UMS 2014-PLBS, CNRS (R.L., C.B., G.K., R.V., J.-P.P., X.L.), CHU Lille, Inserm, Université de Lille, France; and Institute for Stroke and Dementia Research (M.K.G., M. Duering, M. Dichgans), LMU Munich University Hospital, Germany
| | - Xavier Leclerc
- From U1172-LilNCog-Lille Neuroscience & Cognition (R.L., C.B., G.K., T.D., A.-M.M., J.-P.P., H.H., C.C., X.L., R.B.) and Institut Pasteur de Lille, US 41-UMS 2014-PLBS, CNRS (R.L., C.B., G.K., R.V., J.-P.P., X.L.), CHU Lille, Inserm, Université de Lille, France; and Institute for Stroke and Dementia Research (M.K.G., M. Duering, M. Dichgans), LMU Munich University Hospital, Germany
| | - Régis Bordet
- From U1172-LilNCog-Lille Neuroscience & Cognition (R.L., C.B., G.K., T.D., A.-M.M., J.-P.P., H.H., C.C., X.L., R.B.) and Institut Pasteur de Lille, US 41-UMS 2014-PLBS, CNRS (R.L., C.B., G.K., R.V., J.-P.P., X.L.), CHU Lille, Inserm, Université de Lille, France; and Institute for Stroke and Dementia Research (M.K.G., M. Duering, M. Dichgans), LMU Munich University Hospital, Germany
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Vicentini JE, Weiler M, Casseb RF, Almeida SR, Valler L, de Campos BM, Li LM. Subacute functional connectivity correlates with cognitive recovery six months after stroke. NEUROIMAGE-CLINICAL 2020; 29:102538. [PMID: 33385880 PMCID: PMC7779317 DOI: 10.1016/j.nicl.2020.102538] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 11/19/2020] [Accepted: 12/15/2020] [Indexed: 12/27/2022]
Abstract
Stroke disrupts ipsilesional and inter-hemispheric functional connectivity of DMN. Subacute cognition correlated to inter-hemispheric and ipsilesional DMN connectivity. Subacute cognition correlated to weaker contralesional SN connectivity. Functional connectivity remapping was not observed after six months. Cognitive recovery correlated to DMN and SN connectivity from the subacute phase.
Background and purpose Cognitive impairment is a common consequence of stroke, and the rewiring of the surviving brain circuits might contribute to cognitive recovery. Studies investigating how the functional connectivity of networks change across time and whether their remapping relates to cognitive recovery in stroke patients are scarce. We aimed to investigate whether resting-state functional connectivity was associated with cognitive performance in stroke patients and if any alterations in these networks were correlated with cognitive recovery. Methods Using an fMRI ROI-ROI approach, we compared the ipsilesional, contralesional and interhemispheric functional connectivity of three resting-state networks involved in cognition – the Default Mode (DMN), Salience (SN) and Central Executive Networks (CEN), in subacute ischemic stroke patients (time 1, n = 37, stroke onset: 24.32 ± 7.44 days, NIHSS: 2.66 ± 3.45) with cognitively healthy controls (n = 20). Patients were reassessed six months after the stroke event (time 2, n = 20, stroke onset: 182.05 ± 8.17 days) to verify the subsequent reorganization of functional connections and whether such reorganization was associated with cognitive recovery. Results At time 1, patients had weaker interhemispheric connectivity in the DMN than controls; better cognitive performance at time 1 was associated with stronger interhemispheric and ipsilesional DMN connectivity, and weaker contralesional SN connectivity. At time 2, there were no changes in functional connectivity in stroke patients, compared to time 1. Better cognitive recovery measured at time 2 (time 2 – time 1) was associated with stronger functional connectivity in the DMN, and weaker interhemispheric subacute connectivity in the SN, both from time 1. Conclusions Stroke disrupts the functional connectivity of the DMN, not only at the lesioned hemisphere but also between hemispheres. Six months after the stroke event, we could not detect the remapping of networks. Cognitive recovery was associated with the connectivity of both the DMN and SN of time 1. Our findings may be helpful for facilitating further understanding of the potential mechanisms underlying post-stroke cognitive performance.
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Affiliation(s)
- Jéssica Elias Vicentini
- Brazilian Institute of Neuroscience and Neurotechnology - Brainn, Department of Neurology, Faculty of Medical Sciences - University of Campinas (UNICAMP), Brazil
| | - Marina Weiler
- Neurocognitive Aging Section, Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health (NIA/NIH), Intramural Research Program, United States
| | | | - Sara Regina Almeida
- Brazilian Institute of Neuroscience and Neurotechnology - Brainn, Department of Neurology, Faculty of Medical Sciences - University of Campinas (UNICAMP), Brazil
| | - Lenise Valler
- Brazilian Institute of Neuroscience and Neurotechnology - Brainn, Department of Neurology, Faculty of Medical Sciences - University of Campinas (UNICAMP), Brazil
| | - Brunno Machado de Campos
- Brazilian Institute of Neuroscience and Neurotechnology - Brainn, Department of Neurology, Faculty of Medical Sciences - University of Campinas (UNICAMP), Brazil
| | - Li Min Li
- Brazilian Institute of Neuroscience and Neurotechnology - Brainn, Department of Neurology, Faculty of Medical Sciences - University of Campinas (UNICAMP), Brazil.
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Sjøgård M, Wens V, Van Schependom J, Costers L, D'hooghe M, D'haeseleer M, Woolrich M, Goldman S, Nagels G, De Tiège X. Brain dysconnectivity relates to disability and cognitive impairment in multiple sclerosis. Hum Brain Mapp 2020; 42:626-643. [PMID: 33242237 PMCID: PMC7814767 DOI: 10.1002/hbm.25247] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 09/10/2020] [Accepted: 09/29/2020] [Indexed: 12/27/2022] Open
Abstract
The pathophysiology of cognitive dysfunction in multiple sclerosis (MS) is still unclear. This magnetoencephalography (MEG) study investigates the impact of MS on brain resting-state functional connectivity (rsFC) and its relationship to disability and cognitive impairment. We investigated rsFC based on power envelope correlation within and between different frequency bands, in a large cohort of participants consisting of 99 MS patients and 47 healthy subjects. Correlations were investigated between rsFC and outcomes on disability, disease duration and 7 neuropsychological scores within each group, while stringently correcting for multiple comparisons and possible confounding factors. Specific dysconnections correlating with MS-induced physical disability and disease duration were found within the sensorimotor and language networks, respectively. Global network-level reductions in within- and cross-network rsFC were observed in the default-mode network. Healthy subjects and patients significantly differed in their scores on cognitive fatigue and verbal fluency. Healthy subjects and patients showed different correlation patterns between rsFC and cognitive fatigue or verbal fluency, both of which involved a shift in patients from the posterior default-mode network to the language network. Introducing electrophysiological rsFC in a regression model of verbal fluency and cognitive fatigue in MS patients significantly increased the explained variance compared to a regression limited to structural MRI markers (relative thalamic volume and lesion load). This MEG study demonstrates that MS induces distinct changes in the resting-state functional brain architecture that relate to disability, disease duration and specific cognitive functioning alterations. It highlights the potential value of electrophysiological intrinsic rsFC for monitoring the cognitive impairment in patients with MS.
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Affiliation(s)
- Martin Sjøgård
- Laboratoire de Cartographie fonctionnelle du Cerveau, UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Vincent Wens
- Laboratoire de Cartographie fonctionnelle du Cerveau, UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium.,Department of Functional Neuroimaging, Service of Nuclear Medicine, CUB-Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Jeroen Van Schependom
- Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium.,National MS Center, Belgium
| | - Lars Costers
- Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Marie D'hooghe
- Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium.,National MS Center, Belgium
| | - Miguel D'haeseleer
- Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium.,National MS Center, Belgium
| | - Mark Woolrich
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Serge Goldman
- Laboratoire de Cartographie fonctionnelle du Cerveau, UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium.,Department of Functional Neuroimaging, Service of Nuclear Medicine, CUB-Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Guy Nagels
- Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium.,National MS Center, Belgium.,St Edmund Hall, University of Oxford, Oxford, UK
| | - Xavier De Tiège
- Laboratoire de Cartographie fonctionnelle du Cerveau, UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium.,Department of Functional Neuroimaging, Service of Nuclear Medicine, CUB-Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
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26
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Alteration of Resting-state Functional Connectivity in the Sensorimotor Network in Patients with Thalamic Infarction. Clin Neuroradiol 2020; 31:721-728. [PMID: 33006652 DOI: 10.1007/s00062-020-00966-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 09/09/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To explore changes in functional connectivity (FC) within the sensorimotor network (SMN) and the relationship between the SMN and bilateral thalamus in patients with thalamic infarction (TI) using resting state functional magnetic resonance imaging (rs-fMRI). Also determined was whether those measures are useful for monitoring the functional recovery of somatosensory deficits. METHODS The study included 31 patients with TI presenting somatosensory dysfunction and 31 controls who underwent clinical assessments and MRI scanning at 6 months after a stroke. An independent component analysis was used to identify the SMN. The mean time courses of SMN activity were extracted for each subject, and FC with the bilateral thalamus was assessed. Differences in connectivity strength were compared between groups. Finally, we correlated the altered FC values with clinical data from patients with TI. RESULTS Compared to controls, patients with TI showed decreases in FC within SMN in the ipsilesional posterior central gyrus (PCG) (Z-score = -4.581, cluster size = 171), but presented increased FC within the SMN in the ipsilesional supplementary motor area (SMA) (Z-score = 4.648, cluster size = 46). The FC values of the ipsilesional SMA correlated with the somatosensory function score of patients with TI (r = 0.426, P = 0.027). Increased FC was observed between the SMN and bilateral thalamus in patients with TI. The region exhibiting increased FC was adjacent to the lesion in the affected thalamus, while the area with increased FC overlapped the location of the lesion when the lesion was mirrored onto the unaffected thalamus. CONCLUSION The increased FC in the ipsilesional SMA and between the SMN and perilesional thalamus might reflect functional reorganization in patients with TI presenting somatosensory deficits.
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Yin M, Liu Y, Zhang L, Zheng H, Peng L, Ai Y, Luo J, Hu X. Effects of rTMS Treatment on Cognitive Impairment and Resting-State Brain Activity in Stroke Patients: A Randomized Clinical Trial. Front Neural Circuits 2020; 14:563777. [PMID: 33117131 PMCID: PMC7561423 DOI: 10.3389/fncir.2020.563777] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/07/2020] [Indexed: 12/13/2022] Open
Abstract
Background Repetitive transcranial magnetic stimulation (rTMS) has been employed for motor function rehabilitation for stroke patients, but its effects on post-stroke cognitive impairment (PSCI) remains controversial. Objective To identify the effects of rTMS intervention on PSCI patients and its potential neural correlates to behavioral improvements. Methods We recruited 34 PSCI patients for 20 sessions of 10 Hz rTMS or no-stim control treatments over the left dorsal lateral prefrontal cortex (DLPFC). Cognitive function was evaluated with the Montreal Cognitive Assessment Scale, Victoria Stroop Test, Rivermead Behavior Memory Test, and Activities of Daily Living (ADL) assessed with the Modified Barthel Index. 14 patients received functional MRI scan, a useful non-invasive technique of determining how structurally segregated and functionally specialized brain areas were interconnected, which was reflected by blood oxygenation level–dependent signals. The amplitude of low-frequency fluctuation (ALFF) and functional connectivity (FC) were applied as the analytical approaches, which were used to measure the resting-state brain activity and functional connection. Results rTMS improved cognitive functions and ADLs for PSCI patients relative to patients who received no-stim control treatment. The cognitive improvements correlated to increased ALFF of the left medial prefrontal cortex, and increased FC of right medial prefrontal cortex and right ventral anterior cingulate cortex. Conclusion 10 Hz rTMS at DLPFC could improve cognitive function and quality of life for PSCI patients, which is associated with an altered frontal cortical activity. Clinical Registration Chinese Clinical Trial Registry, ChiCTR-IPR-17011908, http://www.chictr.org.cn/index.aspx.
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Affiliation(s)
- Mingyu Yin
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuanwen Liu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Liying Zhang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haiqing Zheng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lingrong Peng
- Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yinan Ai
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jing Luo
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiquan Hu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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28
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Wang R, Liu N, Tao YY, Gong XQ, Zheng J, Yang C, Yang L, Zhang XM. The Application of rs-fMRI in Vascular Cognitive Impairment. Front Neurol 2020; 11:951. [PMID: 33041965 PMCID: PMC7517303 DOI: 10.3389/fneur.2020.00951] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/22/2020] [Indexed: 02/05/2023] Open
Abstract
The incidence of vascular cognitive impairment (VCI) has been increasing for years and has become a major disabling factor in middle-aged and elderly populations. The pathogenesis of VCI is unclear, and there are no standard diagnostic criteria. Resting-state functional magnetic resonance imaging (rs-fMRI) can be used to detect spontaneous brain functional activity in a resting state, which facilitates in-depth investigation of the pathogenesis of VCI and provides an objective reference for early diagnosis, differential diagnosis, and prognostic evaluation. This article mainly reviews the principle and analysis of rs-fMRI data, as well as the progress of its application for VCI diagnosis.
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Affiliation(s)
- Ran Wang
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Nian Liu
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yun-Yun Tao
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xue-Qin Gong
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jing Zheng
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Cui Yang
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Lin Yang
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xiao-Ming Zhang
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Faria AV, Meyer A, Friedman R, Tippett DC, Hillis AE. Baseline MRI associates with later naming status in primary progressive aphasia. BRAIN AND LANGUAGE 2020; 201:104723. [PMID: 31864209 PMCID: PMC7282486 DOI: 10.1016/j.bandl.2019.104723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 07/29/2019] [Accepted: 11/13/2019] [Indexed: 06/10/2023]
Abstract
Advanced imaging studies in neurodegenerative disease have yielded new insights into subtypes of disease, progression of disease in various brain regions, and changes in structural and functional connectivity between brain regions related to symptom progression. However, few studies have revealed imaging markers at baseline that correlate with rate or degree of decline in function. Here we tested the hypothesis that imaging features at baseline correlate with outcome of naming in primary progressive aphasia. We obtained longitudinal multimodal imaging in 15 individuals with primary progressive aphasia at the same time points as assessment of naming. We found that functional connectivity between particular brain regions (measured with resting state functional connectivity magnetic resonance imaging) is strongly associated with accuracy of naming 21 months later, independently of baseline severity of naming impairment. These data indicate that functional connectivity may carry information about later performance in naming, and is potentially useful for refining prognosis.
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Affiliation(s)
- Andreia V Faria
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Aaron Meyer
- Department of Neurology, Georgetown University School of Medicine, Washington, USA
| | - Rhonda Friedman
- Department of Neurology, Georgetown University School of Medicine, Washington, USA
| | - Donna C Tippett
- Department of Otolaryngology & Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, USA
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Chen H, Shi M, Zhang H, Zhang YD, Geng W, Jiang L, Wang Z, Chen YC, Yin X. Different Patterns of Functional Connectivity Alterations Within the Default-Mode Network and Sensorimotor Network in Basal Ganglia and Pontine Stroke. Med Sci Monit 2019; 25:9585-9593. [PMID: 31838483 PMCID: PMC6929567 DOI: 10.12659/msm.918185] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The aim of this study was to investigate whether patients with basal ganglia stroke and patients with pontine stroke have different types of functional connectivity (FC) alterations in the early chronic phase. Material/Methods We included 14 patients with pontine stroke, 17 patients with basal ganglia stroke, and 20 well-matched healthy controls (HCs). All of them underwent resting-state functional magnetic resonance imaging (rs-fMRI) scanning. The independent component analysis (ICA) approach was applied to extract information regarding the default-mode network (DMN), including anterior DMN (aDMN) and posterior DMN (pDMN) components and the sensorimotor network (SMN). Results Compared with HCs, patients with basal ganglia stroke exhibited significantly reduced FC in the left precuneus of the pDMN, right supplementary motor area (SMA), and right superior frontal gyrus (SFG) of the SMN. Additionally, FC in the left medial prefrontal gyrus (MFG) of the aDMN, right precuneus and right posterior cingulate cortex (PCC) of the pDMN, and left middle cingulate gyrus (mid-CC) of the SMN decreased in patients with pontine stroke. Conclusions The different patterns of FC damage in patients with basal ganglia stroke and patients with pontine stroke in the early chronic phase may provide a new method for investigating lesion-induced network plasticity.
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Affiliation(s)
- Huiyou Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Mengye Shi
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Hong Zhang
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Ying-Dong Zhang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Wen Geng
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Liang Jiang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Zhengqian Wang
- Department of Radiology, Lianshui County People's Hospital, Huai'an, Jiangsu, China (mainland)
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
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Tani N, Yaegaki T, Nishino A, Fujimoto K, Hashimoto H, Horiuchi K, Nishiguchi M, Kishima H. Functional connectivity analysis and prediction of cognitive change after carotid artery stenting. J Neurosurg 2019; 131:1709-1715. [PMID: 30554182 DOI: 10.3171/2018.7.jns18404] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 07/19/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The neurocognitive course of patients who have undergone cerebral revascularization has been the subject of many studies, and the reported effects of carotid artery stenting (CAS) on cognitive function have varied from study to study. The authors hypothesized that cognitive amelioration after CAS is associated with alteration of the default mode network (DMN) connectivity, and they investigated the correlation between functional connectivity (FC) of the DMN and post-CAS changes in cognitive function in order to find a clinical marker that can be used to predict the effect of cerebral revascularization on patients' cognitive function in this preliminary exploratory study. METHODS The authors examined post-CAS changes in cognitive function in relation to FC in patients treated for unilateral carotid artery stenosis. Resting-state functional MRI (rs-fMRI) was performed with a 3-T scanner before and 6 months after CAS in 8 patients. Neuropsychological tests (Wechsler Adult Intelligence Scale III and Wechsler Memory Scale-Revised) were administered to each patient before and 6 months after CAS. The DMN was mapped for each patient through independent component analysis of the rs-fMR images, and the correlation between FC of the DMN and post-CAS change in cognitive function was analyzed on a voxel level. Multivariable regression analysis was performed to identify preoperative factors associated with a post-CAS change in cognitive function. RESULTS Post-CAS cognitive function varied between patients and between categories of neuropsychological tests. Although there was no significant overall improvement in Working Memory scores after CAS, post-CAS Working Memory scores changed in negative correlation with changes in FC between the DMN and the precentral/superior frontal gyrus and between the DMN and the middle frontal gyrus. In addition, the preoperative FC between those areas correlated positively with the post-CAS improvement in working memory. CONCLUSIONS FC between the DMN and working memory-related areas is closely associated with improvement in working memory after CAS. Preoperative analysis of FC of the DMN may be useful for predicting postoperative improvement in the working memory of patients being treated for unilateral stenosis of the extracranial internal carotid artery.Clinical trial registration no.: UMIN000020045 (www.umin.ac.jp/ctr/index.htm).
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Affiliation(s)
- Naoki Tani
- 1Department of Neurosurgery, Osaka General Medical Center, Osaka
- 2Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita; and
| | - Takahide Yaegaki
- 1Department of Neurosurgery, Osaka General Medical Center, Osaka
| | - Akio Nishino
- 3Department of Neurosurgery, Hanwa Memorial Hospital, Osaka, Japan
| | - Kenta Fujimoto
- 1Department of Neurosurgery, Osaka General Medical Center, Osaka
| | | | - Kaoru Horiuchi
- 1Department of Neurosurgery, Osaka General Medical Center, Osaka
| | | | - Haruhiko Kishima
- 2Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita; and
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Iyer KK, Zalesky A, Barlow KM, Cocchi L. Default mode network anatomy and function is linked to pediatric concussion recovery. Ann Clin Transl Neurol 2019; 6:2544-2554. [PMID: 31755665 PMCID: PMC6917315 DOI: 10.1002/acn3.50951] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 10/31/2019] [Indexed: 12/20/2022] Open
Abstract
Objective To determine whether anatomical and functional brain features relate to key persistent post–concussion symptoms (PPCS) in children recovering from mild traumatic brain injuries (mTBI), and whether such brain indices can predict individual recovery from PPCS. Methods One hundred and ten children with mixed recovery following mTBI were seen at the concussion clinic at Neurology department Alberta Children’s Hospital. The primary outcome was the Post–Concussion Symptom Inventory (PCSI, parent proxy). Sleep disturbance scores (PCSI subdomain) and the Neurocognition Index (CNS Vital Signs) were also measured longitudinally. PPCS was assessed at 4 weeks postinjury and 8–10 weeks postinjury. Gray matter volumes were assessed using magnetic resonance imaging (MRI) and voxel‐based morphometry at 4 weeks postinjury. Functional connectivity was estimated at the same timepoint using resting‐state MRI. Two complementary machine learning methods were used to assess if the combination of gray matter and functional connectivity indices carried meaningful prognostic information. Results Higher scores on a composite index of sleep disturbance, including fatigue, were associated with converging decreases in gray matter volume and local functional connectivity in two key nodes of the default mode network: the posterior cingulate cortex and the medial prefrontal cortex. Sleep‐related disturbances also significantly correlated with reductions in functional connectivity between these brain regions. The combination of structural and functional brain indices associated to individual variations in the default mode network accurately predicted clinical outcomes at follow‐up (area under the curve = 0.86). Interpretation These results highlight that the function–structure profile of core default mode regions underpins sleep‐related problems following mTBI and carries meaningful prognostic information for pediatric concussion recovery.
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Affiliation(s)
- Kartik K. Iyer
- Child Health Research CentreFaculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre & Department of Biomedical EngineeringThe University of MelbourneVictoriaAustralia
| | - Karen M. Barlow
- Child Health Research CentreFaculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
- Department of NeurologyQueensland Children’s HospitalBrisbaneQueenslandAustralia
- Alberta Children's Hospital Research InstituteCalgaryCanada
- University of CalgaryCalgaryCanada
| | - Luca Cocchi
- Clinical Brain Networks GroupQIMR Berghofer Medical Research InstituteHerstonQueenslandAustralia
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Wong WW, Fang Y, Chu WCW, Shi L, Tong KY. What Kind of Brain Structural Connectivity Remodeling Can Relate to Residual Motor Function After Stroke? Front Neurol 2019; 10:1111. [PMID: 31708857 PMCID: PMC6819511 DOI: 10.3389/fneur.2019.01111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 10/04/2019] [Indexed: 01/19/2023] Open
Abstract
Recent findings showed that brain networks far away from a lesion could be altered to adapt changes after stroke. This study examined 13 chronic stroke patients with moderate to severe motor impairment and 13 age-comparable healthy controls using diffusion tensor imaging to investigate the stroke impact on the reorganization of structural connectivity. Each subject's brain was segmented into 68 cortical and 12 subcortical regions of interest (ROIs), and connectivity measures including fractional anisotropy (FA), regional FA (rFA), connection weight (CW) and connection strength (CS) were adopted to compare two subject groups. Correlations between these measures and clinical scores of motor functions (Action Research Arm Test and Fugl-Meyer Assessment for upper extremity) were done. Network-based statistic (NBS) was conducted to identify the connectivity differences between patients and controls from the perspective of whole-brain network. The results showed that both rFAs and CSs demonstrated significant differences between patients and controls in the ipsilesional sensory-motor areas and subcortical network, and bilateral attention and default mode networks. Significant positive correlations were found between the paretic motor functions and the rFAs/CSs of the contralesional medial orbitofrontal cortex (mOFC) and rostral anterior cingulate cortex (rACC), and remained significant even after removing the effect of the ipsilesional corticospinal tract. Additionally, all the connections linked with the contralesional mOFC and rACC showed significantly higher FA/CW values in the stroke patients compared to the healthy controls from the NBS results. These findings indicated that these contralesional prefrontal areas exhibited stronger connections after stroke and strongly related to the residual motor function of the stroke patients.
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Affiliation(s)
- Wan-Wa Wong
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Psychiatry and Biobehavioural Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Yuqi Fang
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Winnie C W Chu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Lin Shi
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kai-Yu Tong
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, Hong Kong.,Brain and Mind Institute, The Chinese University of Hong Kong, Shatin, Hong Kong
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Puig J, Blasco G, Alberich-Bayarri A, Schlaug G, Deco G, Biarnes C, Navas-Martí M, Rivero M, Gich J, Figueras J, Torres C, Daunis-I-Estadella P, Oramas-Requejo CL, Serena J, Stinear CM, Kuceyeski A, Soriano-Mas C, Thomalla G, Essig M, Figley CR, Menon B, Demchuk A, Nael K, Wintermark M, Liebeskind DS, Pedraza S. Resting-State Functional Connectivity Magnetic Resonance Imaging and Outcome After Acute Stroke. Stroke 2019; 49:2353-2360. [PMID: 30355087 DOI: 10.1161/strokeaha.118.021319] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose- Physiological effects of stroke are best assessed over entire brain networks rather than just focally at the site of structural damage. Resting-state functional magnetic resonance imaging can map functional-anatomic networks by analyzing spontaneously correlated low-frequency activity fluctuations across the brain, but its potential usefulness in predicting functional outcome after acute stroke remains unknown. We assessed the ability of resting-state functional magnetic resonance imaging to predict functional outcome after acute stroke. Methods- We scanned 37 consecutive reperfused stroke patients (age, 69±14 years; 14 females; 3-day National Institutes of Health Stroke Scale score, 6±5) on day 3 after symptom onset. After imaging preprocessing, we used a whole-brain mask to calculate the correlation coefficient matrices for every paired region using the Harvard-Oxford probabilistic atlas. To evaluate functional outcome, we applied the modified Rankin Scale at 90 days. We used region of interest analyses to explore the functional connectivity between regions and graph-computation analysis to detect differences in functional connectivity between patients with good functional outcome (modified Rankin Scale score ≤2) and those with poor outcome (modified Rankin Scale score >2). Results- Patients with good outcome had greater functional connectivity than patients with poor outcome. Although 3-day National Institutes of Health Stroke Scale score was the most accurate independent predictor of 90-day modified Rankin Scale (84.2%), adding functional connectivity increased accuracy to 94.7%. Preserved bilateral interhemispheric connectivity between the anterior inferior temporal gyrus and superior frontal gyrus and decreased connectivity between the caudate and anterior inferior temporal gyrus in the left hemisphere had the greatest impact in favoring good prognosis. Conclusions- These data suggest that information about functional connectivity from resting-state functional magnetic resonance imaging may help predict 90-day stroke outcome.
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Affiliation(s)
- Josep Puig
- From the Imaging Research Unit, Department of Radiology (Girona Biomedical Research Institute) Girona Biomedical Research Institute, Diagnostic Imaging Institute (IDI) (J.P., G.B., C.B., M.N.-M., C.L.O.-R., S.P.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Gerard Blasco
- From the Imaging Research Unit, Department of Radiology (Girona Biomedical Research Institute) Girona Biomedical Research Institute, Diagnostic Imaging Institute (IDI) (J.P., G.B., C.B., M.N.-M., C.L.O.-R., S.P.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Angel Alberich-Bayarri
- Quantitative Imaging Biomarkers In Medicine, La Fe Health Research Institute, La Fe Polytechnics and University Hospital, Valencia, Spain (A.A.-B.)
| | - Gottfried Schlaug
- Neuroimaging and Stroke Recovery Laboratory, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (G.S.)
| | - Gustavo Deco
- Center for Brain and Cognition, Universitat Pompeu Fabra, Barcelona, Spain (G.D.).,ICREA Institut Catalan de Recerca i Estudis Avançats, Barcelona, Spain (G.D.)
| | - Carles Biarnes
- From the Imaging Research Unit, Department of Radiology (Girona Biomedical Research Institute) Girona Biomedical Research Institute, Diagnostic Imaging Institute (IDI) (J.P., G.B., C.B., M.N.-M., C.L.O.-R., S.P.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Marian Navas-Martí
- From the Imaging Research Unit, Department of Radiology (Girona Biomedical Research Institute) Girona Biomedical Research Institute, Diagnostic Imaging Institute (IDI) (J.P., G.B., C.B., M.N.-M., C.L.O.-R., S.P.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Mireia Rivero
- Department of Neurology, Girona Biomedical Research Institute (M.R., J.G., J.S.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Jordi Gich
- Department of Neurology, Girona Biomedical Research Institute (M.R., J.G., J.S.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Jaume Figueras
- Department of Rehabilitation (J.F., C.T.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Cristina Torres
- Department of Rehabilitation (J.F., C.T.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Pepus Daunis-I-Estadella
- Department of Computer Science, Applied Mathematics, and Statistics, University of Girona, Spain (P.D.-i.-E.)
| | - Celia L Oramas-Requejo
- From the Imaging Research Unit, Department of Radiology (Girona Biomedical Research Institute) Girona Biomedical Research Institute, Diagnostic Imaging Institute (IDI) (J.P., G.B., C.B., M.N.-M., C.L.O.-R., S.P.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Joaquín Serena
- Department of Neurology, Girona Biomedical Research Institute (M.R., J.G., J.S.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Cathy M Stinear
- Department of Medicine, Centre for Brain Research, University of Auckland, New Zealand (C.M.S.)
| | - Amy Kuceyeski
- Department of Radiology, Weill Cornell Medical College, NY (A.K.)
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-Instituto de Investigación Biomédica de Bellvitge, Hospitalet del Llobregat, Barcelona, Spain (C.S.-M.).,Centro de Investigación en Salud Mental, Barcelona, Spain (C.S.-M.).,Department of Psychobiology and Methodology in Health Sciences, Universitat Autonoma de Barcelona, Spain (C.S.-M.)
| | - Götz Thomalla
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (G.T.)
| | - Marco Essig
- Department of Radiology, University of Manitoba, Winnipeg, Canada (M.E., C.R.F.)
| | - Chase R Figley
- Department of Radiology, University of Manitoba, Winnipeg, Canada (M.E., C.R.F.)
| | - Bijoy Menon
- Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta, Canada (B.M., A.D.)
| | - Andrew Demchuk
- Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta, Canada (B.M., A.D.)
| | - Kambiz Nael
- Department of Radiology, Icahn School of Medicine at Mount Sinai, NY (K.N.)
| | - Max Wintermark
- Neuroradiology Division, Department of Radiology, Stanford University, Palo Alto, CA (M.W.)
| | - David S Liebeskind
- Neurovascular Imaging Research Core and University of California Los Angeles Stroke Center, Los Angeles, CA (D.S.L.)
| | - Salvador Pedraza
- From the Imaging Research Unit, Department of Radiology (Girona Biomedical Research Institute) Girona Biomedical Research Institute, Diagnostic Imaging Institute (IDI) (J.P., G.B., C.B., M.N.-M., C.L.O.-R., S.P.), Dr Josep Trueta University Hospital, Girona, Spain
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Marins T, Rodrigues EC, Bortolini T, Melo B, Moll J, Tovar-Moll F. Structural and functional connectivity changes in response to short-term neurofeedback training with motor imagery. Neuroimage 2019; 194:283-290. [PMID: 30898654 DOI: 10.1016/j.neuroimage.2019.03.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 03/10/2019] [Accepted: 03/12/2019] [Indexed: 12/31/2022] Open
Abstract
Recent findings have been challenging current understanding of how fast the human brain change its structural and functional connections in response to training. One powerful way to deepen the inner workings of human brain plasticity is using neurofeedback (NFB) by fMRI, a technique that allows self-induced brain plasticity by means of modulating brain activity in real time. In the present randomized, double-blind and sham-controlled study, we use NFB to train healthy individuals to reinforce brain patterns related to motor execution while performing a motor imagery task, with no overt movement. After 1 h of NFB training, participants displayed increased fractional anisotropy (FA) in the sensorimotor segment of corpus callosum and increased functional connectivity of the sensorimotor resting state network. Increased functional connectivity was also observed in the default mode network. These results were not observed in the control group, which was trained with sham feedback. To our knowledge, this is the first demonstration of white matter FA changes following a very short training schedule (<1 h). Our results suggest that NFB by fMRI can be an interesting tool to explore dynamic aspects of brain plasticity and open new venues for investigating brain plasticity in healthy individuals and in neurological conditions.
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Affiliation(s)
- T Marins
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil; Post-Graduate Program in Morphological Sciences, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - E C Rodrigues
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil; Augusto Motta University (Unisuam), Rio de Janeiro, RJ, Brazil
| | - T Bortolini
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil
| | - Bruno Melo
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil
| | - J Moll
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil; Post-Graduate Program in Morphological Sciences, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - F Tovar-Moll
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil; Post-Graduate Program in Morphological Sciences, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
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Qiu X, Fu Y, Chen J, Ye Y, Wang Z, Ming X. The Correlation between Osteoporosis and Blood Circulation Function Based on Magnetic Resonance Imaging. J Med Syst 2019; 43:91. [PMID: 30826890 DOI: 10.1007/s10916-019-1206-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 02/11/2019] [Indexed: 02/03/2023]
Abstract
In order to investigate the relationship between changes in blood circulation and bone mineral density (BMD) loss, the characteristic parameters reflecting the function of tissue oxygen metabolism are obtained by means of blood oxygen level-dependent magnetic resonance imaging (BOLD-MRI), image processing and semi-quantitative analysis. The correlation and variance analysis of the characteristic parameters of different BMD groups are carried out, and the physiological parameters of bone marrow blood perfusion are obtained by dynamic enhanced MRI (DCE-MRI). Multivariate logistic regression analysis is carried out with the physiological parameters of blood oxygen metabolism function and bone marrow blood perfusion as independent variables and BMD as dependent variables. It is found that there are significant differences in oxygen metabolism between individual muscles in different BMD groups and between skeletal muscles of different types of muscle fibers. Age, total volume of bone marrow and oxygen metabolism ability of tibial anterior muscle have significant independent effects on osteoporosis. It shows that the changes of blood circulation in bone marrow and surrounding muscle tissue are indeed one of the causes of osteoporosis.
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Affiliation(s)
- Xiaoming Qiu
- Department of Radiology, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, No.141 Tianjin Road, Huangshi City, 435000, China.
| | - Yufei Fu
- Department of Radiology, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, No.141 Tianjin Road, Huangshi City, 435000, China
| | - Jiao Chen
- Department of Radiology, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, No.141 Tianjin Road, Huangshi City, 435000, China
| | - Yu Ye
- Department of Radiology, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, No.141 Tianjin Road, Huangshi City, 435000, China
| | - Zhen Wang
- Department of Radiology, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, No.141 Tianjin Road, Huangshi City, 435000, China
| | - Xianfang Ming
- Department of Radiology, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, No.141 Tianjin Road, Huangshi City, 435000, China
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37
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Chi NF, Ku HL, Chen DYT, Tseng YC, Chen CJ, Lin YC, Hsieh YC, Chan L, Chiou HY, Hsu CY, Hu CJ. Cerebral Motor Functional Connectivity at the Acute Stage: An Outcome Predictor of Ischemic Stroke. Sci Rep 2018; 8:16803. [PMID: 30429535 PMCID: PMC6235876 DOI: 10.1038/s41598-018-35192-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 10/16/2018] [Indexed: 12/17/2022] Open
Abstract
Sixty-seven patients with first acute ischemic stroke onset between 3 to 7 days and 25 age- and sex- matched controls were analyzed for the performance of a resting-state functional MRI to investigate whether the functional connectivity (FC) of the motor network in acute ischemic stroke is independently associated with functional outcomes. The FC of cortical motor network and default mode network was analyzed. The FC was compared between controls, patients with favorable outcomes (modified Rankin Scale, mRS ≤1), and patients with unfavorable outcomes (mRS ≥2) at 3 months. Of the 67 patients, 23 (34%) exhibited unfavorable outcomes. In multivariate analysis, the FC between ipsilesional primary motor cortex (M1) and contralesional dorsal premotor area (PMd) ≤0.63, were independently associated with unfavorable outcomes (odds ratio = 6.32, P = 0.032), whereas the FC of default mode network was not different between groups. The interhemispheric FC of the motor network is an independent predictor of functional outcomes in patients with acute ischemic stroke.
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Affiliation(s)
- Nai-Fang Chi
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Neurology, Stroke Center, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Brain and Consciousness Research Center, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Lun Ku
- Brain and Consciousness Research Center, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - David Yen-Ting Chen
- Brain and Consciousness Research Center, Taipei Medical University, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ying-Chi Tseng
- Brain and Consciousness Research Center, Taipei Medical University, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chi-Jen Chen
- Brain and Consciousness Research Center, Taipei Medical University, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ying-Chin Lin
- Department of Family Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan.,Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Chen Hsieh
- The PhD Program of Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Lung Chan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Neurology, Stroke Center, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan
| | - Hung-Yi Chiou
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,School of Public Health, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chung Y Hsu
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Chaur-Jong Hu
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. .,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. .,Department of Neurology, Stroke Center, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan. .,Graduate Institute of Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
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38
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Boyd LA, Hayward KS, Ward NS, Stinear CM, Rosso C, Fisher RJ, Carter AR, Leff AP, Copland DA, Carey LM, Cohen LG, Basso DM, Maguire JM, Cramer SC. Biomarkers of Stroke Recovery: Consensus-Based Core Recommendations from the Stroke Recovery and Rehabilitation Roundtable. Neurorehabil Neural Repair 2018; 31:864-876. [PMID: 29233071 DOI: 10.1177/1545968317732680] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The most difficult clinical questions in stroke rehabilitation are "What is this patient's potential for recovery?" and "What is the best rehabilitation strategy for this person, given her/his clinical profile?" Without answers to these questions, clinicians struggle to make decisions regarding the content and focus of therapy, and researchers design studies that inadvertently mix participants who have a high likelihood of responding with those who do not. Developing and implementing biomarkers that distinguish patient subgroups will help address these issues and unravel the factors important to the recovery process. The goal of the present paper is to provide a consensus statement regarding the current state of the evidence for stroke recovery biomarkers. Biomarkers of motor, somatosensory, cognitive and language domains across the recovery timeline post-stroke are considered; with focus on brain structure and function, and exclusion of blood markers and genetics. We provide evidence for biomarkers that are considered ready to be included in clinical trials, as well as others that are promising but not ready and so represent a developmental priority. We conclude with an example that illustrates the utility of biomarkers in recovery and rehabilitation research, demonstrating how the inclusion of a biomarker may enhance future clinical trials. In this way, we propose a way forward for when and where we can include biomarkers to advance the efficacy of the practice of, and research into, rehabilitation and recovery after stroke.
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Affiliation(s)
- Lara A Boyd
- 1 Department of Physical Therapy & the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Kathryn S Hayward
- 2 Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Nick S Ward
- 3 Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
| | - Cathy M Stinear
- 4 Department of Medicine and Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Charlotte Rosso
- 5 Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, France; AP-HP, Stroke Unit, Pitié-Salpêtrière Hospital, France
| | - Rebecca J Fisher
- 6 Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| | - Alexandre R Carter
- 7 Department of Neurology, Washington University in Saint Louis, St Louis, MO, USA
| | - Alex P Leff
- 8 Department of Brain Repair and Rehabilitation, Institute of Neurology & Institute of Cognitive Neuroscience, University College London, Queens Square, London, UK
| | - David A Copland
- 9 School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, Australia; and University of Queensland Centre for Clinical Research, Brisbane, Australia
| | - Leeanne M Carey
- 10 School of Allied Health, College of Science, Health and Engineering, La Trobe, University, Bundoora, Australia; and Neurorehabilitation and Recovery, Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Leonardo G Cohen
- 11 Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
| | - D Michele Basso
- 12 School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Jane M Maguire
- 13 Faculty of Health, University of Technology Sydney, Ultimo, Sydney, Australia
| | - Steven C Cramer
- 14 University of California, Irvine, CA, USA; Depts. Neurology, Anatomy & Neurobiology, and Physical Medicine & Rehabilitation, Irvine, CA, USA
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39
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Wen T, Zhang X, Liang S, Li Z, Xing X, Liu W, Tao J. Electroacupuncture Ameliorates Cognitive Impairment and Spontaneous Low-Frequency Brain Activity in Rats with Ischemic Stroke. J Stroke Cerebrovasc Dis 2018; 27:2596-2605. [PMID: 30220306 DOI: 10.1016/j.jstrokecerebrovasdis.2018.05.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 05/07/2018] [Accepted: 05/19/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND To evaluate whether electroacupuncture (EA) at Baihui (DU20) and Shenting (DU24) acupoints could improve cognitive function and enhance spontaneous low-frequency brain activity in rats with ischemic stroke. METHODS Total 36 rats were randomly divided into 3 groups-the sham surgery (Sham) group, the middle cerebral artery occlusion induced cognitive deficit (MICD) group, and the MICD with EA (MICD + EA) treatment group. The rats in MICD + EA group received EA treatment at DU20 and DU24 acupoints for 14 consecutive days after the surgery. The Morris water maze test was performed to assess the spatial learning and memory ability of the rats. Magnetic resonance imaging (MRI) was used to investigate the infarction volume and spontaneous low-frequency brain activity of each group. RESULTS After EA for 14 days, the learning and memory ability of the MICD rats was improved, and the brain infarction volume was reduced. Furthermore, basing on the fMRI amplitude of low-frequency fluctuation (ALFF) analysis, the decreased ALFF of the MICD rats was found in auditory cortex, cingulate gyrus, lateral nucleus group of dorsal thalamus, hippocampus, motor cortex, prelimbic cortex, retrosplenial cortex, and sensory cortex compared with the rats in sham group. However, these suppressive regions were notably attenuated after EA treatment. CONCLUSIONS Our results suggested that EA at DU20 and DU24 acupoints could ameliorate cognitive impairment in rats with ischemic stroke, and the protective effect of EA may attribute to reactivating the cognition-related brain regions, such as hippocampus, retrosplenial cortex, cingulate gyrus, prelimbic cortex, and sensory cortex.
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Affiliation(s)
- Tao Wen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China; Rehabilitation Department, Hubei Province Hospital of Traditional Chinese Medicine, Wuhan, China; Hubei Province Academy of Traditional Chinese Medicine, Wuhan, China
| | - Xiufeng Zhang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China; Rehabilitation Department, Taizhou Hospital of Traditional Chinese Medicine, Taizhou, China
| | - Shengxiang Liang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China; College of Physical Science and Technology, Zhengzhou University, Zhengzhou, China
| | - Zuanfang Li
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fujian, China
| | - Xuemei Xing
- Rehabilitation Department, Taizhou Hospital of Traditional Chinese Medicine, Taizhou, China
| | - Weilin Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
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40
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Larivière S, Ward NS, Boudrias MH. Disrupted functional network integrity and flexibility after stroke: Relation to motor impairments. NEUROIMAGE-CLINICAL 2018; 19:883-891. [PMID: 29946512 PMCID: PMC6008503 DOI: 10.1016/j.nicl.2018.06.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 05/17/2018] [Accepted: 06/07/2018] [Indexed: 12/21/2022]
Abstract
Previous studies investigating brain activation present during upper limb movement after stroke have greatly detailed activity alterations in the ipsi- and contralesional primary motor cortices (M1). Despite considerable interest in M1, investigations into the integration and coordination of large-scale functional networks subserving motor, sensory, and cognitive control after stroke remain scarce. The purpose of this study was to assess non-static functional connectivity within whole-brain networks involved in the production of isometric, visually-paced hand grips. Seventeen stroke patients and 24 healthy controls underwent functional MRI while performing a series of 50 isometric hand grips with their affected hand (stroke patients) or dominant hand (control subjects). We used task-based multivariate functional connectivity to derive spatial and temporal information of whole-brain networks specifically underlying hand movement. This technique has the advantage of extracting within-network commonalities across groups and identifying connectivity differences between these groups. We further used a nonparametric statistical approach to identify group differences in regional activity within these task-specific networks and assess whether such alterations were related to the degree of motor impairment in stroke patients. Our whole-brain multivariate analysis revealed group differences in two networks: (1) a motor network, including pre- and postcentral gyri, dorsal and ventral premotor cortices, as well as supplementary motor area, in which stroke patients showed reduced task-related activation compared to controls, and (2) a default-mode network (DMN), including the posterior cingulate cortex, precuneus, and medial prefrontal cortex, in which patients showed less deactivation than controls. Within-network group differences revealed decreased activity in ipsilesional primary sensorimotor cortex in stroke patients, which also positively correlated with lower levels of motor impairment. Moreover, the temporal information extracted from the functional networks revealed that stroke patients did not show a reciprocal DMN deactivation peak following activation of their motor network. This finding suggests that allocation of functional resources to motor areas during hand movement may impair their ability to efficiently switch from one network to another. Taken together, our study expands our understanding of functional reorganization during motor recovery after a stroke, and suggests that modulation of ipsilesional sensorimotor activity may increase the integrity of a whole-brain motor network, contribute to better motor performance, and optimize network flexibility. We assessed connectivity in task-based brain networks underlying hand movement. We compared network properties between stroke patients and healthy controls. Stroke patients have altered default-mode and motor network connectivity. Patients also showed poorer motor performance and impaired network flexibility.
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Affiliation(s)
- Sara Larivière
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montréal, Qc, Canada; Department of Neurology and Neurosurgery, McGill University, Montréal, Qc, Canada
| | - Nick S Ward
- Sobell Department of Motor Neuroscience, Institute of Neurology, University College, London, UK
| | - Marie-Hélène Boudrias
- School of Physical and Occupational Therapy, McGill University, Montréal, Qc, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Qc, Canada.
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41
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Zhao Z, Wu J, Fan M, Yin D, Tang C, Gong J, Xu G, Gao X, Yu Q, Yang H, Sun L, Jia J. Altered intra- and inter-network functional coupling of resting-state networks associated with motor dysfunction in stroke. Hum Brain Mapp 2018; 39:3388-3397. [PMID: 29691945 DOI: 10.1002/hbm.24183] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 03/20/2018] [Accepted: 04/06/2018] [Indexed: 12/18/2022] Open
Abstract
Motor functions are supported through functional integration across the extended motor system network. Individuals following stroke often show deficits on motor performance requiring coordination of multiple brain networks; however, the assessment of connectivity patterns after stroke was still unclear. This study aimed to investigate the changes in intra- and inter-network functional connectivity (FC) of multiple networks following stroke and further correlate FC with motor performance. Thirty-three left subcortical chronic stroke patients and 34 healthy controls underwent resting-state functional magnetic resonance imaging. Eleven resting-state networks were identified via independent component analysis (ICA). Compared with healthy controls, the stroke group showed abnormal FC within the motor network (MN), visual network (VN), dorsal attention network (DAN), and executive control network (ECN). Additionally, the FC values of the ipsilesional inferior parietal lobule (IPL) within the ECN were negatively correlated with the Fugl-Meyer Assessment (FMA) scores (hand + wrist). With respect to inter-network interactions, the ipsilesional frontoparietal network (FPN) decreased FC with the MN and DAN; the contralesional FPN decreased FC with the ECN, but it increased FC with the default mode network (DMN); and the posterior DMN decreased FC with the VN. In sum, this study demonstrated the coexistence of intra- and inter-network alterations associated with motor-visual attention and high-order cognitive control function in chronic stroke, which might provide insights into brain network plasticity following stroke.
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Affiliation(s)
- Zhiyong Zhao
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, 200062, China
| | - Jie Wu
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, 200062, China
| | - Mingxia Fan
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, 200062, China
| | - Dazhi Yin
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Chaozheng Tang
- Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Jiayu Gong
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, 200062, China
| | - Guojun Xu
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, 200062, China
| | - Xinjie Gao
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, 200062, China
| | - Qiurong Yu
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, 200062, China
| | - Hao Yang
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, 200062, China
| | - Limin Sun
- Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Jie Jia
- Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai, 200040, China
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42
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Boyd LA, Hayward KS, Ward NS, Stinear CM, Rosso C, Fisher RJ, Carter AR, Leff AP, Copland DA, Carey LM, Cohen LG, Basso DM, Maguire JM, Cramer SC. Biomarkers of stroke recovery: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable. Int J Stroke 2018; 12:480-493. [PMID: 28697711 DOI: 10.1177/1747493017714176] [Citation(s) in RCA: 225] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The most difficult clinical questions in stroke rehabilitation are "What is this patient's potential for recovery?" and "What is the best rehabilitation strategy for this person, given her/his clinical profile?" Without answers to these questions, clinicians struggle to make decisions regarding the content and focus of therapy, and researchers design studies that inadvertently mix participants who have a high likelihood of responding with those who do not. Developing and implementing biomarkers that distinguish patient subgroups will help address these issues and unravel the factors important to the recovery process. The goal of the present paper is to provide a consensus statement regarding the current state of the evidence for stroke recovery biomarkers. Biomarkers of motor, somatosensory, cognitive and language domains across the recovery timeline post-stroke are considered; with focus on brain structure and function, and exclusion of blood markers and genetics. We provide evidence for biomarkers that are considered ready to be included in clinical trials, as well as others that are promising but not ready and so represent a developmental priority. We conclude with an example that illustrates the utility of biomarkers in recovery and rehabilitation research, demonstrating how the inclusion of a biomarker may enhance future clinical trials. In this way, we propose a way forward for when and where we can include biomarkers to advance the efficacy of the practice of, and research into, rehabilitation and recovery after stroke.
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Affiliation(s)
- Lara A Boyd
- 1 Department of Physical Therapy & the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Kathryn S Hayward
- 2 Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Nick S Ward
- 3 Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
| | - Cathy M Stinear
- 4 Department of Medicine and Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Charlotte Rosso
- 5 Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,6 AP-HP, Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Paris, France
| | - Rebecca J Fisher
- 7 Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| | - Alexandre R Carter
- 8 Department of Neurology, Washington University in Saint Louis, St Louis, MO, USA
| | - Alex P Leff
- 9 Department of Brain Repair and Rehabilitation, Institute of Neurology & Institute of Cognitive Neuroscience, University College London, Queens Square, London, UK
| | - David A Copland
- 10 School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, Australia; and University of Queensland Centre for Clinical Research, Brisbane, Australia
| | - Leeanne M Carey
- 11 School of Allied Health, College of Science, Health and Engineering, La Trobe, University, Bundoora, Australia; and Neurorehabilitation and Recovery, Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Leonardo G Cohen
- 12 Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
| | - D Michele Basso
- 13 School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Jane M Maguire
- 14 Faculty of Health, University of Technology, Ultimo, Sydney, Australia
| | - Steven C Cramer
- 15 University of California, Irvine, CA, USA; Depts. Neurology, Anatomy & Neurobiology, and Physical Medicine & Rehabilitation, Irvine, CA, USA
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43
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Abstract
Neuroimaging studies have shown that local brain lesions could result in abnormal information transfer far from the lesion site in acute ischemic stroke (AIS) patients; yet, little is known about alternations of the topological organization of whole-brain networks in AIS. By using resting state functional magnetic resonance imaging (MRI) and graph theory analysis, we systematically investigated the topological properties of the functional brain networks of 28 healthy controls (HC, age: 56.9 ± 0.45 years) and 29 AIS (age: 57.6 ± 0.21 years) with proximal anterior circulation occlusion within 12 h of symptom onset. In our results, both the AIS and HC groups exhibited small-world network organization, suggesting a functional balance between local specialization and global integration. However, compared with the HC, the AIS patients had a lower shortest path length and higher global efficiency, indicating a tendency of randomization in patients' functional brain networks. The AIS patients had an increased nodal degree in the precuneus (PCUN), middle frontal gyrus (MFG), medial part of the superior frontal gyrus (SFGmed), orbital part of the middle frontal gyrus, and the opercular part of the inferior frontal gyrus, and increased nodal efficiency in the PUCN, MFG, SFGmed, and the angular gyrus. The decreased nodal degree in AIS was found in the heschl gyrus (HES), and no significant decreased nodal efficiency was observed. The dysfunctional connections were mainly concentrated in the HES and prefrontal cortex. Furthermore, the altered nodal centrality of the MFG and abnormal functional connectivity in AIS were associated with patients' Mini-Mental State Examination scores. These results suggested that interrupted functional connectivity in language system organization after focal brain lesions could also result in disruptions in the topological organization of other brain circuits, and this may contribute to disturbances in cognition in AIS patients.
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44
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Wei D, Xie D, Li H, Chen Y, Qi D, Wang Y, Zhang Y, Chen K, Li C, Zhang Z. The positive effects of Xueshuan Xinmai tablets on brain functional connectivity in acute ischemic stroke: a placebo controlled randomized trial. Sci Rep 2017; 7:15244. [PMID: 29127417 PMCID: PMC5681502 DOI: 10.1038/s41598-017-15456-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 10/25/2017] [Indexed: 11/09/2022] Open
Abstract
Through a placebo controlled randomized study, the purpose of this report was to investigate the effects of Xueshuan Xinmai tablets (XXMT) on neurologic deficits, quality of life and brain functional connectivity in acute ischemic stroke patients and to explore the mechanism of action of XXMT. In total, 44 acute ischemic stroke patients were randomly divided to the XXMT treatment group (n = 22) or the placebo group (n = 22) in a 2-week trial. Before and after the treatment, the neurological assessment and functional magnetic resonance imaging examinations were carried out. Compared to the placebo group, the scores of the National Institutes of Health Stroke Scale (NIHSS) and Stroke-Specific Quality of Life Scale (SSQOL) significantly improved in the treatment group. In addition, XXMT-treated patients demonstrated significantly enhanced functional connectivity within the default mode, frontal-parietal, and motor control networks. Furthermore, the changed connectivity in the left precuneus was positively correlated to the improvement of NIHSS and SSQOL scores. The present study indicated that XXMT treatment significantly improved the neurologic deficit and quality of life of acute ischemic stroke patients and that the therapeutic effect may be based on the modulation of XXMT on the functional connectivity of brain networks.
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Affiliation(s)
- Dongfeng Wei
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, P.R. China.,BABRI Centre, Beijing Normal University, Beijing, 100875, P.R. China
| | - Daojun Xie
- The First Affiliated Hospital of Anhui University of traditional Chinese Medicine, Hefei, 230031, P.R. China
| | - He Li
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, P.R. China.,BABRI Centre, Beijing Normal University, Beijing, 100875, P.R. China
| | - Yaojing Chen
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, P.R. China.,BABRI Centre, Beijing Normal University, Beijing, 100875, P.R. China
| | - Di Qi
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, P.R. China.,BABRI Centre, Beijing Normal University, Beijing, 100875, P.R. China
| | - Yujiao Wang
- Graduate School of Anhui University of traditional Chinese Medicine, Hefei, 230038, P.R. China
| | - Yangjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, P.R. China.,BABRI Centre, Beijing Normal University, Beijing, 100875, P.R. China
| | - Kewei Chen
- BABRI Centre, Beijing Normal University, Beijing, 100875, P.R. China.,Banner Alzheimer's Institute, Phoenix, Arizona, 85006, USA
| | - Chuanfu Li
- The First Affiliated Hospital of Anhui University of traditional Chinese Medicine, Hefei, 230031, P.R. China.
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, P.R. China. .,BABRI Centre, Beijing Normal University, Beijing, 100875, P.R. China.
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45
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Loubinoux I, Brihmat N, Castel-Lacanal E, Marque P. Cerebral imaging of post-stroke plasticity and tissue repair. Rev Neurol (Paris) 2017; 173:577-583. [DOI: 10.1016/j.neurol.2017.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 09/11/2017] [Accepted: 09/12/2017] [Indexed: 01/17/2023]
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46
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Zhang J, Zhang Y, Wang L, Sang L, Yang J, Yan R, Li P, Wang J, Qiu M. Disrupted structural and functional connectivity networks in ischemic stroke patients. Neuroscience 2017; 364:212-225. [PMID: 28918259 DOI: 10.1016/j.neuroscience.2017.09.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 09/04/2017] [Accepted: 09/05/2017] [Indexed: 01/10/2023]
Abstract
Local lesions caused by stroke may result in extensive structural and functional reorganization in the brain. Previous studies of this phenomenon have focused on specific brain networks. Here, we aimed to discover abnormalities in whole-brain networks and to explore the decoupling between structural and functional connectivity in patients with stroke. Fifteen ischemic stroke patients and 23 normal controls (NCs) were recruited in this study. A graph theoretical analysis was employed to investigate the abnormal topological properties of structural and functional brain networks in patients with stroke. Both patients with stroke and NCs exhibited small-world organization in brain networks. However, compared to NCs, patients with stroke exhibited abnormal global properties characterized by a higher characteristic path length and lower global efficiency. Furthermore, patients with stroke showed altered nodal characteristics, primarily in certain motor- and cognition-related regions. Positive correlations between the nodal degree of the inferior parietal lobule and the Fugl-Meyer Assessment (FMA) score and between the nodal betweenness centrality of the posterior cingulate gyrus (PCG) and immediate recall were observed in patients with stroke. Most importantly, the strength of the structural-functional connectivity network coupling was decreased, and the coupling degree was related to the FMA score of patients, suggesting that decoupling may provide a novel biomarker for the assessment of motor impairment in patients with stroke. Thus, the topological organization of brain networks is altered in patients with stroke, and our results provide insights into the structural and functional organization of the brain after stroke from the viewpoint of network topology.
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Affiliation(s)
- Jingna Zhang
- Department of Medical Imaging, College of Biomedical Engineering, Third Military Medical University, 30 Gaotanyan Road, Chongqing 40038, China
| | - Ye Zhang
- Department of Medical Imaging, College of Biomedical Engineering, Third Military Medical University, 30 Gaotanyan Road, Chongqing 40038, China
| | - Li Wang
- Department of Medical Imaging, College of Biomedical Engineering, Third Military Medical University, 30 Gaotanyan Road, Chongqing 40038, China
| | - Linqiong Sang
- Department of Medical Imaging, College of Biomedical Engineering, Third Military Medical University, 30 Gaotanyan Road, Chongqing 40038, China
| | - Jun Yang
- Department of Radiology, Southwest Hospital, Third Military Medical University, 30 Gaotanyan Road, Chongqing 400038, China
| | - Rubing Yan
- Department of Rehabilitation, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Pengyue Li
- Department of Medical Imaging, College of Biomedical Engineering, Third Military Medical University, 30 Gaotanyan Road, Chongqing 40038, China
| | - Jian Wang
- Department of Radiology, Southwest Hospital, Third Military Medical University, 30 Gaotanyan Road, Chongqing 400038, China.
| | - Mingguo Qiu
- Department of Medical Imaging, College of Biomedical Engineering, Third Military Medical University, 30 Gaotanyan Road, Chongqing 40038, China.
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47
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Hernandez-Castillo CR, Nashed JY, Fernandez-Ruiz J, Wang J, Gallivan J, Cook DJ. Increased functional connectivity after stroke correlates with behavioral scores in non-human primate model. Sci Rep 2017; 7:6701. [PMID: 28751636 PMCID: PMC5532205 DOI: 10.1038/s41598-017-07175-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/26/2017] [Indexed: 12/27/2022] Open
Abstract
Here we characterized the functional connectivity (FC) changes occurring after a controlled MCA stroke in a primate model. We hypothesize that if FC can inform about the neural changes after a stroke in the non-human primate (NHP) stroke model, then significant FC changes after the stroke would have to correlate with the remaining behavioral capacities. Eleven cynomolgus monkeys underwent an experimental middle cerebral artery occlusion while five monkeys remained as the control group. One month later the neurological function was assessed with a set of fine motor tasks and the Nonhuman Primate Stroke Scale (NHPSS). Structural and functional connectivity analyses were done to compare both groups. Three FC changes showed significant behavioral correlations: right sensorimotor-right lateral intraparietal FC with the six-well task; left posterior intraparietal-left dorsal premotor FC with the hill task; and right visual-left primary motor FC with the NHPSS. In the three instances, stronger FC correlated with better behavioral outcome. The results show that the functional changes correlating with behavioral outcomes involved sensorimotor cortices that were not restricted to the affected hemisphere. These results show that the FC analysis in NHP stroke model is a relevant methodology suitable to inform the neural changes occurring after a stroke.
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Affiliation(s)
| | - Joseph Y Nashed
- Centre for Neuroscience studies, Queen's University, Kingston, Canada
| | - Juan Fernandez-Ruiz
- Departamento de Fisiologia, Facultad de Medicina, Universidad Nacional Autonoma de Mexico, Mexico, Mexico
| | - Justin Wang
- Centre for Neuroscience studies, Queen's University, Kingston, Canada
| | - Jason Gallivan
- Centre for Neuroscience studies, Queen's University, Kingston, Canada
| | - Douglas J Cook
- Centre for Neuroscience studies, Queen's University, Kingston, Canada. .,Department of Surgery, Faculty of Health Sciences, Queen's University, Kingston, Canada.
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Liu J, Wang Q, Liu F, Song H, Liang X, Lin Z, Hong W, Yang S, Huang J, Zheng G, Tao J, Chen LD. Altered functional connectivity in patients with post-stroke memory impairment: A resting fMRI study. Exp Ther Med 2017; 14:1919-1928. [PMID: 28962104 PMCID: PMC5609161 DOI: 10.3892/etm.2017.4751] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 02/17/2017] [Indexed: 11/20/2022] Open
Abstract
Post-stroke memory dysfunction (PMD) is one of the most common forms of cognitive impairment among stroke survivors. However, only a limited number of studies have directly investigated the neural mechanisms associated with memory decline. The aim of the present study was to identify dynamic changes in the functional organization of the default mode network (DMN) and the dorsal attention network of patients with PMD. A total of 27 patients with PMD who experienced a stroke in the right hemisphere were enrolled in the current study, along with 27 healthy control subjects matched by age, sex, and educational level. A behavioral examination and functional magnetic resonance imaging scan were performed. The data were analyzed using an independent component analysis method. The results revealed a significantly increased functional connectivity between the DMN and prefrontal cortex (left middle/inferior frontal and left precentral gyri), temporal regions (left superior temporal gyrus), and bilateral and posterior cingulate gyri/precuneus (P<0.001). There was also a significantly decreased functional connectivity between the DMN and right middle temporal gyrus, left uvula, and right inferior parietal lobule, and between the dorsal attention network and prefrontal cortex (left precentral/inferior and right inferior/middle frontal gyri), right inferior parietal gyrus, and right insula (P<0.001). These results suggest that the stroke affected both the lesioned and contralesional hemispheres. The prefrontal cortex, temporal regions, insula, and posterior cingulate gyrus/precuneus serve a crucial role in memory processing.
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Affiliation(s)
- Jiao Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China.,Fujian Rehabilitation Tech Co-innovation Center, Fuzhou, Fujian 350122, P.R. China
| | - Qin Wang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Feiwen Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Haiyan Song
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Xiaofeng Liang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Zhengkun Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Wenjun Hong
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Shanli Yang
- Fujian University of Traditional Chinese Medicine Subsidiary Rehabilitation Hospital, Fuzhou, Fujian 350003, P.R. China
| | - Jia Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China.,Fujian Rehabilitation Tech Co-innovation Center, Fuzhou, Fujian 350122, P.R. China
| | - Guohua Zheng
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China.,Key Laboratory of Motor Rehabilitation of Fujian, Fuzhou, Fujian 350003, P.R. China.,Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, Fujian 350000, P.R. China
| | - Li-Dian Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China.,Key Laboratory of Motor Rehabilitation of Fujian, Fuzhou, Fujian 350003, P.R. China.,Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, Fujian 350000, P.R. China
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Mirzaei G, Adeli H. Resting state functional magnetic resonance imaging processing techniques in stroke studies. Rev Neurosci 2016; 27:871-885. [DOI: 10.1515/revneuro-2016-0052] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 10/01/2016] [Indexed: 01/15/2023]
Abstract
AbstractIn recent years, there has been considerable research interest in the study of brain connectivity using the resting state functional magnetic resonance imaging (rsfMRI). Studies have explored the brain networks and connection between different brain regions. These studies have revealed interesting new findings about the brain mapping as well as important new insights in the overall organization of functional communication in the brain network. In this paper, after a general discussion of brain networks and connectivity imaging, the brain connectivity and resting state networks are described with a focus on rsfMRI imaging in stroke studies. Then, techniques for preprocessing of the rsfMRI for stroke patients are reviewed, followed by brain connectivity processing techniques. Recent research on brain connectivity using rsfMRI is reviewed with an emphasis on stroke studies. The authors hope this paper generates further interest in this emerging area of computational neuroscience with potential applications in rehabilitation of stroke patients.
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Affiliation(s)
- Golrokh Mirzaei
- 1Department of Computer Science and Engineering, The Ohio State University, Marion, OH 43302, United States of America
| | - Hojjat Adeli
- 2Department of Biomedical Engineering, Biomedical Informatics, Neurology, Neuroscience, Electrical and Computer Engineering, Civil and Environmental Engineering, The Ohio State University, Columbus, OH 43210, United States of America
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50
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Peng CY, Chen YC, Cui Y, Zhao DL, Jiao Y, Tang TY, Ju S, Teng GJ. Regional Coherence Alterations Revealed by Resting-State fMRI in Post-Stroke Patients with Cognitive Dysfunction. PLoS One 2016; 11:e0159574. [PMID: 27454170 PMCID: PMC4959733 DOI: 10.1371/journal.pone.0159574] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 07/04/2016] [Indexed: 11/19/2022] Open
Abstract
Objectives Post-stroke cognitive dysfunction greatly influences patients’ quality of life after stroke. However, its neurophysiological basis remains unknown. This study utilized resting-state functional magnetic resonance imaging (fMRI) to investigate the alterations in regional coherence in patients after subcortical stroke. Methods Resting-state fMRI measurements were acquired from 16 post-stroke patients with poor cognitive function (PSPC), 16 post-stroke patients with good cognitive function (PSGC) and 30 well-matched healthy controls (HC). Regional homogeneity (ReHo) was used to detect alterations in regional coherence. Abnormalities in regional coherence correlated with scores on neuropsychological scales. Results Compared to the HC and the PSGC, the PSPC showed remarkably decreased ReHo in the bilateral anterior cingulate cortex and the left posterior cingulate cortex/precuneus. ReHo in the bilateral anterior cingulate cortex positively correlated with the scores on the Symbol Digit Modalities Test (r = 0.399, P = 0.036) and the Complex Figure Test-delayed recall subtest (r = 0.397, P = 0.036) in all post-stroke patients. Moreover, ReHo in the left posterior cingulate cortex/precuneus positively correlated with the scores on the Forward Digit Span Test (r = 0.485, P = 0.009) in all post-stroke patients. Conclusions Aberrant regional coherence was observed in the anterior and posterior cingulate cortices in post-stroke patients with cognitive dysfunction. ReHo could represent a promising indicator of neurobiological deficiencies in post-stroke patients.
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Affiliation(s)
- Cheng-Yu Peng
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, Jiangsu, China
- Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Ying Cui
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, Jiangsu, China
- Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, China
| | - Deng-Ling Zhao
- Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, China
| | - Yun Jiao
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, Jiangsu, China
| | - Tian-Yu Tang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, Jiangsu, China
| | - Shenghong Ju
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, Jiangsu, China
- Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, China
| | - Gao-Jun Teng
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, Jiangsu, China
- Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, China
- * E-mail:
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