1
|
Maleyeff L, Park HJ, Khazal ZSH, Wypij D, Rollins CK, Yun HJ, Bellinger DC, Watson CG, Roberts AE, Newburger JW, Grant PE, Im K, Morton SU. Meta-regression of sulcal patterns, clinical and environmental factors on neurodevelopmental outcomes in participants with multiple CHD types. Cereb Cortex 2024; 34:bhae224. [PMID: 38836834 DOI: 10.1093/cercor/bhae224] [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: 03/20/2024] [Revised: 05/07/2024] [Accepted: 05/13/2024] [Indexed: 06/06/2024] Open
Abstract
Congenital heart disease affects 1% of infants and is associated with impaired neurodevelopment. Right- or left-sided sulcal features correlate with executive function among people with Tetralogy of Fallot or single ventricle congenital heart disease. Studies of multiple congenital heart disease types are needed to understand regional differences. Further, sulcal pattern has not been studied in people with d-transposition of the great arteries. Therefore, we assessed the relationship between sulcal pattern and executive function, general memory, and processing speed in a meta-regression of 247 participants with three congenital heart disease types (114 single ventricle, 92 d-transposition of the great arteries, and 41 Tetralogy of Fallot) and 94 participants without congenital heart disease. Higher right hemisphere sulcal pattern similarity was associated with improved executive function (Pearson r = 0.19, false discovery rate-adjusted P = 0.005), general memory (r = 0.15, false discovery rate P = 0.02), and processing speed (r = 0.17, false discovery rate P = 0.01) scores. These positive associations remained significant in for the d-transposition of the great arteries and Tetralogy of Fallot cohorts only in multivariable linear regression (estimated change β = 0.7, false discovery rate P = 0.004; β = 4.1, false discovery rate P = 0.03; and β = 5.4, false discovery rate P = 0.003, respectively). Duration of deep hypothermic circulatory arrest was also associated with outcomes in the multivariate model and regression tree analysis. This suggests that sulcal pattern may provide an early biomarker for prediction of later neurocognitive challenges among people with congenital heart disease.
Collapse
Affiliation(s)
- Lara Maleyeff
- Department of Biostatistics, Epidemiology, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Hannah J Park
- Division of Newborn Medicine, Boston Children's Hospital, Boston 02115, MA, United States
| | - Zahra S H Khazal
- Division of Newborn Medicine, Boston Children's Hospital, Boston 02115, MA, United States
| | - David Wypij
- Department of Pediatrics, Harvard Medical School, Boston MA, United States
- Department of Cardiology, Boston Children's Hospital, Boston 02115, MA, United States
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston MA, United States
| | - Caitlin K Rollins
- Department of Neurology, Boston Children's Hospital 02115 Boston, MA, United States
- Department of Neurology, Harvard Medical School, Boston MA, United States
| | - Hyuk Jin Yun
- Division of Newborn Medicine, Boston Children's Hospital, Boston 02115, MA, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston 02115, MA, United States
| | - David C Bellinger
- Department of Neurology, Boston Children's Hospital 02115 Boston, MA, United States
- Department of Psychiatry, Boston Children's Hospital, Boston 02115, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston MA, United States
| | - Christopher G Watson
- Department of Neurology, Boston Children's Hospital 02115 Boston, MA, United States
| | - Amy E Roberts
- Department of Pediatrics, Harvard Medical School, Boston MA, United States
- Department of Cardiology, Boston Children's Hospital, Boston 02115, MA, United States
| | - Jane W Newburger
- Department of Pediatrics, Harvard Medical School, Boston MA, United States
- Department of Cardiology, Boston Children's Hospital, Boston 02115, MA, United States
| | - P Ellen Grant
- Department of Biostatistics, Epidemiology, and Occupational Health, McGill University, Montreal, QC, Canada
- Fetal Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston 02115, MA, United States
- Department of Radiology, Boston Children's Hospital, Boston 02115, MA, United States
| | - Kiho Im
- Division of Newborn Medicine, Boston Children's Hospital, Boston 02115, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston MA, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston 02115, MA, United States
| | - Sarah U Morton
- Division of Newborn Medicine, Boston Children's Hospital, Boston 02115, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston MA, United States
- Fetal Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston 02115, MA, United States
| |
Collapse
|
2
|
Grattan ES, Hart E, Woodbury M, Nichols M. Impact of Spatial Neglect on Activity and Participation: A Mixed-Methods Study. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024; 44:88-97. [PMID: 37599440 DOI: 10.1177/15394492231188314] [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] [Indexed: 08/22/2023]
Abstract
Post-stroke neglect is disabling, yet it is unclear whether existing assessments capture the extent neglect affects activity and participation. The objective of the study is to explore stroke survivor and caregiver perspectives on how neglect affects activity and participation and to compare their experiences to neglect assessments items. We conducted an explanatory sequential mixed-methods study by conducting semi-structured interviews with stroke survivors (n = 7) and caregivers (n = 7) analyzed using thematic analysis. Stroke survivors completed the Catherine Bergego Scale (CBS) and Behavioral Inattention Test (BIT). Descriptive analyses characterized participant's neglect. The standardized CBS and BIT tests indicated that stroke survivors demonstrated mild-to-moderate (CBS) or no-to-mild (BIT) neglect. In contrast, the qualitative data revealed serious safety concerns and significant ongoing difficulties participating in school, work, and family activities because of neglect. Current assessments may not measure the impact of neglect on activity or participation in life for stroke survivors.
Collapse
Affiliation(s)
- Emily S Grattan
- University of Pittsburgh, PA, USA
- VA Pittsburgh Healthcare Center, Pittsburgh, PA, USA
| | - Emerson Hart
- Medical University of South Carolina, Charleston, USA
| | | | | |
Collapse
|
3
|
Tabuchi G, Furui A, Hama S, Yanagawa A, Shimonaga K, Xu Z, Soh Z, Hirano H, Tsuji T. Motor-cognitive functions required for driving in post-stroke individuals identified via machine-learning analysis. J Neuroeng Rehabil 2023; 20:139. [PMID: 37853392 PMCID: PMC10583407 DOI: 10.1186/s12984-023-01263-z] [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: 06/07/2023] [Accepted: 10/10/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND People who were previously hospitalised with stroke may have difficulty operating a motor vehicle, and their driving aptitude needs to be evaluated to prevent traffic accidents in today's car-based society. Although the association between motor-cognitive functions and driving aptitude has been extensively studied, motor-cognitive functions required for driving have not been elucidated. METHODS In this paper, we propose a machine-learning algorithm that introduces sparse regularization to automatically select driving aptitude-related indices from 65 input indices obtained from 10 tests of motor-cognitive function conducted on 55 participants with stroke. Indices related to driving aptitude and their required tests can be identified based on the output probability of the presence or absence of driving aptitude to provide evidence for identifying subjects who must undergo the on-road driving test. We also analyzed the importance of the indices of motor-cognitive function tests in evaluating driving aptitude to further clarify the relationship between motor-cognitive function and driving aptitude. RESULTS The experimental results showed that the proposed method achieved predictive evaluation of the presence or absence of driving aptitude with high accuracy (area under curve 0.946) and identified a group of indices of motor-cognitive function tests that are strongly related to driving aptitude. CONCLUSIONS The proposed method is able to effectively and accurately unravel driving-related motor-cognitive functions from a panoply of test results, allowing for autonomous evaluation of driving aptitude in post-stroke individuals. This has the potential to reduce the number of screening tests required and the corresponding clinical workload, further improving personal and public safety and the quality of life of individuals with stroke.
Collapse
Affiliation(s)
- Genta Tabuchi
- Graduate School of Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima, Hiroshima, 739-8527, Japan
| | - Akira Furui
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima, Hiroshima, 739-8527, Japan
| | - Seiji Hama
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8551, Japan.
- Department of Rehabilitation, Hibino Hospital, 7-9-2 Tomo-Higashi, Asaminami-ku, Hiroshima, Hiroshima, 731-3164, Japan.
| | - Akiko Yanagawa
- Department of Rehabilitation, Hibino Hospital, 7-9-2 Tomo-Higashi, Asaminami-ku, Hiroshima, Hiroshima, 731-3164, Japan
| | - Koji Shimonaga
- Department of Neurosurgery and Interventional Neuroradiology, Hiroshima City North Medical Center Asa Citizens Hospital, 1-2-1 Kameyamaminami, Asakita-ku, Hiroshima, Hiroshima, 731-0293, Japan
| | - Ziqiang Xu
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima, Hiroshima, 739-8527, Japan
| | - Zu Soh
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima, Hiroshima, 739-8527, Japan
| | - Harutoyo Hirano
- Department of Medical Equipment Engineering, Clinical Collaboration Unit, School of Medical Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Toshio Tsuji
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima, Hiroshima, 739-8527, Japan.
| |
Collapse
|
4
|
Artificially-reconstructed brain images with stroke lesions from non-imaging data: modeling in categorized patients based on lesion occurrence and sparsity. Sci Rep 2022; 12:10116. [PMID: 35710703 PMCID: PMC9203453 DOI: 10.1038/s41598-022-14249-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 06/03/2022] [Indexed: 11/08/2022] Open
Abstract
Brain imaging is necessary for understanding disease symptoms, including stroke. However, frequent imaging procedures encounter practical limitations. Estimating the brain information (e.g., lesions) without imaging sessions is beneficial for this scenario. Prospective estimating variables are non-imaging data collected from standard tests. Therefore, the current study aims to examine the variable feasibility for modelling lesion locations. Heterogeneous variables were employed in the multivariate logistic regression. Furthermore, patients were categorized (i.e., unsupervised clustering through k-means method) by the charasteristics of lesion occurrence (i.e., ratio between the lesioned and total regions) and sparsity (i.e., density measure of lesion occurrences across regions). Considering those charasteristics in models improved estimation performances. Lesions (116 regions in Automated Anatomical Labeling) were adequately predicted (sensitivity: 80.0-87.5% in median). We confirmed that the usability of models was extendable to different resolution levels in the brain region of interest (e.g., lobes, hemispheres). Patients' charateristics (i.e., occurrence and sparsity) might also be explained by the non-imaging data as well. Advantages of the current approach can be experienced by any patients (i.e., with or without imaging sessions) in any clinical facilities (i.e., with or without imaging instrumentation).
Collapse
|
5
|
Nishimura A, Sutoko S, Kiguchi M, Atsumori H, Obata A, Funane T, Kandori A, Mizuguchi T, Shimonaga K, Hama S, Tsuji T. Projection of Damaged Visual and Language Regions on Low Trail Making Test Part-B Performance in Stroke Patients. Front Neurol 2022; 13:853942. [PMID: 35720060 PMCID: PMC9201080 DOI: 10.3389/fneur.2022.853942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe Trail Making Test Part-B (TMT-B) is an attention functional test to investigate cognitive dysfunction. It requires the ability to recognize not only numbers but also letters. We analyzed the relationship between brain lesions in stroke patients and their TMT-B performance.MethodsFrom the TMT-B, two parameters (score and completion time) were obtained. The subjects were classified into several relevant groups by their scores and completion times through a data-driven analysis (k-means clustering). The score-classified groups were characterized by low (≤10), moderate (10 < score < 25), and high (25) scores. In terms of the completion time, the subjects were classified into four groups. The lesion degree in the brain was calculated for each of the 116 regions classified by automated anatomical labeling (AAL). For each group, brain sites with a significant difference (corrected p < 0.1) between each of the 116 regions were determined by a Wilcoxon Rank–Sum significant difference test.ResultsLesions at the cuneus and the superior occipital gyrus, which are mostly involved in visual processing, were significant (corrected p < 0.1) in the low-score group. Furthermore, the moderate-score group showed more-severe lesion degrees (corrected p < 0.05) in the regions responsible for the linguistic functions, such as the superior temporal gyrus and the supramarginal gyrus. As for the completion times, lesions in the calcarine, the cuneus, and related regions were significant (corrected p < 0.1) in the fastest group as compared to the slowest group. These regions are also involved in visual processing.ConclusionThe TMT-B results revealed that the subjects in the low-score group or the slowest- group mainly had damage in the visual area, whereas the subjects in the moderate-score group mainly had damage in the language area. These results suggest the potential utility of TMT-B performance in the lesion site.
Collapse
Affiliation(s)
- Ayako Nishimura
- Center for Exploratory Research, Research & Development Group, Hitachi. Ltd., Kokubunji, Japan
- Department of Rehabilitation, Hibino Hospital, Hiroshima, Japan
- *Correspondence: Ayako Nishimura
| | - Stephanie Sutoko
- Center for Exploratory Research, Research & Development Group, Hitachi. Ltd., Kokubunji, Japan
- Department of Rehabilitation, Hibino Hospital, Hiroshima, Japan
| | - Masashi Kiguchi
- Center for Exploratory Research, Research & Development Group, Hitachi. Ltd., Kokubunji, Japan
- Department of Rehabilitation, Hibino Hospital, Hiroshima, Japan
| | - Hirokazu Atsumori
- Center for Exploratory Research, Research & Development Group, Hitachi. Ltd., Kokubunji, Japan
- Department of Rehabilitation, Hibino Hospital, Hiroshima, Japan
| | - Akiko Obata
- Center for Exploratory Research, Research & Development Group, Hitachi. Ltd., Kokubunji, Japan
- Department of Rehabilitation, Hibino Hospital, Hiroshima, Japan
| | - Tsukasa Funane
- Center for Exploratory Research, Research & Development Group, Hitachi. Ltd., Kokubunji, Japan
- Department of Rehabilitation, Hibino Hospital, Hiroshima, Japan
| | - Akihiko Kandori
- Center for Exploratory Research, Research & Development Group, Hitachi. Ltd., Kokubunji, Japan
- Department of Rehabilitation, Hibino Hospital, Hiroshima, Japan
| | - Tomohiko Mizuguchi
- IoT Innovation Department, New Business Produce Division, Maxell Ltd., Yokohama, Japan
| | - Koji Shimonaga
- Department of Neurosurgery and Interventional Neuroradiology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Seiji Hama
- Department of Rehabilitation, Hibino Hospital, Hiroshima, Japan
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Toshio Tsuji
- Graduate School of Advanced Science and Engineering, Hiroshima University, Higashihiroshima, Japan
| |
Collapse
|
6
|
Shimonaga K, Hama S, Furui A, Yanagawa A, Kandori A, Atsumori H, Yamawaki S, Matsushige T, Tsuji T. Increased cerebrovascular reactivity in selected brain regions after extracranial-intracranial bypass improves the speed and accuracy of visual cancellation in patients with severe steno-occlusive disease: a preliminary study. Neurosurg Rev 2022; 45:2257-2268. [PMID: 35094203 PMCID: PMC9160123 DOI: 10.1007/s10143-021-01720-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/24/2021] [Accepted: 12/13/2021] [Indexed: 11/30/2022]
Abstract
The effect of the change in cerebrovascular reactivity (CVR) in each brain area on cognitive function after extracranial-intracranial bypass (EC-IC bypass) was examined. Eighteen patients who underwent EC-IC bypass for severe unilateral steno-occlusive disease were included. Single-photon emission CT (SPECT) for evaluating CVR and the visual cancellation (VC) task were performed before and after surgery. The accuracy of VC was expressed by the arithmetic mean of the age-matched correct answer rate and the accurate answer rate, and the averages of the time (time score) and accuracy (accuracy score) of the four VC subtests were used. The speed of VC tended to be slower, whereas accuracy was maintained before surgery. The EC-IC bypass improved CVR mainly in the cerebral hemisphere on the surgical side. On bivariate analysis, when CVR increased post-operatively, accuracy improved on both surgical sides, but the time score was faster on the left and slower on the right surgical side. Stepwise multiple regression analysis showed that the number of the brain regions associated with the time score was 5 and that associated with the accuracy score was 4. In the hemodynamically ischemic brain, processing speed might be adjusted so that accuracy would be maintained based on the speed-accuracy trade-off mechanism that may become engaged separately in the left and right cerebral hemispheres when performing VC. When considering the treatment for hemodynamic ischemia, the relationship between CVR change and the speed-accuracy trade-off in each brain region should be considered.
Collapse
Affiliation(s)
- Koji Shimonaga
- Department of Neurosurgery and Interventional Neuroradiology, Hiroshima City Asa Citizens Hospital, Hiroshima, 731-0293, Japan
| | - Seiji Hama
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734 8551, Japan.
- Department of Rehabilitation, Hibino Hospital, Hiroshima, 731-3164, Japan.
- Center for Brain, Mind and KANSEI Sciences Research, Hiroshima University, Hiroshima, 734‑8551, Japan.
| | - Akira Furui
- Graduate School of Advanced Science and Engineering, Hiroshima University, Hiroshima, 739-8527, Japan
| | - Akiko Yanagawa
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734 8551, Japan
- Department of Rehabilitation, Hibino Hospital, Hiroshima, 731-3164, Japan
- Center for Brain, Mind and KANSEI Sciences Research, Hiroshima University, Hiroshima, 734‑8551, Japan
| | - Akihiko Kandori
- Center for Exploratory Research, Research and Development Group, Hitachi. Ltd, Tokyo, 185-8601, Japan
| | - Hirokazu Atsumori
- Center for Exploratory Research, Research and Development Group, Hitachi. Ltd, Tokyo, 185-8601, Japan
| | - Shigeto Yamawaki
- Center for Brain, Mind and KANSEI Sciences Research, Hiroshima University, Hiroshima, 734‑8551, Japan
| | - Toshinori Matsushige
- Department of Neurosurgery and Interventional Neuroradiology, Hiroshima City Asa Citizens Hospital, Hiroshima, 731-0293, Japan
| | - Toshio Tsuji
- Graduate School of Advanced Science and Engineering, Hiroshima University, Hiroshima, 739-8527, Japan
| |
Collapse
|
7
|
Zhang Q, Zhang L, He W, Zheng X, Zhao Z, Li Y, Xu S, Zheng J, Zhuang X, Jia W, Zhu C, Xu H, Shan C, Chen W, Zhao J, Chen S. Case Report: Visual Deprivation in Pusher Syndrome Complicated by Hemispatial Neglect After Basal Ganglia Stroke. Front Neurol 2021; 12:706611. [PMID: 34630282 PMCID: PMC8494178 DOI: 10.3389/fneur.2021.706611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/05/2021] [Indexed: 12/03/2022] Open
Abstract
We aimed to explore whether motor function and activities of daily life (ADL) could be improved with the application of visual deprivation in two patients with Pusher syndrome complicated by hemispatial neglect after right basal ganglia stroke. We assessed two stroke patients suffering from severe motor disturbances, both tilting heavily to the left, with diagnoses of Pusher syndrome and left hemispatial neglect. Vision in the left eye was deprived using patches during clinical rehabilitation. Motor function promotion was confirmed using the Burke Lateropulsion Scale (BLS), Fugl–Meyer Balance Scale (FMBS), and Holden grade (HG), while the Barthel index (BI) assessed ADL immediately and 1 week after intervention. Both patients regained standing balance immediately using visual deprivation, as well as walking ability, although both scored 0 on the FMBS and HG. After 1 week of treatment, one patient increased to 11 and 3 on the FMBS and HG, respectively, while the BLS score decreased from 12 to 2, and the ADL increased from 23 to 70. The other patient demonstrated increases to 10 and 3 on the FMBS and HG, respectively, with the BLS decreasing from 13 to 3, and the ADL increasing from 25 to 60. Therefore, in the rehabilitation treatment of Pusher syndrome complicated by hemispatial neglect due to basal ganglia stroke, visual deprivation can significantly improve motor function and shorten the treatment course.
Collapse
Affiliation(s)
- Qian Zhang
- Rehabilitation Department, The Geriatric Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Lixia Zhang
- Rehabilitation Department, The Geriatric Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Wei He
- Rehabilitation Department, Rehabilitation Hospital Affiliated to Nanjing Institute of Physical Education, Wuxi, China
| | - Xuemei Zheng
- Rehabilitation Department, Xinjiang Korla Bazhou People's Hospital, Korla, China
| | - Zhengrui Zhao
- Rehabilitation Department, The Geriatric Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Yuanli Li
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
| | - Shutian Xu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
| | - Juan Zheng
- Rehabilitation Department, The Geriatric Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Xin Zhuang
- Rehabilitation Department, The Geriatric Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Wenting Jia
- Rehabilitation Department, The Geriatric Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Chengyuan Zhu
- Rehabilitation Department, The Geriatric Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Hua Xu
- Rehabilitation Department, The Geriatric Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Chunlei Shan
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China.,Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
| | - Wenhua Chen
- Rehabilitation Department, The First People's Hospital Affiliated With Shanghai Jiao Tong University, Shanghai, China
| | - Jingpu Zhao
- Rehabilitation Department, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Sijing Chen
- Rehabilitation Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| |
Collapse
|
8
|
Almosallam A, Qureshi AZ, Ullah S, Alibrahim A. Return to driving post stroke; patients' perspectives and challenges in Saudi Arabia. Top Stroke Rehabil 2021; 29:192-200. [PMID: 33775236 DOI: 10.1080/10749357.2021.1905201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BackgroundReturning to driving remains one of the most important goals for stroke survivors. In Saudi Arabia, there are no structured processes to address the issue of return to driving in individuals with disabilities. There are increasing rates of strokes in the country and road traffic accidents are the highest in the region. Returning to driving among male stroke survivors in Saudi Arabia is of particular importance due to socio-economic and cultural reasons.AimsThe study aims to explore the factors involved in return to driving among stroke survivors in Saudi population.MethodsThis cross-sectional study was carried out on 100 male stroke survivors who had completed an inpatient rehabilitation program and had at least one follow-up assessment three months post-discharge. Information was collected regarding demographics, stroke characteristics, and factors related to pre and post-stroke driving. Data were analyzed using SPSS.ResultsMajority (60%) of patients were 51 years of age and above. Most commonly reported stroke impairments were weakness and spasticity with majority of participants having right-sided body involvement. Out of 94 stroke survivors who were driving prior to stroke, only 7 resumed driving. None of the stroke survivors who returned to driving reported receiving any formal driving assessment. Only one patient who reported being aware of the need of driving assessment did not resume driving after stroke.ConclusionsThere is a dire need to increase awareness and to develop a structured integrated system in Saudi Arabia to facilitate stroke survivors to return to driving.
Collapse
Affiliation(s)
| | - Ahmad Zaheer Qureshi
- Department of Physical Medicine & RehabilitationKing Fahad Medical City,Ryiadh,Saudi Arabia
| | - Sami Ullah
- Department of Physical Medicine & RehabilitationKing Fahad Medical City,Ryiadh,Saudi Arabia
| | - Abdullah Alibrahim
- Department of Comprehensive Rehabilitation CareKing Fahad Medical City,Riyadh,Saudi Arabia
| |
Collapse
|
9
|
Wu L, Wang C, Liu J, Guo J, Wei Y, Wang K, Miao P, Wang Y, Cheng J. Voxel-Mirrored Homotopic Connectivity Associated With Change of Cognitive Function in Chronic Pontine Stroke. Front Aging Neurosci 2021; 13:621767. [PMID: 33679376 PMCID: PMC7929989 DOI: 10.3389/fnagi.2021.621767] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/18/2021] [Indexed: 12/14/2022] Open
Abstract
Recent neuroimaging studies have shown the possibility of cognitive impairment after pontine stroke. In this study, we aimed to use voxel-mirrored homotopic connectivity (VMHC) to investigate changes in the cognitive function in chronic pontine stroke. Functional MRI (fMRI) and behavioral assessments of cognitive function were obtained from 56 patients with chronic pontine ischemic stroke [28 patients with left-sided pontine stroke (LP) and 28 patients with right-sided pontine stroke (RP)] and 35 matched healthy controls (HC). The one-way ANOVA test was performed for the three groups after the VMHC analysis. Results showed that there were significant decreases in the bilateral lingual gyrus (Lingual_L and Lingual_R) and the left precuneus (Precuneus_L) in patients with chronic pontine ischemic stroke compared to HCs. However, in a post-hoc multiple comparison test, this difference remained only between the HC and RP groups. Moreover, we explored the relationship between the decreased z-values in VMHC and the behavior-task scores using a Pearson's correlation test and found that both scores of short-term memory and long-term memory in the Rey Auditory Verbal Learning Test were positively correlated with z-values of the left lingual gyrus (Lingual_L), the right lingual gyrus (Lingual_R), and the left precuneus (Precuneus_L) in VMHC. Besides that, the z-values of Precuneus_L in VMHC were also negatively correlated with the reaction time for correct responses in the Flanker task and the spatial memory task. In conclusion, first, the lingual gyrus played an important role in verbal memory. Second, the precuneus influenced the working memory, both auditory-verbal memory and visual memory. Third, the right-sided stroke played a greater role in the results of this study. This study provides a basis for further elucidation of the characteristics and mechanisms of cognitive impairment after pontine stroke.
Collapse
Affiliation(s)
- Luobing Wu
- Henan Key Laboratory of Magnetic Resonance Function and Molecular Imaging, Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Caihong Wang
- Henan Key Laboratory of Magnetic Resonance Function and Molecular Imaging, Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingchun Liu
- Tianjin Key Laboratory of Functional Imaging, Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jun Guo
- Department of Radiology, Tianjin Huanhu Hospital, Tianjin, China
| | - Ying Wei
- Henan Key Laboratory of Magnetic Resonance Function and Molecular Imaging, Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kaiyu Wang
- GE Healthcare MR Research, Beijing, China
| | - Peifang Miao
- Henan Key Laboratory of Magnetic Resonance Function and Molecular Imaging, Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yingying Wang
- Henan Key Laboratory of Magnetic Resonance Function and Molecular Imaging, Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Henan Key Laboratory of Magnetic Resonance Function and Molecular Imaging, Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
10
|
Lesions in the right Rolandic operculum are associated with self-rating affective and apathetic depressive symptoms for post-stroke patients. Sci Rep 2020; 10:20264. [PMID: 33219292 PMCID: PMC7679372 DOI: 10.1038/s41598-020-77136-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 11/04/2020] [Indexed: 12/12/2022] Open
Abstract
Stroke survivors majorly suffered from post-stroke depression (PSD). The PSD diagnosis is commonly performed based on the clinical cut-off for psychometric inventories. However, we hypothesized that PSD involves spectrum symptoms (e.g., apathy, depression, anxiety, and stress domains) and severity levels. Therefore, instead of using the clinical cut-off, we suggested a data-driven analysis to interpret patient spectrum conditions. The patients’ psychological conditions were categorized in an unsupervised manner using the k-means clustering method, and the relationships between psychological conditions and quantitative lesion degrees were evaluated. This study involved one hundred sixty-five patient data; all patients were able to understand and perform self-rating psychological conditions (i.e., no aphasia). Four severity levels—low, low-to-moderate, moderate-to-high, and high—were observed for each combination of two psychological domains. Patients with worse conditions showed the significantly greater lesion degree at the right Rolandic operculum (part of Brodmann area 43). The dissimilarities between stress and other domains were also suggested. Patients with high stress were specifically associated with lesions in the left thalamus. Impaired emotion processing and stress-affected functions have been frequently related to those lesion regions. Those lesions were also robust and localized, suggesting the possibility of an objective for predicting psychological conditions from brain lesions.
Collapse
|