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Liu N, Ye TF, Yu QW. The role of the right hemispheric homologous language pathways in recovery from post-stroke aphasia: A systematic review. Psychiatry Res Neuroimaging 2024; 343:111866. [PMID: 39098261 DOI: 10.1016/j.pscychresns.2024.111866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/06/2024] [Accepted: 07/31/2024] [Indexed: 08/06/2024]
Abstract
The involvement of the right hemisphere, mainly the activation of the right cerebral regions, in recovery from post-stroke aphasia has been widely recognized. In contrast, the role of the right white matter pathways in the recovery from post-stroke aphasia is rarely understood. In this study, we aimed to provide a primary overview of the correlation between the structural integrity of the right hemispheric neural tracts based on the dual-stream model of language organization and recovery from post-stroke aphasia by systematically reviewing prior longitudinal interventional studies. By searching electronic databases for relevant studies according to a standard protocol, a total of 10 records (seven group studies and three case studies) including 79 participants were finally included. After comprehensively analyzing these studies and reviewing the literature, although no definite correlation was found between the right hemispheric neural tracts and recovery from post-stroke aphasia, our review provideds a new perspective for investigating the linguistic role of the right hemispheric neural tracts. This suggests that the involvement of the right hemispheric neural tracts in recovery from post-stroke aphasia may be mediated by multiple factors; thus, this topic should be comprehensively investigated in the future.
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Affiliation(s)
- Na Liu
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215008, Jiangsu, China
| | - Tian-Fen Ye
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215008, Jiangsu, China
| | - Qi-Wei Yu
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215008, Jiangsu, China.
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Su H, Yan S, Zhu H, Liu Y, Zhang G, Peng X, Zhang S, Li Y, Zhu W. A normative modeling approach to quantify white matter changes and predict functional outcomes in stroke patients. Front Neurosci 2024; 18:1334508. [PMID: 38379757 PMCID: PMC10877717 DOI: 10.3389/fnins.2024.1334508] [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: 11/07/2023] [Accepted: 01/12/2024] [Indexed: 02/22/2024] Open
Abstract
Objectives The diverse nature of stroke necessitates individualized assessment, presenting challenges to case-control neuroimaging studies. The normative model, measuring deviations from a normal distribution, provides a solution. We aim to evaluate stroke-induced white matter microstructural abnormalities at group and individual levels and identify potential prognostic biomarkers. Methods Forty-six basal ganglia stroke patients and 46 healthy controls were recruited. Diffusion-weighted imaging and clinical assessment were performed within 7 days after stroke. We used automated fiber quantification to characterize intergroup alterations of segmental diffusion properties along 20 fiber tracts. Then each patient was compared to normative reference (46 healthy participants) by Mahalanobis distance tractometry for 7 significant fiber tracts. Mahalanobis distance-based deviation loads (MaDDLs) and fused MaDDLmulti were extracted to quantify individual deviations. We also conducted correlation and logistic regression analyses to explore relationships between MaDDL metrics and functional outcomes. Results Disrupted microstructural integrity was observed across the left corticospinal tract, bilateral inferior fronto-occipital fasciculus, left inferior longitudinal fasciculus, bilateral thalamic radiation, and right uncinate fasciculus. The correlation coefficients between MaDDL metrics and initial functional impairment ranged from 0.364 to 0.618 (p < 0.05), with the highest being MaDDLmulti. Furthermore, MaDDLmulti demonstrated a significant enhancement in predictive efficacy compared to MaDDL (integrated discrimination improvement [IDI] = 9.62%, p = 0.005) and FA (IDI = 34.04%, p < 0.001) of the left corticospinal tract. Conclusion MaDDLmulti allows for assessing behavioral disorders and predicting prognosis, offering significant implications for personalized clinical decision-making and stroke recovery. Importantly, our method demonstrates prospects for widespread application in heterogeneous neurological diseases.
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Affiliation(s)
| | | | | | | | | | | | | | - Yuanhao Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Shao ZD, Gong YJ, Ren J, Wang J. Exploring the arcuate fasciculus from a clinical perspective. Front Neurosci 2023; 17:1307834. [PMID: 38033540 PMCID: PMC10684764 DOI: 10.3389/fnins.2023.1307834] [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: 10/05/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
In recent years, language function impairment caused by intracranial diseases has gained increasing interest, mainly due to its significant impact on the language and cognitive ability, leading to a serious decline in the quality of life of patients. Consequently, researchers aimed to clarify the quantitative degree of lesions of the arcuate fasciculus and therapeutic targets to promote nerve fiber remodeling. The arcuate fasciculus is extremely prone to damage caused by diseases such as stroke and brain tumor. Hallucinating schizophrenia, autism spectrum disorder, epilepsy, chronic fatigue syndrome, chronic tinnitus, and other diseases can also lead to changes in the fractional anisotropy value of arcuate fasciculus; however, different studies have different conclusions about how this change occurs. To obtain a better understanding, more clinical studies are required. Owing to various advancements in neuroimaging, a better understanding and identification of vital targets for restoration of neurological function are possible. The arcuate fasciculus is stratified into three substructures, each having unique neurological functions. Both diffusion tensor imaging (DTI) sequences and deterministic monitoring techniques render it possible to visually and quantitatively analyze the substructure in three parts. In this review, we examined the progress of the arcuate fasciculus and quantitative DTI technology in recent years.
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Affiliation(s)
| | | | | | - Ji Wang
- Second Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
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Zhu W, Deng S, Jiang H, Zhang J, Li B, Liu W, Jia Q, Liu W, Meng Z. Application of diffusion tensor imaging in the diagnosis of post-stroke aphasia: a meta-analysis and systematic review. Front Psychol 2023; 14:1140588. [PMID: 37790217 PMCID: PMC10544987 DOI: 10.3389/fpsyg.2023.1140588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 08/31/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction Diffusion Tensor Imaging (DTI) indicators of different white matter (WM) fibers and brain region lesions for post-stroke aphasia (PSA) are inconsistent in existing studies. Our study examines the consistency and differences between PSA tests performed with DTI. In addition, obtaining consistent and independent conclusions between studies was made possible by utilizing DTI in PSA assessment. Methods In order to gather relevant studies using DTI for diagnosing PSA, we searched the Web of Science, PubMed, Embase, and CNKI databases. Based on the screening and evaluation of the included studies, the meta-analysis was used to conduct a quantitative analysis. Narrative descriptions were provided for studies that met the inclusion criteria but lacked data. Results First, we reported on the left hemisphere. The meta-analysis showed that fractional anisotropy (FA) of the arcuate fasciculus (AF) and superior longitudinal fasciculus (SLF), inferior frontal-occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), and uncinate fasciculus (UF) were decreased in the PSA group in comparison with the healthy controls (p < 0.00001). However, in the comparison of axial diffusivity (AD), there was no statistically significant difference in white matter fiber tracts in the dual-stream language model of the PSA group. Elevated radial diffusivity (RD) was seen only in the IFOF and ILF (PIFOF = 0.01; PILF = 0.05). In the classic Broca's area, the FA of the PSA group was decreased (p < 0.00001) while the apparent diffusion coefficient was elevated (p = 0.03). Secondly, we evaluated the white matter fiber tracts in the dual-stream language model of the right hemisphere. The FA of the PSA group was decreased only in the IFOF (p = 0.001). AD was elevated in the AF and UF (PAF < 0.00001; PUF = 0.009). RD was elevated in the AF and UF (PAF = 0.01; PUF = 0.003). The other fiber tracts did not undergo similar alterations. Conclusion In conclusion, DTI is vital for diagnosing PSA because it detects WM changes effectively, but it still has some limitations. Due to a lack of relevant language scales and clinical manifestations, diagnosing and differentiating PSA independently remain challenging. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=365897.
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Affiliation(s)
- Weiming Zhu
- Clinical Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Shizhe Deng
- Clinical Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Hailun Jiang
- Clinical Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Jieying Zhang
- Clinical Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Boxuan Li
- Clinical Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Wei Liu
- Clinical Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Qingqing Jia
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Wei Liu
- Department of Scientific Research, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhihong Meng
- Clinical Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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Yu Q, Jiang Y, Sun Y, Ju X, Ye T, Liu N, Qian S, Liu K. Effects of Damage to the Integrity of the Left Dual-Stream Frontotemporal Network Mediated by the Arcuate Fasciculus and Uncinate Fasciculus on Acute/Subacute Post-Stroke Aphasia. Brain Sci 2023; 13:1324. [PMID: 37759925 PMCID: PMC10526853 DOI: 10.3390/brainsci13091324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/10/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: To investigate the correlation between the integrity of the left dual-stream frontotemporal network mediated by the arcuate fasciculus (AF) and uncinate fasciculus (UF), and acute/subacute post-stroke aphasia (PSA). (2) Methods: Thirty-six patients were recruited and received both a language assessment and a diffusion tensor imaging (DTI) scan. Correlations between diffusion indices in the bilateral LSAF/UF and language performance assessment were analyzed with correlation analyses. Multiple linear regression analysis was also implemented to investigate the effects of the integrity of the left LSAF/UF on language performance. (3) Results: Correlation analyses showed that the diffusion indices, including mean fractional anisotropy (FA) values and the fiber number of the left LSAF rather than the left UF was significantly positively associated with language domain scores (p < 0.05). Multiple linear regression analysis revealed an independent and positive association between the mean FA value of the left LSAF and the percentage score of language subsets. In addition, no interaction effect of the integrity of the left LSAF and UF on language performance was found (p > 0.05). (4) Conclusions: The integrity of the left LSAF, but not the UF, might play important roles in supporting residual language ability in individuals with acute/subacute PSA; simultaneous disruption of the dual-stream frontotemporal network mediated by the left LSAF and UF would not result in more severe aphasia than damage to either pathway alone.
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Affiliation(s)
- Qiwei Yu
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215008, China; (Q.Y.); (Y.J.); (X.J.); (T.Y.); (N.L.); (S.Q.)
| | - Yuer Jiang
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215008, China; (Q.Y.); (Y.J.); (X.J.); (T.Y.); (N.L.); (S.Q.)
| | - Yan Sun
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215008, China;
| | - Xiaowen Ju
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215008, China; (Q.Y.); (Y.J.); (X.J.); (T.Y.); (N.L.); (S.Q.)
| | - Tianfen Ye
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215008, China; (Q.Y.); (Y.J.); (X.J.); (T.Y.); (N.L.); (S.Q.)
| | - Na Liu
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215008, China; (Q.Y.); (Y.J.); (X.J.); (T.Y.); (N.L.); (S.Q.)
| | - Surong Qian
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215008, China; (Q.Y.); (Y.J.); (X.J.); (T.Y.); (N.L.); (S.Q.)
| | - Kefu Liu
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215008, China;
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Jang SH, Yeo SS, Cho MJ. Relationships of the arcuate fasciculus and nigrostriatal tract with language ability in intracerebral hemorrhage using a diffusion tensor imaging. Sci Rep 2023; 13:9198. [PMID: 37280328 DOI: 10.1038/s41598-023-36307-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/31/2023] [Indexed: 06/08/2023] Open
Abstract
We investigated the relationships of the arcuate fasciculus (AF) and the nigrostriatal tract (NST) with the language ability in patients with putaminal hemorrhage (PH) in the dominant hemisphere, using diffusion tensor tractography (DTT). Twenty-seven consecutive right-handed patients with PH and 27 age- and sex-matched normal control subjects were recruited. The aphasia quotient (AQ) score was used to evaluate the language ability at the early stage (within six weeks after onset). The fractional anisotropy (FA) value and tract volume (TV) of the ipsilesional AF and the ipsilesional NST were measured. The FA values and TVs of the ipsilesional AF and the ipsilesional NST of the patient group were lower than those of the control group (p < 0.05). The AQ score showed no significant correlation with the FA values of the ipsilesional AF and the ipsilesional NST (p > 0.05). By contrast, the AQ score showed a strong positive correlation with the TV of the ipsilesional AF (r = 0.868, p < 0.05). In addition, the AQ score revealed a moderate positive correlation with the TV of the ipsilesional NST (r = 0.577, p < 0.05). The states of the ipsilesional AF and the ipsilesional NST were closely related to the language ability at the early stages in patients with PH in the dominant hemisphere. Furthermore, the ipsilesional AF was more closely related to the language ability than the ipsilesional NST.
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Affiliation(s)
- Sung Ho Jang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, 317-1, Daemyung dong, Namgu, Daegu, 705-717, Republic of Korea
| | - Sang Seok Yeo
- Department of Physical Therapy, College of Health Sciences, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam, 330-714, Republic of Korea
| | - Min Jye Cho
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, 317-1, Daemyung dong, Namgu, Daegu, 705-717, Republic of Korea.
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Olivé G, Peñaloza C, Vaquero L, Laine M, Martin N, Rodriguez-Fornells A. The right uncinate fasciculus supports verbal short-term memory in aphasia. Brain Struct Funct 2023; 228:875-893. [PMID: 37005932 PMCID: PMC10147778 DOI: 10.1007/s00429-023-02628-9] [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: 09/13/2022] [Accepted: 03/05/2023] [Indexed: 04/04/2023]
Abstract
Verbal short-term memory (STM) deficits are associated with language processing impairments in people with aphasia. Importantly, the integrity of STM can predict word learning ability and anomia therapy gains in aphasia. While the recruitment of perilesional and contralesional homologous brain regions has been proposed as a possible mechanism for aphasia recovery, little is known about the white-matter pathways that support verbal STM in post-stroke aphasia. Here, we investigated the relationships between the language-related white matter tracts and verbal STM ability in aphasia. Nineteen participants with post-stroke chronic aphasia completed a subset of verbal STM subtests of the TALSA battery including nonword repetition (phonological STM), pointing span (lexical-semantic STM without language output) and repetition span tasks (lexical-semantic STM with language output). Using a manual deterministic tractography approach, we investigated the micro- and macrostructural properties of the structural language network. Next, we assessed the relationships between individually extracted tract values and verbal STM scores. We found significant correlations between volume measures of the right Uncinate Fasciculus and all three verbal STM scores, with the association between the right UF volume and nonword repetition being the strongest one. These findings suggest that the integrity of the right UF is associated with phonological and lexical-semantic verbal STM ability in aphasia and highlight the potential compensatory role of right-sided ventral white matter language tracts in supporting verbal STM after aphasia-inducing left hemisphere insult.
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Affiliation(s)
- Guillem Olivé
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain.
- Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Claudia Peñaloza
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
- Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Lucía Vaquero
- Legal Medicine, Psychiatry and Pathology Department, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain
| | - Matti Laine
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Nadine Martin
- Department of Communication Sciences and Disorders, Eleanor M. Saffran Center for Cognitive Neuroscience, Temple University, Philadelphia, PA, USA
| | - Antoni Rodriguez-Fornells
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain.
- Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain.
- Institució Catalana de Recerca i Estudis Avançats, ICREA, 08010, Barcelona, Spain.
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Zhu H, Fitzhugh MC, Keator LM, Johnson L, Rorden C, Bonilha L, Fridriksson J, Rogalsky C. How can graph theory inform the dual-stream model of speech processing? a resting-state fMRI study of post-stroke aphasia. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.17.537216. [PMID: 37131756 PMCID: PMC10153155 DOI: 10.1101/2023.04.17.537216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The dual-stream model of speech processing has been proposed to represent the cortical networks involved in speech comprehension and production. Although it is arguably the prominent neuroanatomical model of speech processing, it is not yet known if the dual-stream model represents actual intrinsic functional brain networks. Furthermore, it is unclear how disruptions after a stroke to the functional connectivity of the dual-stream model's regions are related to specific types of speech production and comprehension impairments seen in aphasia. To address these questions, in the present study, we examined two independent resting-state fMRI datasets: (1) 28 neurotypical matched controls and (2) 28 chronic left-hemisphere stroke survivors with aphasia collected at another site. Structural MRI, as well as language and cognitive behavioral assessments, were collected. Using standard functional connectivity measures, we successfully identified an intrinsic resting-state network amongst the dual-stream model's regions in the control group. We then used both standard functional connectivity analyses and graph theory approaches to determine how the functional connectivity of the dual-stream network differs in individuals with post-stroke aphasia, and how this connectivity may predict performance on clinical aphasia assessments. Our findings provide strong evidence that the dual-stream model is an intrinsic network as measured via resting-state MRI, and that weaker functional connectivity of the hub nodes of the dual-stream network defined by graph theory methods, but not overall average network connectivity, is weaker in the stroke group than in the control participants. Also, the functional connectivity of the hub nodes predicted specific types of impairments on clinical assessments. In particular, the relative strength of connectivity of the right hemisphere's homologues of the left dorsal stream hubs to the left dorsal hubs versus right ventral stream hubs is a particularly strong predictor of post-stroke aphasia severity and symptomology.
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Shekari E, Nozari N. A narrative review of the anatomy and function of the white matter tracts in language production and comprehension. Front Hum Neurosci 2023; 17:1139292. [PMID: 37051488 PMCID: PMC10083342 DOI: 10.3389/fnhum.2023.1139292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/24/2023] [Indexed: 03/28/2023] Open
Abstract
Much is known about the role of cortical areas in language processing. The shift towards network approaches in recent years has highlighted the importance of uncovering the role of white matter in connecting these areas. However, despite a large body of research, many of these tracts’ functions are not well-understood. We present a comprehensive review of the empirical evidence on the role of eight major tracts that are hypothesized to be involved in language processing (inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, extreme capsule, middle longitudinal fasciculus, superior longitudinal fasciculus, arcuate fasciculus, and frontal aslant tract). For each tract, we hypothesize its role based on the function of the cortical regions it connects. We then evaluate these hypotheses with data from three sources: studies in neurotypical individuals, neuropsychological data, and intraoperative stimulation studies. Finally, we summarize the conclusions supported by the data and highlight the areas needing further investigation.
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Affiliation(s)
- Ehsan Shekari
- Department of Neuroscience, Iran University of Medical Sciences, Tehran, Iran
| | - Nazbanou Nozari
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, United States
- Center for the Neural Basis of Cognition (CNBC), Pittsburgh, PA, United States
- *Correspondence: Nazbanou Nozari
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Schevenels K, Gerrits R, Lemmens R, De Smedt B, Zink I, Vandermosten M. Early white matter connectivity and plasticity in post stroke aphasia recovery. Neuroimage Clin 2022; 36:103271. [PMID: 36510409 PMCID: PMC9723316 DOI: 10.1016/j.nicl.2022.103271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/30/2022] [Accepted: 11/17/2022] [Indexed: 11/21/2022]
Abstract
A disruption of white matter connectivity is negatively associated with language (recovery) in patients with aphasia after stroke, and behavioral gains have been shown to coincide with white matter neuroplasticity. However, most brain-behavior studies have been carried out in the chronic phase after stroke, with limited generalizability to earlier phases. Furthermore, few studies have investigated neuroplasticity patterns during spontaneous recovery (i.e., not related to a specific treatment) in the first months after stroke, hindering the investigation of potential early compensatory mechanisms. Finally, the majority of previous research has focused on damaged left hemisphere pathways, while neglecting the potential protective value of their right hemisphere counterparts for language recovery. To address these outstanding issues, we present a longitudinal study of thirty-two patients with aphasia (21 males and 11 females, M = 69.47 years, SD = 10.60 years) who were followed up for a period of 1 year with test moments in the acute (1-2 weeks), subacute (3-6 months) and chronic phase (9-12 months) after stroke. Constrained Spherical Deconvolution-based tractography was performed in the acute and subacute phase to measure Fiber Bundle Capacity (FBC), a quantitative connectivity measure that is valid in crossing fiber regions, in the bilateral dorsal arcuate fasciculus (AF) and the bilateral ventral inferior fronto-occipital fasciculus (IFOF). First, concurrent analyses revealed positive associations between the left AF and phonology, and between the bilateral IFOF and semantics in the acute - but not subacute - phase, supporting the dual-stream language model. Second, neuroplasticity analyses revealed a decrease in connection density of the bilateral AF - but not the IFOF - from the acute to the subacute phase, possibly reflecting post stroke white matter degeneration in areas adjacent to the lesion. Third, predictive analyses revealed no contribution of acute FBC measures to the prediction of later language outcomes over and above the initial language scores, suggesting no added value ofthe diffusion measures for languageprediction. Our study provides new insights on (changes in) connectivity of damaged and undamaged language pathways in patients with aphasia in the first months after stroke, as well as if/how such measures are related to language outcomes at different stages of recovery. Individual results are discussed in the light of current frameworks of language processing and aphasia recovery.
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Affiliation(s)
- Klara Schevenels
- Research Group Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, Onderwijs en Navorsing 2 (O&N2), Herestraat 49 box 721, 3000 Leuven, Belgium,Leuven Brain Institute, KU Leuven, Onderwijs en Navorsing 5 (O&N 5), Herestraat 49 box 1020, 3000 Leuven, Belgium
| | - Robin Gerrits
- Department of Experimental Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Robin Lemmens
- Department of Neurology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium,Research Group Experimental Neurology, Department of Neurosciences, KU Leuven, Herestraat 49 box 7003, 3000 Leuven, Belgium,Laboratory of Neurobiology, VIB Center for Brain & Disease Research, Onderwijs en Navorsing 5 (O&N 5), Herestraat 49 box 602, 3000 Leuven, Belgium,Leuven Brain Institute, KU Leuven, Onderwijs en Navorsing 5 (O&N 5), Herestraat 49 box 1020, 3000 Leuven, Belgium
| | - Bert De Smedt
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, Leopold Vanderkelenstraat 32 box 3765, 3000 Leuven, Belgium,Leuven Brain Institute, KU Leuven, Onderwijs en Navorsing 5 (O&N 5), Herestraat 49 box 1020, 3000 Leuven, Belgium
| | - Inge Zink
- Research Group Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, Onderwijs en Navorsing 2 (O&N2), Herestraat 49 box 721, 3000 Leuven, Belgium,Leuven Brain Institute, KU Leuven, Onderwijs en Navorsing 5 (O&N 5), Herestraat 49 box 1020, 3000 Leuven, Belgium
| | - Maaike Vandermosten
- Research Group Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, Onderwijs en Navorsing 2 (O&N2), Herestraat 49 box 721, 3000 Leuven, Belgium,Leuven Brain Institute, KU Leuven, Onderwijs en Navorsing 5 (O&N 5), Herestraat 49 box 1020, 3000 Leuven, Belgium,Corresponding author at: Research Group Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, Onderwijs en Navorsing 2 (O&N2), Herestraat 49 box 721, 3000 Leuven, Belgium.
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Braun EJ, Billot A, Meier EL, Pan Y, Parrish TB, Kurani AS, Kiran S. White matter microstructural integrity pre- and post-treatment in individuals with chronic post-stroke aphasia. BRAIN AND LANGUAGE 2022; 232:105163. [PMID: 35921727 PMCID: PMC9641951 DOI: 10.1016/j.bandl.2022.105163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 06/15/2023]
Abstract
While previous studies have found that white matter damage relates to impairment severity in individuals with aphasia, further study is required to understand the relationship between white matter integrity and treatment response. In this study, 34 individuals with chronic post-stroke aphasia underwent behavioral testing and structural magnetic resonance imaging at two timepoints. Thirty participants within this sample completed typicality-based semantic feature treatment for anomia. Tractography of bi-hemispheric white matter tracts was completed via Automated Fiber Quantification. Associations between microstructural integrity metrics and behavioral measures were evaluated at the tract level and in nodes along the tract. Diffusion measures of the left inferior longitudinal, superior longitudinal, and arcuate fasciculi were related to aphasia severity and diffusion measures of the left inferior longitudinal fasciculus were related to naming and treatment response. This study also found preliminary evidence of left inferior longitudinal fasciculus microstructural changes following treatment.
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Affiliation(s)
- Emily J Braun
- Aphasia Research Laboratory, Department of Speech, Language & Hearing Sciences, College of Health & Rehabilitation Sciences, Sargent College, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02115, USA.
| | - Anne Billot
- Aphasia Research Laboratory, Department of Speech, Language & Hearing Sciences, College of Health & Rehabilitation Sciences, Sargent College, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02115, USA; School of Medicine, Boston University, Boston, MA, USA
| | - Erin L Meier
- Aphasia Research Laboratory, Department of Speech, Language & Hearing Sciences, College of Health & Rehabilitation Sciences, Sargent College, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02115, USA
| | - Yue Pan
- Aphasia Research Laboratory, Department of Speech, Language & Hearing Sciences, College of Health & Rehabilitation Sciences, Sargent College, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02115, USA
| | - Todd B Parrish
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N. Michigan Avenue, Suite 1600, Chicago, IL 60611, USA
| | - Ajay S Kurani
- Department of Neurology, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Avenue, Suite 1150, Chicago, IL 60611, USA
| | - Swathi Kiran
- Aphasia Research Laboratory, Department of Speech, Language & Hearing Sciences, College of Health & Rehabilitation Sciences, Sargent College, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02115, USA
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12
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Liu XW, Lu WR, Zhang TY, Hou XS, Fa ZQ, Zhang SZ. Cerebral corridor creator for resection of trigone ventricular tumors: Two case reports. World J Clin Cases 2022; 10:1914-1921. [PMID: 35317166 PMCID: PMC8891768 DOI: 10.12998/wjcc.v10.i6.1914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/04/2021] [Accepted: 01/14/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Resection of deep intracranial tumors requires significant brain retraction, which frequently causes brain damage. In particular, tumor in the trigone of the lateral ventricular presents a surgical challenge due to its inaccessible location and intricate adjacent relationships with essential structures such as the optic radiation (OR) fibers. New brain retraction systems have been developed to minimize retraction-associated injury. To date, there is little evidence supporting the superiority of any retraction system in preserving the white matter tract integrity. This report illustrates the initial surgical excision in two patients using a new retraction system termed the cerebral corridor creator (CCC) and demonstrates its advantage in protecting OR fibers.
CASE SUMMARY We report two patients with nonspecific symptoms, who had trigone ventricular lesions that involved the neighboring OR identified on preoperative diffusion tensor imaging (DTI). Both patients underwent successful surgical excision using the CCC. Total tumor removal was achieved without additional neurological deficit. DTI showed that the OR fibers were preserved along the surgical field. Preoperative symptoms were alleviated immediately after surgery. Clinical outcomes were improved according to the Glasgow-Outcome-Scale and Activity-of-Daily-Living Scale assessments.
CONCLUSION In the two cases, the CCC was a safe and useful tool for creating access to the deep trigonal area while preserving the white matter tract integrity. The CCC is thus a promising alternative brain retractor.
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Affiliation(s)
- Xing-Wu Liu
- Department of Functional Neurosurgery, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China
| | - Wei-Rong Lu
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China
| | - Tian-Yi Zhang
- General Hospital of Xinjiang Military Region, Shihezi University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Xu-Sheng Hou
- Department of Functional Neurosurgery, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China
| | - Zhi-Qiang Fa
- Department of Functional Neurosurgery, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China
| | - Shi-Zhong Zhang
- Department of Functional Neurosurgery, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China
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13
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Johnson JP, Meier EL, Pan Y, Kiran S. Abnormally weak functional connections get stronger in chronic stroke patients who benefit from naming therapy. BRAIN AND LANGUAGE 2021; 223:105042. [PMID: 34695614 PMCID: PMC8638784 DOI: 10.1016/j.bandl.2021.105042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/07/2021] [Accepted: 10/12/2021] [Indexed: 06/03/2023]
Abstract
Language recovery in aphasia is likely supported by a network of brain regions, but few studies have investigated treatment-related changes in functional connectivity while controlling for the absence of treatment. We examined functional connectivity in a 38-region picture-naming network in 30 patients with chronic aphasia who did or did not receive naming therapy. Compared to healthy controls, patients had abnormally low connectivity in a subset of connections from the naming network. Linear mixed models showed that the connectivity of abnormal connections increased significantly in patients who benefited from therapy, but not in those who did not benefit from or receive therapy. Changes in responders were specific to abnormal connections and did not extend to the larger network. Thus, successful naming therapy was associated with increased connectivity in connections that were abnormal prior to treatment. The potential to strengthen such connections may be a prerequisite for a successful treatment response.
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Affiliation(s)
- Jeffrey P Johnson
- Aphasia Research Laboratory, Department of Speech, Language, & Hearing Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02215, USA.
| | - Erin L Meier
- Aphasia Research Laboratory, Department of Speech, Language, & Hearing Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02215, USA
| | - Yue Pan
- Aphasia Research Laboratory, Department of Speech, Language, & Hearing Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02215, USA
| | - Swathi Kiran
- Aphasia Research Laboratory, Department of Speech, Language, & Hearing Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02215, USA
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14
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Zhang J, Zheng W, Shang D, Chen Y, Zhong S, Ye J, Li L, Yu Y, Zhang L, Cheng R, He F, Wu D, Ye X, Luo B. Fixel-based evidence of microstructural damage in crossing pathways improves language mapping in Post-stroke aphasia. NEUROIMAGE-CLINICAL 2021; 31:102774. [PMID: 34371239 PMCID: PMC8358698 DOI: 10.1016/j.nicl.2021.102774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 07/16/2021] [Accepted: 07/22/2021] [Indexed: 12/28/2022]
Abstract
FBA shows greater specificity in mapping injured fibers in post-stroke aphasia. Intra-axonal volume of axons in dual streams is reduced in post-stroke aphasia. FBA could locate more precise segments associated with language defects. FBA could attribute language subdomain scores to fiber density of distinct tracts.
Background The complex crossing-fiber characteristics in the dual-stream system have been ignored by traditional diffusion tensor models regarding disconnections in post-stroke aphasia. It is valuable to identify microstructural damage of crossing-fiber pathways and reveal accurate fiber-specific language mapping in patients with aphasia. Methods This cross-sectional study collected magnetic resonance imaging data from 29 participants with post-stroke aphasia in the subacute stage and from 33 age- and sex-matched healthy controls. Fixel-based analysis was performed to examine microstructural fiber density (FD) and bundle cross-section alterations of specific fiber populations in crossing-fiber regions. Group comparisons were performed, and relationships with language scores were assessed. Results The aphasic group exhibited significant fixel-wise FD reductions in the dual-stream tracts, including the left inferior fronto-occipital fasciculus (IFOF), arcuate fasciculus, and superior longitudinal fasciculus (SLF) III (family-wise-error-corrected p < 0.05). Voxel- and fixel-wise comparisons revealed mismatched distributions in regions with crossing-fiber nexuses. Fixel-wise correlation analyses revealed significant associations between comprehension impairment and reduced FD in the temporal and frontal segments of the left IFOF, and also mapped naming ability to the IFOF. Average features along the whole course of dominant tracts assessed with tract-wise analyses attributed word-level comprehension to the IFOF (r = 0.723, p < 0.001) and revealed a trend-level correlation between sentence-level comprehension and FD of the SLF III (r = 0.451, p = 0.021). The mean FD of the uncinate fasciculus (UF) and IFOF correlated with total and picture naming scores, and the IFOF also correlated with responsive naming subdomains (Bonferroni corrected p < 0.05). Conclusions FD reductions of dual streams suggest that intra-axonal volume reduction constitutes the microstructural damage of white matter integrity in post-stroke aphasia. Fixel-based analysis provides a complementary method of language mapping that identifies fiber-specific tracts in the left hemisphere language network with greater specificity than voxel-based analysis. It precisely locates the precise segments of the IFOF for comprehension, yields fiber-specific evidence for the debated UF-naming association, and reveals dissociative subdomain associations with distinct tracts.
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Affiliation(s)
- Jie Zhang
- Department of Neurology & Brain Medical Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Rehabilitation Medicine Center & Rehabilitation Research Institute of Zhejiang Province, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Weihao Zheng
- School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Desheng Shang
- Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yating Chen
- Rehabilitation Medicine Center & Rehabilitation Research Institute of Zhejiang Province, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Shuchang Zhong
- Rehabilitation Medicine Center & Rehabilitation Research Institute of Zhejiang Province, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Jing Ye
- Rehabilitation Medicine Center & Rehabilitation Research Institute of Zhejiang Province, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Lingling Li
- Department of Neurology & Brain Medical Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yamei Yu
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Li Zhang
- Rehabilitation Medicine Center & Rehabilitation Research Institute of Zhejiang Province, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Ruidong Cheng
- Rehabilitation Medicine Center & Rehabilitation Research Institute of Zhejiang Province, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Fangping He
- Department of Neurology & Brain Medical Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dan Wu
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Xiangming Ye
- Rehabilitation Medicine Center & Rehabilitation Research Institute of Zhejiang Province, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Benyan Luo
- Department of Neurology & Brain Medical Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Collaborative Innovation Center for Brain Science, Zhejiang University School of Medicine, China.
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15
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Kourtidou E, Kasselimis D, Angelopoulou G, Karavasilis E, Velonakis G, Kelekis N, Zalonis I, Evdokimidis I, Potagas C, Petrides M. The Role of the Right Hemisphere White Matter Tracts in Chronic Aphasic Patients After Damage of the Language Tracts in the Left Hemisphere. Front Hum Neurosci 2021; 15:635750. [PMID: 34239424 PMCID: PMC8258417 DOI: 10.3389/fnhum.2021.635750] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
The involvement of the right hemisphere (RH) in language, and especially after aphasia resulting from left hemisphere (LH) lesions, has been recently highlighted. The present study investigates white matter structure in the right hemisphere of 25 chronic post-stroke aphasic patients after LH lesions in comparison with 24 healthy controls, focusing on the four cortico-cortical tracts that link posterior parietal and temporal language-related areas with Broca’s region in the inferior frontal gyrus of the LH: the Superior Longitudinal Fasciculi II and III (SLF II and SLF III), the Arcuate Fasciculus (AF), and the Temporo-Frontal extreme capsule Fasciculus (TFexcF). Additionally, the relationship of these RH white matter tracts to language performance was examined. The patients with post-stroke aphasia in the chronic phase and the healthy control participants underwent diffusion tensor imaging (DTI) examination. The aphasic patients were assessed with standard aphasia tests. The results demonstrated increased axial diffusivity in the RH tracts of the aphasic patients. Patients were then divided according to the extent of the left hemisphere white matter loss. Correlations of language performance with radial diffusivity (RD) in the right hemisphere homologs of the tracts examined were demonstrated for the TFexcF, SLF III, and AF in the subgroup with limited damage to the LH language networks and only with the TFexcF in the subgroup with extensive damage. The results argue in favor of compensatory roles of the right hemisphere tracts in language functions when the LH networks are disrupted.
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Affiliation(s)
- Evie Kourtidou
- Neuropsychology and Language Disorders Unit, Eginition Hospital, First Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Kasselimis
- Neuropsychology and Language Disorders Unit, Eginition Hospital, First Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Angelopoulou
- Neuropsychology and Language Disorders Unit, Eginition Hospital, First Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstratios Karavasilis
- Second Department of Radiology, National and Kapodistrian University of Athens, General University Hospital "Attikon", Haidari, Greece
| | - Georgios Velonakis
- Second Department of Radiology, National and Kapodistrian University of Athens, General University Hospital "Attikon", Haidari, Greece
| | - Nikolaos Kelekis
- Second Department of Radiology, National and Kapodistrian University of Athens, General University Hospital "Attikon", Haidari, Greece
| | - Ioannis Zalonis
- Eginition Hospital, Neuropsychological Laboratory, First Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Evdokimidis
- Neuropsychology and Language Disorders Unit, Eginition Hospital, First Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantin Potagas
- Neuropsychology and Language Disorders Unit, Eginition Hospital, First Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Michael Petrides
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
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Lee JK, Ko MH, Park SH, Kim GW. Prediction of Aphasia Severity in Patients with Stroke Using Diffusion Tensor Imaging. Brain Sci 2021; 11:304. [PMID: 33673638 PMCID: PMC7997243 DOI: 10.3390/brainsci11030304] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/31/2021] [Accepted: 02/23/2021] [Indexed: 11/26/2022] Open
Abstract
This study classified the severity of aphasia through the Western Aphasia Battery and determined the optimal cut-off value for each Language-Related White Matter fiber and their combinations, we further examined the correlations between Language-Related White Matter and Western Aphasia Battery subscores. This retrospective study recruited 64 patients with aphasia. Mild/moderate and severe aphasia were classified according to cut-off Aphasia Quotient score of 51 points. Diffusion tensor imaging and fractional anisotropy reconstructed Language-Related White Matter in multiple fasciculi. We determined the area under the covariate-adjusted receiver operating characteristic curve to evaluate the accuracy of predicting aphasia severity. The optimal fractional-anisotropy cut-off values for the individual fibers of the Language-Related White Matter and their combinations were determined. Their correlations with Western Aphasia Battery subscores were analyzed. The arcuate and superior longitudinal fasciculi showed fair accuracy, the inferior frontal occipital fasciculus poor accuracy, and their combinations fair accuracy. Correlations between Language-Related White Matter parameters and Western Aphasia Battery subscores were found between the arcuate, superior longitudinal, and inferior frontal occipital fasciculi and spontaneous speech, auditory verbal comprehension, repetition, and naming. Diffusion-tensor-imaging-based language-Related White Matter analysis may help predict the severity of language impairment in patients with aphasia following stroke.
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Affiliation(s)
- Jin-Kook Lee
- Department of Physical Medicine & Rehabilitation, Jeonbuk National University Medical School, Jeonju 54907, Korea; (J.-K.L.); (M.-H.K.); (S.-H.P.)
- Department of Speech-Language Therapy, The Graduate School, Jeonbuk National University, Jeonju 54907, Korea
| | - Myoung-Hwan Ko
- Department of Physical Medicine & Rehabilitation, Jeonbuk National University Medical School, Jeonju 54907, Korea; (J.-K.L.); (M.-H.K.); (S.-H.P.)
- Department of Speech-Language Therapy, The Graduate School, Jeonbuk National University, Jeonju 54907, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, Korea
| | - Sung-Hee Park
- Department of Physical Medicine & Rehabilitation, Jeonbuk National University Medical School, Jeonju 54907, Korea; (J.-K.L.); (M.-H.K.); (S.-H.P.)
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, Korea
| | - Gi-Wook Kim
- Department of Physical Medicine & Rehabilitation, Jeonbuk National University Medical School, Jeonju 54907, Korea; (J.-K.L.); (M.-H.K.); (S.-H.P.)
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, Korea
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Jin L, Li C, Zhang Y, Yuan T, Ying J, Zuo Z, Gui S. The Functional Reorganization of Language Network Modules in Glioma Patients: New Insights From Resting State fMRI Study. Front Oncol 2021; 11:617179. [PMID: 33718172 PMCID: PMC7953055 DOI: 10.3389/fonc.2021.617179] [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] [Received: 10/14/2020] [Accepted: 01/12/2021] [Indexed: 12/11/2022] Open
Abstract
Background Prior investigations of language functions have focused on the response profiles of particular brain regions. However, the specialized and static view of language processing does not explain numerous observations of functional recovery following brain surgery. To investigate the dynamic alterations of functional connectivity (FC) within language network (LN) in glioma patients, we explored a new flexible model based on the neuroscientific hypothesis of core-periphery organization in LN. Methods Group-level LN mapping was determined from 109 glioma patients and forty-two healthy controls (HCs) using independent component analysis (ICA). FC and mean network connectivity (mNC: l/rFCw, FCb, and FCg) were compared between patients and HCs. Correlations between mNC and tumor volume (TV) were calculated. Results We identified ten separate LN modules from ICA. Compared to HCs, glioma patients showed a significant reduction in language network functional connectivity (LNFC), with a distinct pattern modulated by tumor position. Left hemisphere gliomas had a broader impact on FC than right hemisphere gliomas, with more reduced edges away from tumor sites (p=0.011). mNC analysis revealed a significant reduction in all indicators of FC except for lFCw in right hemisphere gliomas. These alterations were associated with TV in a double correlative relationship depending on the tumor position across hemispheres. Conclusion Our findings emphasize the importance of considering the modulatory effects of core-periphery mechanisms from a network perspective. Preoperative evaluation of changes in LN caused by gliomas could provide the surgeon a reference to optimize resection while maintaining functional balance.
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Affiliation(s)
- Lu Jin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chuzhong Li
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Yazhuo Zhang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Taoyang Yuan
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Jianyou Ying
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Zhentao Zuo
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Songbai Gui
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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18
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Monroy-Sosa A, Chakravarthi SS, Cortes-Contreras AP, Hernandez-Varela M, Andres-Arrieta V, Epping A, Rovin RA. The Evolution of Cerebral Language Localization: Historical Analysis and Current Trends. World Neurosurg 2020; 145:89-97. [PMID: 32916360 DOI: 10.1016/j.wneu.2020.09.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/05/2020] [Accepted: 09/05/2020] [Indexed: 01/08/2023]
Abstract
Language localization has been an evolving concept over the past 150 years, with the emergence of several important yet conflicting ideologies. The classical theory, starting from the phrenologic work of Gall to the identification of specific regions of language function by Broca, Wernicke, and others, proposed that discrete subcomponents of language were organized into separate anatomic structural regions. The holism theory was postulated in an attempt to disclose that language function was instead attributed to a larger region of the cortex, in which cerebral regions may have the capability of assuming the function of damaged areas. However, this theory was largely abandoned in favor of discrete structural localizationist viewpoints. The subsequent cortical stimulatory work of Penfield led to the development of maps of localization, assigning an eloquent designation to specific regions. The expanding knowledge of cortical and subcortical anatomy allowed for the development of anatomically and functionally integrative language models. In particular, the dual stream model revisited the concept of regional interconnectivity and expanded the concept of eloquence. Advancements in cortical-subcortical stimulation, neurophysiologic monitoring, magnetic resonance diffusion tensor imaging/functional magnetic resonance imaging, awake neurosurgical technique, and knowledge gained by white matter tract anatomy and the Human Connectome Project, shed new light on the dynamic interconnectivity of the cerebrum. New studies are progressively opening doors to this paradigm, showing the dynamic and interdependent nature of language function. In this review, the evolution of language toward the evolving paradigm of dynamic language function and interconnectivity and its impact on shaping the neurosurgical paradigm are outlined.
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Affiliation(s)
- Alejandro Monroy-Sosa
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin; Skull Base, Brain & Cerebrovascular Laboratory, Advocate Aurora Research Health Institute, Milwaukee, Wisconsin.
| | - Srikant S Chakravarthi
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin; Skull Base, Brain & Cerebrovascular Laboratory, Advocate Aurora Research Health Institute, Milwaukee, Wisconsin
| | | | | | - Victor Andres-Arrieta
- Faculty of Medicine, PECEM, Universidad Nacional Autonónoma de México, Mexico City, Mexico
| | - Austin Epping
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin; Skull Base, Brain & Cerebrovascular Laboratory, Advocate Aurora Research Health Institute, Milwaukee, Wisconsin
| | - Richard A Rovin
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin
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19
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Keser Z, Meier EL, Stockbridge MD, Hillis AE. The role of microstructural integrity of major language pathways in narrative speech in the first year after stroke. J Stroke Cerebrovasc Dis 2020; 29:105078. [PMID: 32807476 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105078] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND AND PURPOSE Left hemisphere stroke often results in a variety of language deficits due to varying patterns of damage to language networks. The Cookie Theft picture description task, a classic, quick bedside assessment, has been shown to quantify narrative speech reliably. In this study, we utilized diffusion tensor imaging (DTI) to assess language network white matter tract correlates of lexical-semantic and syntactic impairments longitudinally. METHODS Twenty-eight patients with mild to severe language impairments after left hemispheric lobar and/or subcortical ischemic stroke underwent the Cookie Theft picture description test and DTI up to three different time points: within the first three months, six months and twelve months after stroke. Dorsal and ventral stream language pathways were segmented to obtain DTI integrity metrics of both hemispheres. Multivariable regression models and partial correlation analyses adjusted for age, education, and lesion load were conducted to evaluate the temporal DTI profile of the white matter microstructural integrity of the language tracts as neural correlates of narrative speech within the first year after stroke. RESULTS Among all the major language white matter pathways, the integrity of the left arcuate (AF), inferior fronto-occipital, and inferior longitudinal fasciculi (ILF) were related to picture description performance. After FDR correction, left ILF fractional anisotropy correlated with syntactic cohesiveness (r=0.85,p=0.00087) within the first three months after stroke, whereas at one year post-stroke, the strongest correlations were found between lexical-semantic performance and left AF radial diffusivity (r = -0.71, p = 0.00065). CONCLUSION Our study provides a temporal profile of associations between the integrity of the main language pathways and lexical semantics and syntactic impairments in left hemispheric strokes.
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Affiliation(s)
- Zafer Keser
- Department of Neurology, The University of Texas Health Science Center, Houston TX, United States; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
| | - Erin L Meier
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
| | - Melissa D Stockbridge
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
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20
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Osa García A, Brambati SM, Brisebois A, Désilets-Barnabé M, Houzé B, Bedetti C, Rochon E, Leonard C, Desautels A, Marcotte K. Predicting Early Post-stroke Aphasia Outcome From Initial Aphasia Severity. Front Neurol 2020; 11:120. [PMID: 32153496 PMCID: PMC7047164 DOI: 10.3389/fneur.2020.00120] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/03/2020] [Indexed: 12/11/2022] Open
Abstract
Background: The greatest degree of language recovery in post-stroke aphasia takes place within the first weeks. Aphasia severity and lesion measures have been shown to be good predictors of long-term outcomes. However, little is known about their implications in early spontaneous recovery. The present study sought to determine which factors better predict early language outcomes in individuals with post-stroke aphasia. Methods: Twenty individuals with post-stroke aphasia were assessed <72 h (acute) and 10-14 days (subacute) after stroke onset. We developed a composite score (CS) consisting of several linguistic sub-tests: repetition, oral comprehension and naming. Lesion volume, lesion load and diffusion measures [fractional anisotropy (FA) and axial diffusivity (AD)] from both arcuate fasciculi (AF) were also extracted using MRI scans performed at the same time points. A series of regression analyses were performed to predict the CS at the second assessment. Results: Among the diffusion measures, only FA from right AF was found to be a significant predictor of early subacute aphasia outcome. However, when combined in two hierarchical models with FA, age and either lesion load or lesion size, the initial aphasia severity was found to account for most of the variance (R 2 = 0.678), similarly to the complete models (R 2 = 0.703 and R 2 = 0.73, respectively). Conclusions: Initial aphasia severity was the best predictor of early post-stroke aphasia outcome, whereas lesion measures, though highly correlated, show less influence on the prediction model. We suggest that factors predicting early recovery may differ from those involved in long-term recovery.
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Affiliation(s)
- Alberto Osa García
- Centre de Recherche du Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
- École d'Orthophonie et d'Audiologie, Université de Montréal, Montreal, QC, Canada
| | - Simona Maria Brambati
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada
| | - Amélie Brisebois
- Centre de Recherche du Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
- École d'Orthophonie et d'Audiologie, Université de Montréal, Montreal, QC, Canada
| | - Marianne Désilets-Barnabé
- Centre de Recherche du Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
- École d'Orthophonie et d'Audiologie, Université de Montréal, Montreal, QC, Canada
| | - Bérengère Houzé
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Christophe Bedetti
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Elizabeth Rochon
- Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- Toronto Rehabilitation Institute, Toronto, ON, Canada
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Carol Leonard
- Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Alex Desautels
- Centre de Recherche du Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
- Département de Neurosciences, Université de Montréal, Montreal, QC, Canada
- Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada
| | - Karine Marcotte
- Centre de Recherche du Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
- École d'Orthophonie et d'Audiologie, Université de Montréal, Montreal, QC, Canada
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Drummond C, Coutinho G, Monteiro MC, Assuncao N, Teldeschi A, de Souza AS, Oliveira N, Bramati I, Sudo FK, Vanderboght B, Brandao CO, Fonseca RP, de Oliveira-Souza R, Moll J, Mattos P, Tovar-Moll F. Narrative impairment, white matter damage and CSF biomarkers in the Alzheimer's disease spectrum. Aging (Albany NY) 2019; 11:9188-9208. [PMID: 31682234 PMCID: PMC6834410 DOI: 10.18632/aging.102391] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/21/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Narrative discourse (ND) refers to one's ability to verbally reproduce a sequence of temporally and logically-linked events. Impairments in ND may occur in subjects with Amnestic Mild Cognitive Impairment (aMCI) and Alzheimer's Disease (AD), but correlates across this function, neuroimaging and cerebrospinal fluid (CSF) AD biomarkers remain understudied. OBJECTIVES We sought to measure correlates among ND, Diffusion Tensor Imaging (DTI) indexes and AD CSF biomarkers in patients within the AD spectrum. RESULTS Groups differed in narrative production (NProd) and comprehension. aMCI and AD presented poorer inference abilities than controls. AD subjects were more impaired than controls and aMCI regarding WB (p<0.01). ROIs DTI assessment distinguished the three groups. Mean Diffusivity (MD) in the uncinate, bilateral parahippocampal cingulate and left inferior occipitofrontal fasciculi negatively correlated with NProd. Changes in specific tracts correlated with T-tau/Aβ1-42 ratio in CSF. CONCLUSIONS AD and aMCI patients presented more ND impairments than controls. Those findings were associated with changes in ventral language-associated and in the inferior parahippocampal pathways. The latest were correlated with biomarkers' levels in the CSF. METHODS AD (N=14), aMCI (N=31) and Control (N=39) groups were compared for whole brain (WB) and regions of interest (ROI) DTI parameters, ND and AD CSF biomarkers.
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Affiliation(s)
- Claudia Drummond
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
- Department of Speech and Hearing Pathology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Graduate Program in Morphological Sciences, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gabriel Coutinho
- Graduate Program in Morphological Sciences, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Psychology, Celso Lisboa University Center, Rio de Janeiro, Brazil
| | - Marina Carneiro Monteiro
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Naima Assuncao
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
- Graduate Program in Morphological Sciences, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alina Teldeschi
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Andrea Silveira de Souza
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Natalia Oliveira
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Ivanei Bramati
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Felipe Kenji Sudo
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Bart Vanderboght
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | | | - Rochele Paz Fonseca
- Laboratory of Clinical and Experimental Neuropsychology, Department of Psychology, Pontificial Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ricardo de Oliveira-Souza
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Jorge Moll
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Paulo Mattos
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
- Graduate Program in Morphological Sciences, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Psychiatry and Forensic Medicine, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernanda Tovar-Moll
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
- Graduate Program in Morphological Sciences, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Yang M, Li J, Li Z, Yao D, Liao W, Chen H. Whole-brain functional connectome-based multivariate classification of post-stroke aphasia. Neurocomputing 2017. [DOI: 10.1016/j.neucom.2016.10.094] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Yang M, Yang P, Fan YS, Li J, Yao D, Liao W, Chen H. Altered Structure and Intrinsic Functional Connectivity in Post-stroke Aphasia. Brain Topogr 2017; 31:300-310. [PMID: 28921389 DOI: 10.1007/s10548-017-0594-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 09/13/2017] [Indexed: 01/19/2023]
Abstract
Previous studies have demonstrated that alterations of gray matter exist in post-stroke aphasia (PSA) patients. However, so far, few studies combined structural alterations of gray matter volume (GMV) and intrinsic functional connectivity (iFC) imbalances of resting-state functional MRI to investigate the mechanism underlying PSA. The present study investigated specific regions with GMV abnormality in patients with PSA (n = 17) and age- and sex- matched healthy controls (HCs, n = 20) using voxel-based morphometry. In addition, we examined whether there is a link between abnormal gray matter and altered iFC. Furthermore, we explored the correlations between abnormal iFC and clinical scores in aphasic patients. We found significantly increased GMV in the right superior temporal gyrus, right inferior parietal lobule (IPL)/supramarginal gyrus (SMG), and left middle occipital gyrus. Decreased GMV was found in the right caudate gyrus, bilateral thalami in PSA patients. Patients showed increased remote interregional FC between the right IPL/SMG and right precuneus, right angular gyrus, right superior occipital gyrus; while reduced FC in the right caudate gyrus and supplementary motor area, dorsolateral superior frontal gyrus. Moreover, iFC strength between the left middle occipital gyrus and the left orbital middle frontal gyrus was positively correlated with the performance quotient. We suggest that GMV abnormality contributes to interregional FC in PSA. These results may provide useful information to understand the pathogenesis of post-stroke aphasia.
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Affiliation(s)
- Mi Yang
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China
- Department of Stomatology, the Fourth People's Hospital of Chengdu, Chengdu, 610036, People's Republic of China
| | - Pu Yang
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China
| | - Yun-Shuang Fan
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China
| | - Jiao Li
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China
| | - Dezhong Yao
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China
| | - Wei Liao
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China.
| | - Huafu Chen
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China.
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Defining an Analytic Framework to Evaluate Quantitative MRI Markers of Traumatic Axonal Injury: Preliminary Results in a Mouse Closed Head Injury Model. eNeuro 2017; 4:eN-NWR-0164-17. [PMID: 28966972 PMCID: PMC5616192 DOI: 10.1523/eneuro.0164-17.2017] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 07/17/2017] [Accepted: 08/05/2017] [Indexed: 01/11/2023] Open
Abstract
Diffuse axonal injury (DAI) is a hallmark of traumatic brain injury (TBI) pathology. Recently, the Closed Head Injury Model of Engineered Rotational Acceleration (CHIMERA) was developed to generate an experimental model of DAI in a mouse. The characterization of DAI using diffusion tensor magnetic resonance imaging (MRI; diffusion tensor imaging, DTI) may provide a useful set of outcome measures for preclinical and clinical studies. The objective of this study was to identify the complex neurobiological underpinnings of DTI features following DAI using a comprehensive and quantitative evaluation of DTI and histopathology in the CHIMERA mouse model. A consistent neuroanatomical pattern of pathology in specific white matter tracts was identified across ex vivo DTI maps and photomicrographs of histology. These observations were confirmed by voxelwise and regional analysis of DTI maps, demonstrating reduced fractional anisotropy (FA) in distinct regions such as the optic tract. Similar regions were identified by quantitative histology and exhibited axonal damage as well as robust gliosis. Additional analysis using a machine-learning algorithm was performed to identify regions and metrics important for injury classification in a manner free from potential user bias. This analysis found that diffusion metrics were able to identify injured brains almost with the same degree of accuracy as the histology metrics. Good agreement between regions detected as abnormal by histology and MRI was also found. The findings of this work elucidate the complexity of cellular changes that give rise to imaging abnormalities and provide a comprehensive and quantitative evaluation of the relative importance of DTI and histological measures to detect brain injury.
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