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Li T, Xu J, Wang L, Xu K, Chen W, Zhang L, Niu G, Zhang Y, Ding Z, Lv Y. Functional network reorganization after endovascular thrombectomy in patients with anterior circulation stroke. Neuroimage Clin 2024; 43:103648. [PMID: 39067302 DOI: 10.1016/j.nicl.2024.103648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 07/05/2024] [Accepted: 07/22/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Endovascular thrombectomy has been confirmed to be an effective therapy for acute ischemic stroke (AIS). However, how functional brain networks reorganize after restoration of blood supply in AIS patients, and whether the degree of reperfusion associates with functional network changes remains unclear. METHODS Resting-state fMRI data were collected from 43 AIS patients with anterior circulation occlusion after thrombectomy and 37 healthy controls (HCs). Both static and dynamic functional connectivity (FC) within four advanced functional networks including dorsal attention network (DAN), ventral attention network (VAN), executive control network (ECN) and default mode network (DMN), were calculated and compared between post-thrombectomy patients and HCs, and between two subgroups of post-thrombectomy patients with different reperfusion conditions. RESULTS As compared to HCs, patients showed significant differences in static FC of four functional networks, and in dynamic FC of DAN, ECN and DMN. Furthermore, patients with better reperfusion conditions exhibited increased static FC with precuneus, and altered dynamic FC within precuneus. Moreover, these alterations were associated with clinical assessments of stroke severity and functional recovery in post-thrombectomy patients. CONCLUSIONS Collectively, these findings may provide the potential imaging markers for assessment of thrombectomy efficacy and help establish the specific rehabilitation treatments for post-thrombectomy patients.
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Affiliation(s)
- Tongyue Li
- Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang, China
| | - Jiaona Xu
- Department of Rehabilitation, Affiliated Hangzhou First People's Hospital, Westlake University, Hangzhou, Zhejiang, China
| | - Luoyu Wang
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Westlake University, Hangzhou, Zhejiang, China
| | - Kang Xu
- Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang, China
| | - Weiwei Chen
- Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang, China
| | - Liqing Zhang
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Westlake University, Hangzhou, Zhejiang, China
| | - Guozhong Niu
- Department of Neurology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang, China
| | - Yu Zhang
- Department of Psychology, Affiliated Hangzhou First People's Hospital, Westlake University, Hangzhou, Zhejiang, China
| | - Zhongxiang Ding
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Westlake University, Hangzhou, Zhejiang, China.
| | - Yating Lv
- Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang, China.
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Fruhwirth V, Berger L, Gattringer T, Fandler-Höfler S, Kneihsl M, Eppinger S, Ropele S, Fink A, Deutschmann H, Reishofer G, Enzinger C, Pinter D. White matter integrity and functional connectivity of the default mode network in acute stroke are associated with cognitive outcome three months post-stroke. J Neurol Sci 2024; 462:123071. [PMID: 38850772 DOI: 10.1016/j.jns.2024.123071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Knowledge about factors that are associated with post-stroke cognitive outcome is important to identify patients with high risk for impairment. We therefore investigated the associations of white matter integrity and functional connectivity (FC) within the brain's default-mode network (DMN) in acute stroke patients with cognitive outcome three months post-stroke. METHODS Patients aged between 18 and 85 years with an acute symptomatic MRI-proven unilateral ischemic middle cerebral artery infarction, who had received reperfusion therapy, were invited to participate in this longitudinal study. All patients underwent brain MRI within 24-72 h after symptom onset, and participated in a neuropsychological assessment three months post-stroke. We performed hierarchical regression analyses to explore the incremental value of baseline white matter integrity and FC beyond demographic, clinical, and macrostructural information for cognitive outcome. RESULTS The study cohort comprised 34 patients (mean age: 64 ± 12 years, 35% female). The initial median National Institutes of Health Stroke Scale (NIHSS) score was 10, and significantly improved three months post-stroke to a median NIHSS = 1 (p < .001). Nonetheless, 50% of patients showed cognitive impairment three months post-stroke. FC of the non-lesioned anterior cingulate cortex of the affected hemisphere explained 15% of incremental variance for processing speed (p = .007), and fractional anisotropy of the non-lesioned cingulum of the affected hemisphere explained 13% of incremental variance for cognitive flexibility (p = .033). CONCLUSIONS White matter integrity and functional MRI markers of the DMN in acute stroke explain incremental variance for post-stroke cognitive outcome beyond demographic, clinical, and macrostructural information.
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Affiliation(s)
- Viktoria Fruhwirth
- Department of Neurology, Medical University of Graz, Graz, Austria; Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria; Institute of Psychology, Department of Biological Psychology, University of Graz, Graz, Austria
| | - Lisa Berger
- Institute of Psychology, Department of Neuropsychology - Neuroimaging, University of Graz, Graz, Austria
| | - Thomas Gattringer
- Department of Neurology, Medical University of Graz, Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | | | - Markus Kneihsl
- Department of Neurology, Medical University of Graz, Graz, Austria
| | | | - Stefan Ropele
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Andreas Fink
- Institute of Psychology, Department of Biological Psychology, University of Graz, Graz, Austria
| | - Hannes Deutschmann
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Gernot Reishofer
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Christian Enzinger
- Department of Neurology, Medical University of Graz, Graz, Austria; Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Daniela Pinter
- Department of Neurology, Medical University of Graz, Graz, Austria; Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria.
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Șerban CA, Barborică A, Roceanu AM, Mîndruță IR, Ciurea J, Stancu M, Pâslaru AC, Zăgrean AM, Zăgrean L, Moldovan M. Towards an electroencephalographic measure of awareness based on the reactivity of oscillatory macrostates to hearing a subject's own name. Eur J Neurosci 2024; 59:771-785. [PMID: 37675619 DOI: 10.1111/ejn.16138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 08/09/2023] [Accepted: 08/16/2023] [Indexed: 09/08/2023]
Abstract
We proposed that the brain's electrical activity is composed of a sequence of alternating states with repeating topographic spectral distributions on scalp electroencephalogram (EEG), referred to as oscillatory macrostates. The macrostate showing the largest decrease in the probability of occurrence, measured as a percentage (reactivity), during sensory stimulation was labelled as the default EEG macrostate (DEM). This study aimed to assess the influence of awareness on DEM reactivity (DER). We included 11 middle cerebral artery ischaemic stroke patients with impaired awareness having a median Glasgow Coma Scale (GCS) of 6/15 and a group of 11 matched healthy controls. EEG recordings were carried out during auditory 1 min stimulation epochs repeating either the subject's own name (SON) or the SON in reverse (rSON). The DEM was identified across three SON epochs alternating with three rSON epochs. Compared with the patients, the DEM of controls contained more posterior theta activity reflecting source dipoles that could be mapped in the posterior cingulate cortex. The DER was measured from the 1 min quiet baseline preceding each stimulation epoch. The difference in mean DER between the SON and rSON epochs was measured by the salient EEG reactivity (SER) theoretically ranging from -100% to 100%. The SER was 12.4 ± 2.7% (Mean ± standard error of the mean) in controls and only 1.3 ± 1.9% in the patient group (P < 0.01). The patient SER decreased with the Glasgow Coma Scale. Our data suggest that awareness increases DER to SON as measured by SER.
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Affiliation(s)
- Cosmin-Andrei Șerban
- Physics Department, University of Bucharest, Bucharest, Romania
- Termobit Prod SRL, Bucharest, Romania
- FHC Inc, Bowdoin, Maine, USA
| | - Andrei Barborică
- Physics Department, University of Bucharest, Bucharest, Romania
- Termobit Prod SRL, Bucharest, Romania
- FHC Inc, Bowdoin, Maine, USA
| | | | | | - Jan Ciurea
- Department of Neurosurgery, Bagdasar-Arseni Emergency Hospital, Bucharest, Romania
| | - Mihai Stancu
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Division of Neurobiology, Faculty of Biology, Ludwig Maximilian University, Munich, Germany
| | - Alexandru C Pâslaru
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ana-Maria Zăgrean
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Leon Zăgrean
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Mihai Moldovan
- Termobit Prod SRL, Bucharest, Romania
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark
- Clinical Neurophysiology and Neurology, Rigshospitalet, Copenhagen, Denmark
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Kong Y, Peng W, Li J, Zhu C, Zhang C, Fan Y. Alteration in brain functional connectivity in patients with post-stroke cognitive impairment during memory task: A fNIRS study. J Stroke Cerebrovasc Dis 2023; 32:107280. [PMID: 37517137 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/11/2023] [Accepted: 07/24/2023] [Indexed: 08/01/2023] Open
Abstract
OBJECTIVE This study attempted to evaluate the functional connectivity (FC) in relevant cortex areas during three memory tasks using the functional near-infrared spectroscopy (fNIRS) method to expound the neural mechanisms in individuals with post-stroke cognitive impairment (PSCI). METHODS Short-term memory and visuospatial abilities were assessed using the clock drawing test, digit span test, and Corsi Block-tapping tests with simultaneous fNIRS. The oxygenated hemoglobin concentration signals were recorded from the bilateral motor sense cortex (LMS/RMS) and prefrontal lobe (LPFT/PFT/RPFT) of 19 subjects with cognitive impairment (PSCI group), 27 stroke subjects (STR group) and 26 healthy subjects (HC group). RESULTS MMSE scores were positively correlated with the clock drawing test and digit span test scores but not with Corsi Block-tapping scores. During each test, functional connectivity between the bilateral MS (LMS/RMS) was highest within each group, but the functional connectivity between motor sense cortex and frontal lobe was lowest. PSCI group showed decreased FC between bilateral motor sense cortex (P < 0.05) and between motor sense cortex and frontal lobe (P > 0.05) during clock drawing test and Corsi Block-tapping test while decreased FC between each region of interest during digit span test with no significant difference. Functional connectivity levels were closely related to MMSE scores. CONCLUSIONS Decreased functional connectivity level may be a marker of impaired cognitive function in post-stroke cognitive impairment. The fNIRS-based functional connectivity provides a non-invasive method to recognize cognitive impairment post-stroke. Functional connectivity changes may help to further understand the neural mechanisms of cognitive impairment post stroke.
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Affiliation(s)
- Ying Kong
- Department of Rehabilitation, the Second Xiangya Hospital, Central South University, No. 139, Renmin Rd. Furong District, Changsha 410011, Hunan China
| | - Wenna Peng
- Department of Rehabilitation, the Second Xiangya Hospital, Central South University, No. 139, Renmin Rd. Furong District, Changsha 410011, Hunan China
| | - Jing Li
- Department of Rehabilitation, the Second Xiangya Hospital, Central South University, No. 139, Renmin Rd. Furong District, Changsha 410011, Hunan China
| | - Chunjiao Zhu
- Department of Rehabilitation, the Second Xiangya Hospital, Central South University, No. 139, Renmin Rd. Furong District, Changsha 410011, Hunan China
| | - Changjie Zhang
- Department of Rehabilitation, the Second Xiangya Hospital, Central South University, No. 139, Renmin Rd. Furong District, Changsha 410011, Hunan China
| | - Yongmei Fan
- Department of Rehabilitation, the Second Xiangya Hospital, Central South University, No. 139, Renmin Rd. Furong District, Changsha 410011, Hunan China.
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Braaß H, Gutgesell L, Backhaus W, Higgen FL, Quandt F, Choe CU, Gerloff C, Schulz R. Early functional connectivity alterations in contralesional motor networks influence outcome after severe stroke: a preliminary analysis. Sci Rep 2023; 13:11010. [PMID: 37419966 PMCID: PMC10328915 DOI: 10.1038/s41598-023-38066-0] [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: 03/11/2023] [Accepted: 07/02/2023] [Indexed: 07/09/2023] Open
Abstract
Connectivity studies have significantly extended the knowledge on motor network alterations after stroke. Compared to interhemispheric or ipsilesional networks, changes in the contralesional hemisphere are poorly understood. Data obtained in the acute stage after stroke and in severely impaired patients are remarkably limited. This exploratory, preliminary study aimed to investigate early functional connectivity changes of the contralesional parieto-frontal motor network and their relevance for the functional outcome after severe motor stroke. Resting-state functional imaging data were acquired in 19 patients within the first 2 weeks after severe stroke. Nineteen healthy participants served as a control group. Functional connectivity was calculated from five key motor areas of the parieto-frontal network on the contralesional hemisphere as seed regions and compared between the groups. Connections exhibiting stroke-related alterations were correlated with clinical follow-up data obtained after 3-6 months. The main finding was an increase in coupling strength between the contralesional supplementary motor area and the sensorimotor cortex. This increase was linked to persistent clinical deficits at follow-up. Thus, an upregulation in contralesional motor network connectivity might be an early pattern in severely impaired stroke patients. It might carry relevant information regarding the outcome which adds to the current concepts of brain network alterations and recovery processes after severe stroke.
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Affiliation(s)
- Hanna Braaß
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Lily Gutgesell
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Winifried Backhaus
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Focko L Higgen
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Fanny Quandt
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Chi-Un Choe
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Robert Schulz
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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6
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Zou J, Yin Y, Lin Z, Gong Y. The analysis of brain functional connectivity of post-stroke cognitive impairment patients: an fNIRS study. Front Neurosci 2023; 17:1168773. [PMID: 37214384 PMCID: PMC10196111 DOI: 10.3389/fnins.2023.1168773] [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: 02/18/2023] [Accepted: 04/18/2023] [Indexed: 05/24/2023] Open
Abstract
Background Post-stroke cognitive impairment (PSCI) is a considerable risk factor for developing dementia and reoccurrence of stroke. Understanding the neural mechanisms of cognitive impairment after stroke can facilitate early identification and intervention. Objectives Using functional near-infrared spectroscopy (fNRIS), the present study aimed to examine whether resting-state functional connectivity (FC) of brain networks differs in patients with PSCI, patients with Non-PSCI (NPSCI), and healthy controls (HCs), and whether these features could be used for clinical diagnosis of PSCI. Methods The present study recruited 16 HCs and 32 post-stroke patients. Based on the diagnostic criteria of PSCI, post-stroke patients were divided to the PSCI or NPSCI group. All participants underwent a 6-min resting-state fNRIS test to measure the hemodynamic responses from regions of interests (ROIs) that were primarily distributed in the prefrontal, somatosensory, and motor cortices. Results The results showed that, when compared to the HC group, the PSCI group exhibited significantly decreased interhemispheric FC and intra-right hemispheric FC. ROI analyses showed significantly decreased FC among the regions of somatosensory cortex, dorsolateral prefrontal cortex, and medial prefrontal cortex for the PSCI group than for the HC group. However, no significant difference was found in the FC between the PSCI and the NPSCI groups. Conclusion Our findings provide evidence for compromised interhemispheric and intra-right hemispheric functional connectivity in patients with PSCI, suggesting that fNIRS is a promising approach to investigate the effects of stroke on functional connectivity of brain networks.
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Affiliation(s)
- Jiahuan Zou
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu,Sichuan, China
| | - Yongyan Yin
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu,Sichuan, China
| | - Zhenfang Lin
- Department of Neurology, Sichuan Bayi Rehabilitation Center (Sichuan Provincial Rehabilitation Hospital), Chengdu, Sichuan, China
| | - Yulai Gong
- Department of Neurology, Sichuan Bayi Rehabilitation Center (Sichuan Provincial Rehabilitation Hospital), Chengdu, Sichuan, China
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Dadario NB, Tanglay O, Stafford JF, Davis EJ, Young IM, Fonseka RD, Briggs RG, Yeung JT, Teo C, Sughrue ME. Topology of the lateral visual system: The fundus of the superior temporal sulcus and parietal area H connect nonvisual cerebrum to the lateral occipital lobe. Brain Behav 2023; 13:e2945. [PMID: 36912573 PMCID: PMC10097165 DOI: 10.1002/brb3.2945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND AND PURPOSE Mapping the topology of the visual system is critical for understanding how complex cognitive processes like reading can occur. We aim to describe the connectivity of the visual system to understand how the cerebrum accesses visual information in the lateral occipital lobe. METHODS Using meta-analytic software focused on task-based functional MRI studies, an activation likelihood estimation (ALE) of the visual network was created. Regions of interest corresponding to the cortical parcellation scheme previously published under the Human Connectome Project were co-registered onto the ALE to identify the hub-like regions of the visual network. Diffusion Spectrum Imaging-based fiber tractography was performed to determine the structural connectivity of these regions with extraoccipital cortices. RESULTS The fundus of the superior temporal sulcus (FST) and parietal area H (PH) were identified as hub-like regions for the visual network. FST and PH demonstrated several areas of coactivation beyond the occipital lobe and visual network. Furthermore, these parcellations were highly interconnected with other cortical regions throughout extraoccipital cortices related to their nonvisual functional roles. A cortical model demonstrating connections to these hub-like areas was created. CONCLUSIONS FST and PH are two hub-like areas that demonstrate extensive functional coactivation and structural connections to nonvisual cerebrum. Their structural interconnectedness with language cortices along with the abnormal activation of areas commonly located in the temporo-occipital region in dyslexic individuals suggests possible important roles of FST and PH in the integration of information related to language and reading. Future studies should refine our model by examining the functional roles of these hub areas and their clinical significance.
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Affiliation(s)
- Nicholas B Dadario
- Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Onur Tanglay
- Omniscient Neurotechnology, Sydney, New South Wales, Australia
| | - Jordan F Stafford
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | | | | | - R Dineth Fonseka
- Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Sydney, New South Wales, Australia
| | - Robert G Briggs
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | | | - Charles Teo
- Cingulum Health, Sydney, New South Wales, Australia
| | - Michael E Sughrue
- Omniscient Neurotechnology, Sydney, New South Wales, Australia.,Cingulum Health, Sydney, New South Wales, Australia.,Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Sydney, New South Wales, Australia
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8
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Bian R, Huo M, Liu W, Mansouri N, Tanglay O, Young I, Osipowicz K, Hu X, Zhang X, Doyen S, Sughrue ME, Liu L. Connectomics underlying motor functional outcomes in the acute period following stroke. Front Aging Neurosci 2023; 15:1131415. [PMID: 36875697 PMCID: PMC9975347 DOI: 10.3389/fnagi.2023.1131415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
Objective Stroke remains the number one cause of morbidity in many developing countries, and while effective neurorehabilitation strategies exist, it remains difficult to predict the individual trajectories of patients in the acute period, making personalized therapies difficult. Sophisticated and data-driven methods are necessary to identify markers of functional outcomes. Methods Baseline anatomical T1 magnetic resonance imaging (MRI), resting-state functional MRI (rsfMRI), and diffusion weighted scans were obtained from 79 patients following stroke. Sixteen models were constructed to predict performance across six tests of motor impairment, spasticity, and activities of daily living, using either whole-brain structural or functional connectivity. Feature importance analysis was also performed to identify brain regions and networks associated with performance in each test. Results The area under the receiver operating characteristic curve ranged from 0.650 to 0.868. Models utilizing functional connectivity tended to have better performance than those utilizing structural connectivity. The Dorsal and Ventral Attention Networks were among the top three features in several structural and functional models, while the Language and Accessory Language Networks were most commonly implicated in structural models. Conclusions Our study highlights the potential of machine learning methods combined with connectivity analysis in predicting outcomes in neurorehabilitation and disentangling the neural correlates of functional impairments, though further longitudinal studies are necessary.
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Affiliation(s)
- Rong Bian
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ming Huo
- University of Health and Rehabilitation Sciences, Qingdao, China
| | - Wan Liu
- Department of Rehabilitation, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | | | - Onur Tanglay
- Omniscient Neurotechnology, Sydney, NSW, Australia
| | | | | | - Xiaorong Hu
- Xijia Medical Technology Company Limited, Shenzhen, China
| | - Xia Zhang
- Xijia Medical Technology Company Limited, Shenzhen, China.,International Joint Research Center on Precision Brain Medicine, Xidian Group Hospital, Xi'an, China
| | | | - Michael E Sughrue
- Omniscient Neurotechnology, Sydney, NSW, Australia.,International Joint Research Center on Precision Brain Medicine, Xidian Group Hospital, Xi'an, China
| | - Li Liu
- Department of Rehabilitation, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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9
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Li Y, Yu Z, Zhou X, Wu P, Chen J. Aberrant interhemispheric functional reciprocities of the default mode network and motor network in subcortical ischemic stroke patients with motor impairment: A longitudinal study. Front Neurol 2022; 13:996621. [PMID: 36267883 PMCID: PMC9577250 DOI: 10.3389/fneur.2022.996621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of the present study was to explore the longitudinal changes in functional homotopy in the default mode network (DMN) and motor network and its relationships with clinical characteristics in patients with stroke. Methods Resting-state functional magnetic resonance imaging was performed in stroke patients with subcortical ischemic lesions and healthy controls. The voxel-mirrored homotopic connectivity (VMHC) method was used to examine the differences in functional homotopy in patients with stroke between the two time points. Support vector machine (SVM) and correlation analyses were also applied to investigate whether the detected significant changes in VMHC were the specific feature in patients with stroke. Results The patients with stroke had significantly lower VMHC in the DMN and motor-related regions than the controls, including in the precuneus, parahippocampus, precentral gyrus, supplementary motor area, and middle frontal gyrus. Longitudinal analysis revealed that the impaired VMHC of the superior precuneus showed a significant increase at the second time point, which was no longer significantly different from the controls. Between the two time points, the changes in VMHC in the superior precuneus were significantly correlated with the changes in clinical scores. SVM analysis revealed that the VMHC of the superior precuneus could be used to correctly identify the patients with stroke from the controls with a statistically significant accuracy of 81.25% (P ≤ 0.003). Conclusions Our findings indicated that the increased VMHC in the superior precuneus could be regarded as the neuroimaging manifestation of functional recovery. The significant correlation and the discriminative power in classification results might provide novel evidence to understand the neural mechanisms responsible for brain reorganization after stroke.
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Affiliation(s)
- Yongxin Li
- School of Traditional Chinese Medicine, Formula-Pattern Research Center, Jinan University, Guangzhou, China
- *Correspondence: Yongxin Li
| | - Zeyun Yu
- Acupuncture and Tuina School/Tird Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xuan Zhou
- School of Traditional Chinese Medicine, Formula-Pattern Research Center, Jinan University, Guangzhou, China
| | - Ping Wu
- Acupuncture and Tuina School/Tird Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Ping Wu
| | - Jiaxu Chen
- School of Traditional Chinese Medicine, Formula-Pattern Research Center, Jinan University, Guangzhou, China
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10
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Min Y, Liu C, Zuo L, Wang Y, Li Z. The Relationship between Altered Degree Centrality and Cognitive Function in Mild Subcortical Stroke: A Resting-State fMRI Study. Brain Res 2022; 1798:148125. [DOI: 10.1016/j.brainres.2022.148125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/28/2022] [Accepted: 10/10/2022] [Indexed: 11/02/2022]
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11
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Wang S, Rao B, Miao G, Zhang X, Zheng J, Lin J, Yu M, Zhou X, Xu H, Liao W. The resting-state topological organization damage of language-related brain regions in post-stroke cognitive impairment. Brain Imaging Behav 2022; 16:2608-2617. [PMID: 36136202 DOI: 10.1007/s11682-022-00716-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2022] [Indexed: 11/27/2022]
Abstract
The topology of brain networks is the foundation of cognition. We hypothesized that stroke damaged topological organization resulting in cognitive impairment. The aim was to explore the damage pattern of the resting-state topology in post-stroke cognitive impairment (PSCI) patients. Thirty-seven patients with PSCI and thirty-seven gender- and age-matched healthy controls (HC) were recruited. The structural and functional data were collected from all subjects. The degree centrality (DC), betweenness centrality (BC), and global properties of brain networks were analyzed between groups. Spearman correlation analysis was performed between topological properties that changed significantly and clinical cognitive function scale scores. Compared with HC, the PSCI patients had significantly reduced DC in language-related brain regions and significantly higher DC in the right frontal lobe, hippocampus, and paracentral lobule. The decreased BC was located in the left caudate, thalamus, temporal, and frontal lobes. The increased BC was detected in the left cuneus and right precuneus. In addition, PSCI exhibited increased characteristic path length and decreased small-worldness. PSCI patients had impaired functional topology of the language-related brain regions, mainly in the left hemisphere. The enhanced processing and relaying information of some right high-order cognitive brain regions may be a compensatory mechanism. However, the whole brain's function integration was reduced, and there was an imbalance between efficiency and consumption.
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Affiliation(s)
- Sirui Wang
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Bo Rao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Guofu Miao
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Xin Zhang
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Jun Zheng
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Junbin Lin
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Minhua Yu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Xiaoli Zhou
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.
| | - Weijing Liao
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.
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Rao B, Wang S, Yu M, Chen L, Miao G, Zhou X, Zhou H, Liao W, Xu H. Suboptimal states and frontoparietal network-centered incomplete compensation revealed by dynamic functional network connectivity in patients with post-stroke cognitive impairment. Front Aging Neurosci 2022; 14:893297. [PMID: 36003999 PMCID: PMC9393744 DOI: 10.3389/fnagi.2022.893297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundNeural reorganization occurs after a stroke, and dynamic functional network connectivity (dFNC) pattern is associated with cognition. We hypothesized that dFNC alterations resulted from neural reorganization in post-stroke cognitive impairment (PSCI) patients, and specific dFNC patterns characterized different pathological types of PSCI.MethodsResting-state fMRI data were collected from 16 PSCI patients with hemorrhagic stroke (hPSCI group), 21 PSCI patients with ischemic stroke (iPSCI group), and 21 healthy controls (HC). We performed the dFNC analysis for the dynamic connectivity states, together with their topological and temporal features.ResultsWe identified 10 resting-state networks (RSNs), and the dFNCs could be clustered into four reoccurring states (modular, regional, sparse, and strong). Compared with HC, the hPSCI and iPSCI patients showed lower standard deviation (SD) and coefficient of variation (CV) in the regional and modular states, respectively (p < 0.05). Reduced connectivities within the primary network (visual, auditory, and sensorimotor networks) and between the primary and high-order cognitive control domains were observed (p < 0.01).ConclusionThe transition trend to suboptimal states may play a compensatory role in patients with PSCI through redundancy networks. The reduced exploratory capacity (SD and CV) in different suboptimal states characterized cognitive impairment and pathological types of PSCI. The functional disconnection between the primary and high-order cognitive control network and the frontoparietal network centered (FPN-centered) incomplete compensation may be the pathological mechanism of PSCI. These results emphasize the flexibility of neural reorganization during self-repair.
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Affiliation(s)
- Bo Rao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Sirui Wang
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Minhua Yu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Linglong Chen
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Guofu Miao
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiaoli Zhou
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hong Zhou
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Weijing Liao
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- *Correspondence: Weijing Liao,
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Haibo Xu,
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13
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The effects and mechanisms of transcranial ultrasound stimulation combined with cognitive rehabilitation on post-stroke cognitive impairment. Neurol Sci 2022; 43:4315-4321. [DOI: 10.1007/s10072-022-05906-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
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14
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Tian N, Liang L, Luo X, Hu R, Long W, Song R. More than just statics: Altered complexity of dynamic amplitude of low-frequency fluctuations in the resting brain after stroke. J Neural Eng 2022; 19. [PMID: 35594839 DOI: 10.1088/1741-2552/ac71ce] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/20/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Previous neuroimaging studies mainly focused on static characteristics of brain activity, and little is known about its characteristics over time, especially in post-stroke (PS) patients. In this study, we aimed to investigate the static and dynamic characteristics of brain activity after stroke using functional magnetic resonance imaging (fMRI). APPROACH Twenty ischemic PS patients and nineteen healthy controls (HCs) were recruited to receive a resting-state fMRI scanning. The static amplitude of low-frequency fluctuations (sALFF) and fuzzy entropy of dynamic ALFF (FE-dALFF) were applied to identify the stroke-induced alterations. MAIN RESULTS Compared with the HCs, PS patients showed significantly increased FE-dALFF values in the right angular gyrus (ANG), bilateral precuneus (PCUN), and right inferior parietal lobule (IPL) as well as significantly decreased FE-dALFF values in the right postcentral gyrus (PoCG), right dorsolateral superior frontal gyrus (SFGdor), and right precentral gyrus (PreCG). The ROC analyses demonstrated that FE-dALFF and sALFF possess comparable sensitivity in distinguishing PS patients from the HCs. Moreover, a significantly positive correlation was observed between the FE-dALFF values and the Fugl-Meyer Assessment (FMA) scores in the right SFGdor (r =0.547), right IPL (r =0.522), and right PCUN (r =0.486). SIGNIFICANCE This study provided insight into the stroke-induced alterations in static and dynamic characteristics of local brain activity, highlighting the potential of FE-dALFF in understanding neurophysiological mechanisms and evaluating pathological changes.
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Affiliation(s)
- Na Tian
- Sun Yat-Sen University, Higher Mega Education Center, Guangzhou, Guangdong, 510006, CHINA
| | - Liuke Liang
- School of Biomedical Engineering, Sun Yat-Sen University, Higher Mega Education Center, Guangzhou, Guangdong, 510006, CHINA
| | - Xuemao Luo
- Department of Radiology, Jiangmen Central Hospital, Jiangmen, Guangdong, CN, Jiangmen, Guangdong, 529030, CHINA
| | - Rongliang Hu
- Department of Rehabilitation Medicine, Jiangmen Central Hospital, Jiangmen, Guangdong, CN, Jiangmen, Guangdong, 529030, CHINA
| | - Wansheng Long
- Department of Radiology, Jiangmen Central Hospital, Jiangmen, Guangdong, CN, Jiangmen, Guangdong, 529030, CHINA
| | - Rong Song
- Biomedical Engineering, National Sun Yat-sen University, Higher Mega Education Center, Guangzhou, 510006, CHINA
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15
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Luo B, Dong W, Chang L, Qiu C, Lu Y, Liu D, Xue C, Zhang L, Liu W, Zhang W, Yan J. Altered Interhemispheric Functional Connectivity Associated With Early Verbal Fluency Decline After Deep Brain Stimulation in Parkinson’s Disease. Front Aging Neurosci 2022; 14:799545. [PMID: 35431904 PMCID: PMC9011328 DOI: 10.3389/fnagi.2022.799545] [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: 10/21/2021] [Accepted: 02/08/2022] [Indexed: 11/25/2022] Open
Abstract
Background Patients with Parkinson’s disease (PD) experience a decline in verbal fluency (VF) immediately after undergoing deep brain stimulation (DBS) of the subthalamic nucleus (STN). This phenomenon is thought to be related to surgical microlesions. Purpose We investigated the alterations in interhemispheric functional connectivity after STN-DBS in PD patients. We also evaluated the correlation between these changes and decreased VF scores. Method Overall, 30 patients with PD were enrolled in the study. Resting-state functional magnetic resonance imaging scans were performed twice, once before and once after DBS, in PD patients. Voxel-mirrored homotopic connectivity (VMHC) was applied in order to evaluate the synchronicity of functional connectivity between the hemispheres. Result After undergoing STN-DBS, PD patients demonstrated reduced VMHC value in the posterior cerebellum lobe, angular gyrus, precuneus/posterior cingulate gyrus (PCC), supramarginal gyrus, superior frontal gyrus (SFG) (medial and dorsolateral) and middle frontal gyrus (MFG). In addition, we observed a significant positive correlation between the altered VMHC value in the SFG and MFG and the change of phonemic VF scores. Conclusion PD patients demonstrated an interhemispheric coordination disorder in the prefrontal cortex, cerebellum, supramarginal gyrus and DMN after undergoing STN-DBS. The positive correlation between reduced VMHC value in the SFG and MFG and the changes of VF scores provides a novel understanding with regard to the decline of VF after DBS.
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Affiliation(s)
- Bei Luo
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenwen Dong
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Lei Chang
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chang Qiu
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yue Lu
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Dongming Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chen Xue
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Li Zhang
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Weiguo Liu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenbin Zhang
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Wenbin Zhang,
| | - Jun Yan
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Jun Yan,
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16
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Li Z, Hu J, Wang Z, You R, Cao D. Basal ganglia stroke is associated with altered functional connectivity of the left inferior temporal gyrus. J Neuroimaging 2022; 32:744-751. [PMID: 35175633 DOI: 10.1111/jon.12978] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSE Acute cerebral infarction in the basal ganglia is associated with an increased risk of cognitive impairment, suggesting that cognitive networks might be involved in neural plasticity after ischemic stroke. This study was conducted to explore the abnormalities in functional and causal connectivity of the brain network in patients with acute ischemic stroke (AIS) in the basal ganglia. METHODS Resting-state functional magnetic resonance imaging was performed in 27 patients with AIS in the basal ganglia and 27 healthy controls (HCs). Brain regions with statistically different degree centrality (DC) values between groups were selected as seed points for granger causality analysis (GCA) analysis. The effective connectivity values of GCA were extracted, and the correlation between them and the Montreal Cognitive Assessment (MoCA) score was analyzed. RESULTS Compared with HCs group, AIS patients displayed increased DC value in the left inferior temporal gyrus (ITG) and hippocampus head, reduced effective connectivity from the left ITG to the left precentral and postcentral gyri, increased effective connectivity from the left precentral and postcentral gyri to the left ITG, and reduced effective connectivity from the left anterior cingulate gyrus to the left ITG. The MoCA score of the AIS group was lower than that of the HCs group (t = -7.33, p < .05). CONCLUSION Alterations of functional and causal connectivity among multiple brain regions suggest that patients with AIS in the basal ganglia have impairment of multifunctional networks in the whole brain.
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Affiliation(s)
- Zhongming Li
- Department of Imaging, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Jianping Hu
- Department of Imaging, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Zhimin Wang
- Department of Imaging, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Ruixiong You
- Department of Imaging, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Dairong Cao
- Department of Imaging, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
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17
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Miao G, Rao B, Wang S, Fang P, Chen Z, Chen L, Zhang X, Zheng J, Xu H, Liao W. Decreased Functional Connectivities of Low-Degree Level Rich Club Organization and Caudate in Post-stroke Cognitive Impairment Based on Resting-State fMRI and Radiomics Features. Front Neurosci 2022; 15:796530. [PMID: 35250435 PMCID: PMC8890030 DOI: 10.3389/fnins.2021.796530] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 12/31/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundStroke is an important cause of cognitive impairment. Rich club organization, a highly interconnected network brain core region, is closely related to cognition. We hypothesized that the disturbance of rich club organization exists in patients with post-stroke cognitive impairment (PSCI).MethodsWe collected data on resting-state functional magnetic resonance imaging (rs-fMRI) with 21 healthy controls (HC), 16 hemorrhagic stroke (hPSCI), and 21 infarct stroke (iPSCI). 3D shape features and first-order statistics of stroke lesions were extracted using 3D slicer software. Additionally, we assessed cognitive function using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE).ResultsNormalized rich club coefficients were higher in hPSCI and iPSCI than HC at low-degree k-levels (k = 1–8 in iPSCI, k = 2–8 in hPSCI). Feeder and local connections were significantly decreased in PSCI patients versus HC, mainly distributed in salience network (SN), default-mode network (DMN), cerebellum network (CN), and orbitofrontal cortex (ORB), especially involving the right and left caudate with changed nodal efficiency. The feeder and local connections of significantly between-group difference were positively related to MMSE and MoCA scores, primarily distributed in the sensorimotor network (SMN) and visual network (VN) in hPSCI, SN, and DMN in iPSCI. Additionally, decreased local connections and low-degree ϕnorm(k) were correlated to 3D shape features and first-order statistics of stroke lesions.ConclusionThis study reveals the disrupted low-degree level rich club organization and relatively preserved functional core network in PSCI patients. Decreased feeder and local connections in cognition-related networks (DMN, SN, CN, and ORB), particularly involving the caudate nucleus, may offer insight into pathological mechanism of PSCI patients. The shape and signal features of stroke lesions may provide an essential clue for the damage of functional connectivity and the whole brain networks.
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Affiliation(s)
- Guofu Miao
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Bo Rao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Sirui Wang
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Pinyan Fang
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Radiology, TEDA International Cardiovascular Hospital, Tianjin, China
| | - Zhuo Chen
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Linglong Chen
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xin Zhang
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jun Zheng
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
- *Correspondence: Haibo Xu,
| | - Weijing Liao
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Weijing Liao,
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18
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Wei L, Baeken C, Liu D, Zhang J, Wu GR. Functional connectivity–based prediction of global cognition and motor function in riluzole-naive amyotrophic lateral sclerosis patients. Netw Neurosci 2022; 6:161-174. [PMID: 35356196 PMCID: PMC8959121 DOI: 10.1162/netn_a_00217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/17/2021] [Indexed: 12/03/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is increasingly recognized as a multisystem disorder accompanied by cognitive changes. To date, no effective therapy is available for ALS patients, partly due to disease heterogeneity and an imperfect understanding of the underlying pathophysiological processes. Reliable models that can predict cognitive and motor deficits are needed to improve symptomatic treatment and slow down disease progression. This study aimed to identify individualized functional connectivity–based predictors of cognitive and motor function in ALS by using multiple kernel learning (MKL) regression. Resting-state fMRI scanning was performed on 34 riluzole-naive ALS patients. Motor severity and global cognition were separately measured with the revised ALS functional rating scale (ALSFRS-R) and the Montreal Cognitive Assessment (MoCA). Our results showed that functional connectivity within the default mode network (DMN) as well as between the DMN and the sensorimotor network (SMN), fronto-parietal network (FPN), and salience network (SN) were predictive for MoCA scores. Additionally, the observed connectivity patterns were also predictive for the individual ALSFRS-R scores. Our findings demonstrate that cognitive and motor impairments may share common connectivity fingerprints in ALS patients. Furthermore, the identified brain connectivity signatures may serve as novel targets for effective disease-modifying therapies. Amyotrophic lateral sclerosis is recognized as a multisystem disorder, and currently no effective therapy is available for this devastating disease. Reliable models that can predict disease progression may facilitate the development of more efficient symptomatic treatment. This study used multiple kernel learning algorithm to identify a potential functional connectivity–based marker for cognitive and motor functioning in ALS. The results show that cognitive decline and motor progression could be predicted by seed-based functional connectivity from the medial prefrontal cortex/posterior cingulate cortex to the sensorimotor network, fronto-parietal network, and salience network. The identified brain connectivity signatures may serve as novel targets for effective disease-modifying therapies.
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Affiliation(s)
- Luqing Wei
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Chris Baeken
- Ghent Experimental Psychiatry Lab, Department of Head and Skin, UZ Gent/Universiteit Gent, Ghent, Belgium
- Department of Psychiatry, UZ Brussel/Free University of Brussels, Brussels, Belgium
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Daihong Liu
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing, China
| | - Jiuquan Zhang
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing, China
| | - Guo-Rong Wu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China
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Serban CA, Barborica A, Roceanu AM, Mindruta I, Ciurea J, Pâslaru AC, Zăgrean AM, Zăgrean L, Moldovan M. A method to assess the default EEG macrostate and its reactivity to stimulation. Clin Neurophysiol 2021; 134:50-64. [PMID: 34973517 DOI: 10.1016/j.clinph.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 08/23/2021] [Accepted: 12/04/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The default mode network (DMN) is deactivated by stimulation. We aimed to assess the DMN reactivity impairment by routine EEG recordings in stroke patients with impaired consciousness. METHODS Binocular light flashes were delivered at 1 Hz in 1-minute epochs, following a 1-minute baseline (PRE). The EEG was decomposed in a series of binary oscillatory macrostates by topographic spectral clustering. The most deactivated macrostate was labeled the default EEG macrostate (DEM). Its reactivity (DER) was quantified as the decrease in DEM occurrence probability during stimulation. A normalized DER index (DERI) was calculated as DER/PRE. The measures were compared between 14 healthy controls and 32 comatose patients under EEG monitoring following an acute stroke. RESULTS The DEM was mapped to the posterior DMN hubs. In the patients, these DEM source dipoles were 3-4 times less frequent and were associated with an increased theta activity. Even in a reduced 6-channel montage, a DER below 6.26% corresponding to a DERI below 0.25 could discriminate the patients with sensitivity and specificity well above 80%. CONCLUSION The method detected the DMN impairment in post-stroke coma patients. SIGNIFICANCE The DEM and its reactivity to stimulation could be useful to monitor the DMN function at bedside.
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Affiliation(s)
- Cosmin-Andrei Serban
- Physics Department, University of Bucharest, Romania; Termobit Prod SRL, Bucharest, Romania; FHC Inc, Bowdoin, ME, USA.
| | - Andrei Barborica
- Physics Department, University of Bucharest, Romania; Termobit Prod SRL, Bucharest, Romania; FHC Inc, Bowdoin, ME, USA.
| | | | - Ioana Mindruta
- Neurology Department, University Emergency Hospital, Bucharest, Romania.
| | - Jan Ciurea
- Department of Neurosurgery, Bagdasar-Arseni Emergency Hospital, Bucharest, Romania.
| | - Alexandru C Pâslaru
- Division of Physiology and Neuroscience, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Ana-Maria Zăgrean
- Division of Physiology and Neuroscience, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Leon Zăgrean
- Division of Physiology and Neuroscience, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Mihai Moldovan
- Termobit Prod SRL, Bucharest, Romania; Division of Physiology and Neuroscience, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; Neuroscience, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark.
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20
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Wang S, Rao B, Chen L, Chen Z, Fang P, Miao G, Xu H, Liao W. Using Fractional Amplitude of Low-Frequency Fluctuations and Functional Connectivity in Patients With Post-stroke Cognitive Impairment for a Simulated Stimulation Program. Front Aging Neurosci 2021; 13:724267. [PMID: 34483891 PMCID: PMC8414996 DOI: 10.3389/fnagi.2021.724267] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 07/22/2021] [Indexed: 12/26/2022] Open
Abstract
Stroke causes alterations in local spontaneous neuronal activity and related networks functional connectivity. We hypothesized that these changes occur in patients with post-stroke cognitive impairment (PSCI). Fractional amplitude of low-frequency fluctuations (fALFF) was calculated in 36 patients with cognitive impairment, including 16 patients with hemorrhagic stroke (hPSCI group), 20 patients with ischemic stroke (iPSCI group). Twenty healthy volunteers closely matched to the patient groups with respect to age and gender were selected as the healthy control group (HC group). Regions with significant alteration were regarded as regions of interest (ROIs) using the one-way analysis of variance, and then the seed-based functional connectivity (FC) with other regions in the brain was analyzed. Pearson correlation analyses were performed to investigate the correlation between functional indexes and cognitive performance in patients with PSCI. Our results showed that fALFF values of bilateral posterior cingulate cortex (PCC)/precuneus and bilateral anterior cingulate cortex in the hPSCI group were lower than those in the HC group. Compared with the HC group, fALFF values were lower in the superior frontal gyrus and basal ganglia in the iPSCI group. Correlation analysis showed that the fALFF value of left PCC was positively correlated with MMSE scores and MoCA scores in hPSCI. Besides, the reduction of seed-based FC values was reported, especially in regions of the default-mode network (DMN) and the salience network (SN). Abnormalities of spontaneous brain activity and functional connectivity are observed in PSCI patients. The decreased fALFF and FC values in DMN of patients with hemorrhagic and SN of patients with ischemic stroke may be the pathological mechanism of cognitive impairment. Besides, we showed how to use fALFF values and functional connectivity maps to specify a target map on the cortical surface for repetitive transcranial magnetic stimulation (rTMS).
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Affiliation(s)
- Sirui Wang
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Bo Rao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Linglong Chen
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhuo Chen
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Pinyan Fang
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Guofu Miao
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Weijing Liao
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
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21
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Hu M, Cheng HJ, Ji F, Chong JSX, Lu Z, Huang W, Ang KK, Phua KS, Chuang KH, Jiang X, Chew E, Guan C, Zhou JH. Brain Functional Changes in Stroke Following Rehabilitation Using Brain-Computer Interface-Assisted Motor Imagery With and Without tDCS: A Pilot Study. Front Hum Neurosci 2021; 15:692304. [PMID: 34335210 PMCID: PMC8322606 DOI: 10.3389/fnhum.2021.692304] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022] Open
Abstract
Brain-computer interface-assisted motor imagery (MI-BCI) or transcranial direct current stimulation (tDCS) has been proven effective in post-stroke motor function enhancement, yet whether the combination of MI-BCI and tDCS may further benefit the rehabilitation of motor functions remains unknown. This study investigated brain functional activity and connectivity changes after a 2 week MI-BCI and tDCS combined intervention in 19 chronic subcortical stroke patients. Patients were randomized into MI-BCI with tDCS group and MI-BCI only group who underwent 10 sessions of 20 min real or sham tDCS followed by 1 h MI-BCI training with robotic feedback. We derived amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), and functional connectivity (FC) from resting-state functional magnetic resonance imaging (fMRI) data pre- and post-intervention. At baseline, stroke patients had lower ALFF in the ipsilesional somatomotor network (SMN), lower ReHo in the contralesional insula, and higher ALFF/Reho in the bilateral posterior default mode network (DMN) compared to age-matched healthy controls. After the intervention, the MI-BCI only group showed increased ALFF in contralesional SMN and decreased ALFF/Reho in the posterior DMN. In contrast, no post-intervention changes were detected in the MI-BCI + tDCS group. Furthermore, higher increases in ALFF/ReHo/FC measures were related to better motor function recovery (measured by the Fugl-Meyer Assessment scores) in the MI-BCI group while the opposite association was detected in the MI-BCI + tDCS group. Taken together, our findings suggest that brain functional re-normalization and network-specific compensation were found in the MI-BCI only group but not in the MI-BCI + tDCS group although both groups gained significant motor function improvement post-intervention with no group difference. MI-BCI and tDCS may exert differential or even opposing impact on brain functional reorganization during post-stroke motor rehabilitation; therefore, the integration of the two strategies requires further refinement to improve efficacy and effectiveness.
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Affiliation(s)
- Mengjiao Hu
- NTU Institute for Health Technologies, Interdisciplinary Graduate Programme, Nanyang Technological University, Singapore, Singapore.,Center for Sleep and Cognition, Center for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hsiao-Ju Cheng
- Center for Sleep and Cognition, Center for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Biomedical Engineering, Faculty of Engineering, National University of Singapore, Singapore, Singapore
| | - Fang Ji
- Center for Sleep and Cognition, Center for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Joanna Su Xian Chong
- Center for Sleep and Cognition, Center for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Zhongkang Lu
- Institute for Infocomm Research, Agency for Science Technology and Research, Singapore, Singapore
| | - Weimin Huang
- Institute for Infocomm Research, Agency for Science Technology and Research, Singapore, Singapore
| | - Kai Keng Ang
- Institute for Infocomm Research, Agency for Science Technology and Research, Singapore, Singapore.,School of Computer Science and Engineering, Nanyang Technological University, Singapore, Singapore
| | - Kok Soon Phua
- Institute for Infocomm Research, Agency for Science Technology and Research, Singapore, Singapore
| | - Kai-Hsiang Chuang
- Singapore Bioimaging Consortium, Agency for Science Technology and Research, Singapore, Singapore.,Queensland Brain Institute and Centre for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - Xudong Jiang
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, Singapore
| | - Effie Chew
- Division of Neurology, University Medicine Cluster, National University Health System, Singapore, Singapore
| | - Cuntai Guan
- School of Computer Science and Engineering, Nanyang Technological University, Singapore, Singapore
| | - Juan Helen Zhou
- Center for Sleep and Cognition, Center for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore.,Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore, Singapore
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22
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Lee KP, Chang AYW, Sung PS. Association between Blood Pressure, Blood Pressure Variability, and Post-Stroke Cognitive Impairment. Biomedicines 2021; 9:773. [PMID: 34356837 PMCID: PMC8301473 DOI: 10.3390/biomedicines9070773] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/23/2021] [Accepted: 06/29/2021] [Indexed: 12/18/2022] Open
Abstract
After stroke, dynamic changes take place from necrotic-apoptotic continuum, inflammatory response to poststroke neurogenesis, and remodeling of the network. These changes and baseline brain pathology such as small vessel disease (SVD) and amyloid burden may be associated with the occurrence of early or late poststroke cognitive impairment (PSCI) or dementia (PSD), which affect not only stroke victims but also their families and even society. We reviewed the current concepts and understanding of the pathophysiology for PSCI/PSD and identified useful tools for the diagnosis and the prediction of PSCI in serological, CSF, and image characteristics. Then, we untangled their relationships with blood pressure (BP) and blood pressure variability (BPV), important but often overlooked risk factors for PSCI/PSD. Finally, we provided evidence for the modifying effects of BP and BPV on PSCI as well as pharmacological and non-pharmacological interventions and life style modification for PSCI/PSD prevention and treatment.
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Affiliation(s)
- Kang-Po Lee
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan;
- Department of Neurology, E-DA Hospital, Kaohsiung 824, Taiwan
| | - Alice Y. W. Chang
- Department of Physiology, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan;
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Pi-Shan Sung
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan;
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
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23
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Jobson DD, Hase Y, Clarkson AN, Kalaria RN. The role of the medial prefrontal cortex in cognition, ageing and dementia. Brain Commun 2021; 3:fcab125. [PMID: 34222873 PMCID: PMC8249104 DOI: 10.1093/braincomms/fcab125] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 04/08/2021] [Accepted: 04/14/2021] [Indexed: 01/18/2023] Open
Abstract
Humans require a plethora of higher cognitive skills to perform executive functions, such as reasoning, planning, language and social interactions, which are regulated predominantly by the prefrontal cortex. The prefrontal cortex comprises the lateral, medial and orbitofrontal regions. In higher primates, the lateral prefrontal cortex is further separated into the respective dorsal and ventral subregions. However, all these regions have variably been implicated in several fronto-subcortical circuits. Dysfunction of these circuits has been highlighted in vascular and other neurocognitive disorders. Recent advances suggest the medial prefrontal cortex plays an important regulatory role in numerous cognitive functions, including attention, inhibitory control, habit formation and working, spatial or long-term memory. The medial prefrontal cortex appears highly interconnected with subcortical regions (thalamus, amygdala and hippocampus) and exerts top-down executive control over various cognitive domains and stimuli. Much of our knowledge comes from rodent models using precise lesions and electrophysiology readouts from specific medial prefrontal cortex locations. Although, anatomical disparities of the rodent medial prefrontal cortex compared to the primate homologue are apparent, current rodent models have effectively implicated the medial prefrontal cortex as a neural substrate of cognitive decline within ageing and dementia. Human brain connectivity-based neuroimaging has demonstrated that large-scale medial prefrontal cortex networks, such as the default mode network, are equally important for cognition. However, there is little consensus on how medial prefrontal cortex functional connectivity specifically changes during brain pathological states. In context with previous work in rodents and non-human primates, we attempt to convey a consensus on the current understanding of the role of predominantly the medial prefrontal cortex and its functional connectivity measured by resting-state functional MRI in ageing associated disorders, including prodromal dementia states, Alzheimer's disease, post-ischaemic stroke, Parkinsonism and frontotemporal dementia. Previous cross-sectional studies suggest that medial prefrontal cortex functional connectivity abnormalities are consistently found in the default mode network across both ageing and neurocognitive disorders such as Alzheimer's disease and vascular cognitive impairment. Distinct disease-specific patterns of medial prefrontal cortex functional connectivity alterations within specific large-scale networks appear to consistently feature in the default mode network, whilst detrimental connectivity alterations are associated with cognitive impairments independently from structural pathological aberrations, such as grey matter atrophy. These disease-specific patterns of medial prefrontal cortex functional connectivity also precede structural pathological changes and may be driven by ageing-related vascular mechanisms. The default mode network supports utility as a potential biomarker and therapeutic target for dementia-associated conditions. Yet, these associations still require validation in longitudinal studies using larger sample sizes.
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Affiliation(s)
- Dan D Jobson
- Translational and Clinical Research Institute,
Newcastle University, Campus for Ageing & Vitality,
Newcastle upon Tyne NE4 5PL, UK
| | - Yoshiki Hase
- Translational and Clinical Research Institute,
Newcastle University, Campus for Ageing & Vitality,
Newcastle upon Tyne NE4 5PL, UK
| | - Andrew N Clarkson
- Department of Anatomy, Brain Health Research Centre
and Brain Research New Zealand, University of Otago, Dunedin 9054,
New Zealand
| | - Rajesh N Kalaria
- Translational and Clinical Research Institute,
Newcastle University, Campus for Ageing & Vitality,
Newcastle upon Tyne NE4 5PL, UK
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24
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Bonkhoff AK, Schirmer MD, Bretzner M, Etherton M, Donahue K, Tuozzo C, Nardin M, Giese A, Wu O, D. Calhoun V, Grefkes C, Rost NS. Abnormal dynamic functional connectivity is linked to recovery after acute ischemic stroke. Hum Brain Mapp 2021; 42:2278-2291. [PMID: 33650754 PMCID: PMC8046120 DOI: 10.1002/hbm.25366] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/26/2021] [Accepted: 01/29/2021] [Indexed: 12/30/2022] Open
Abstract
The aim of the current study was to explore the whole-brain dynamic functional connectivity patterns in acute ischemic stroke (AIS) patients and their relation to short and long-term stroke severity. We investigated resting-state functional MRI-based dynamic functional connectivity of 41 AIS patients two to five days after symptom onset. Re-occurring dynamic connectivity configurations were obtained using a sliding window approach and k-means clustering. We evaluated differences in dynamic patterns between three NIHSS-stroke severity defined groups (mildly, moderately, and severely affected patients). Furthermore, we built Bayesian hierarchical models to evaluate the predictive capacity of dynamic connectivity and examine the interrelation with clinical measures, such as white matter hyperintensity lesions. Finally, we established correlation analyses between dynamic connectivity and AIS severity as well as 90-day neurological recovery (ΔNIHSS). We identified three distinct dynamic connectivity configurations acutely post-stroke. More severely affected patients spent significantly more time in a configuration that was characterized by particularly strong connectivity and isolated processing of functional brain domains (three-level ANOVA: p < .05, post hoc t tests: p < .05, FDR-corrected). Configuration-specific time estimates possessed predictive capacity of stroke severity in addition to the one of clinical measures. Recovery, as indexed by the realized change of the NIHSS over time, was significantly linked to the dynamic connectivity between bilateral intraparietal lobule and left angular gyrus (Pearson's r = -.68, p = .003, FDR-corrected). Our findings demonstrate transiently increased isolated information processing in multiple functional domains in case of severe AIS. Dynamic connectivity involving default mode network components significantly correlated with recovery in the first 3 months poststroke.
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Affiliation(s)
- Anna K. Bonkhoff
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
- Cognitive NeuroscienceInstitute of Neuroscience and Medicine (INM‐3), Research Centre JuelichJuelichGermany
| | - Markus D. Schirmer
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
- Department of Population Health SciencesGerman Centre for Neurodegenerative Diseases (DZNE)Germany
| | - Martin Bretzner
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
- Neurosciences and CognitionUniversity of LilleLilleFrance
| | - Mark Etherton
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
| | - Kathleen Donahue
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
| | - Carissa Tuozzo
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
| | - Marco Nardin
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
| | - Anne‐Katrin Giese
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
- Department of NeurologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Ona Wu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of RadiologyMassachusetts General HospitalCharlestownMassachusettsUSA
| | - Vince D. Calhoun
- Tri‐institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of TechnologyEmory UniversityAtlantaGeorgiaUSA
| | - Christian Grefkes
- Cognitive NeuroscienceInstitute of Neuroscience and Medicine (INM‐3), Research Centre JuelichJuelichGermany
- Department of NeurologyUniversity Hospital CologneCologneGermany
| | - Natalia S. Rost
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
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25
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Vicentini JE, Weiler M, Casseb RF, Almeida SR, Valler L, de Campos BM, Li LM. Subacute functional connectivity correlates with cognitive recovery six months after stroke. NEUROIMAGE-CLINICAL 2020; 29:102538. [PMID: 33385880 PMCID: PMC7779317 DOI: 10.1016/j.nicl.2020.102538] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 11/19/2020] [Accepted: 12/15/2020] [Indexed: 12/27/2022]
Abstract
Stroke disrupts ipsilesional and inter-hemispheric functional connectivity of DMN. Subacute cognition correlated to inter-hemispheric and ipsilesional DMN connectivity. Subacute cognition correlated to weaker contralesional SN connectivity. Functional connectivity remapping was not observed after six months. Cognitive recovery correlated to DMN and SN connectivity from the subacute phase.
Background and purpose Cognitive impairment is a common consequence of stroke, and the rewiring of the surviving brain circuits might contribute to cognitive recovery. Studies investigating how the functional connectivity of networks change across time and whether their remapping relates to cognitive recovery in stroke patients are scarce. We aimed to investigate whether resting-state functional connectivity was associated with cognitive performance in stroke patients and if any alterations in these networks were correlated with cognitive recovery. Methods Using an fMRI ROI-ROI approach, we compared the ipsilesional, contralesional and interhemispheric functional connectivity of three resting-state networks involved in cognition – the Default Mode (DMN), Salience (SN) and Central Executive Networks (CEN), in subacute ischemic stroke patients (time 1, n = 37, stroke onset: 24.32 ± 7.44 days, NIHSS: 2.66 ± 3.45) with cognitively healthy controls (n = 20). Patients were reassessed six months after the stroke event (time 2, n = 20, stroke onset: 182.05 ± 8.17 days) to verify the subsequent reorganization of functional connections and whether such reorganization was associated with cognitive recovery. Results At time 1, patients had weaker interhemispheric connectivity in the DMN than controls; better cognitive performance at time 1 was associated with stronger interhemispheric and ipsilesional DMN connectivity, and weaker contralesional SN connectivity. At time 2, there were no changes in functional connectivity in stroke patients, compared to time 1. Better cognitive recovery measured at time 2 (time 2 – time 1) was associated with stronger functional connectivity in the DMN, and weaker interhemispheric subacute connectivity in the SN, both from time 1. Conclusions Stroke disrupts the functional connectivity of the DMN, not only at the lesioned hemisphere but also between hemispheres. Six months after the stroke event, we could not detect the remapping of networks. Cognitive recovery was associated with the connectivity of both the DMN and SN of time 1. Our findings may be helpful for facilitating further understanding of the potential mechanisms underlying post-stroke cognitive performance.
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Affiliation(s)
- Jéssica Elias Vicentini
- Brazilian Institute of Neuroscience and Neurotechnology - Brainn, Department of Neurology, Faculty of Medical Sciences - University of Campinas (UNICAMP), Brazil
| | - Marina Weiler
- Neurocognitive Aging Section, Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health (NIA/NIH), Intramural Research Program, United States
| | | | - Sara Regina Almeida
- Brazilian Institute of Neuroscience and Neurotechnology - Brainn, Department of Neurology, Faculty of Medical Sciences - University of Campinas (UNICAMP), Brazil
| | - Lenise Valler
- Brazilian Institute of Neuroscience and Neurotechnology - Brainn, Department of Neurology, Faculty of Medical Sciences - University of Campinas (UNICAMP), Brazil
| | - Brunno Machado de Campos
- Brazilian Institute of Neuroscience and Neurotechnology - Brainn, Department of Neurology, Faculty of Medical Sciences - University of Campinas (UNICAMP), Brazil
| | - Li Min Li
- Brazilian Institute of Neuroscience and Neurotechnology - Brainn, Department of Neurology, Faculty of Medical Sciences - University of Campinas (UNICAMP), Brazil.
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26
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Zhang J, Li Z, Cao X, Zuo L, Wen W, Zhu W, Jiang J, Cheng J, Sachdev P, Liu T, Wang Y. Altered Prefrontal-Basal Ganglia Effective Connectivity in Patients With Poststroke Cognitive Impairment. Front Neurol 2020; 11:577482. [PMID: 33391148 PMCID: PMC7772311 DOI: 10.3389/fneur.2020.577482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/23/2020] [Indexed: 12/14/2022] Open
Abstract
We investigated the association between poststroke cognitive impairment and a specific effective network connectivity in the prefrontal-basal ganglia circuit. The resting-state effective connectivity of this circuit was modeled by employing spectral dynamic causal modeling in 11 poststroke patients with cognitive impairment (PSCI), 8 poststroke patients without cognitive impairment (non-PSCI) at baseline and 3-month follow-up, and 28 healthy controls. Our results showed that different neuronal models of effective connectivity in the prefrontal-basal ganglia circuit were observed among healthy controls, non-PSCI, and PSCI patients. Additional connected paths (extra paths) appeared in the neuronal models of stroke patients compared with healthy controls. Moreover, changes were detected in the extra paths of non-PSCI between baseline and 3-month follow-up poststroke, indicating reorganization in the ipsilesional hemisphere and suggesting potential compensatory changes in the contralesional hemisphere. Furthermore, the connectivity strengths of the extra paths from the contralesional ventral anterior nucleus of thalamus to caudate correlated significantly with cognitive scores in non-PSCI and PSCI patients. These suggest that the neuronal model of effective connectivity of the prefrontal-basal ganglia circuit may be sensitive to stroke-induced cognitive decline, and it could be a biomarker for poststroke cognitive impairment 3 months poststroke. Importantly, contralesional brain regions may play an important role in functional compensation of cognitive decline.
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Affiliation(s)
- Jing Zhang
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Zixiao Li
- Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Xingxing Cao
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Lijun Zuo
- Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Wei Wen
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA), University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Wanlin Zhu
- Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Jiyang Jiang
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA), University of New South Wales, Sydney, NSW, Australia
| | - Jian Cheng
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beijing, China
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA), University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Tao Liu
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beijing, China
- Beijing Advanced Innovation Center for Biomedical Engineering, Beijing, China
| | - Yongjun Wang
- Beijing TianTan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
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27
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Yao G, Li J, Liu S, Wang J, Cao X, Li X, Cheng L, Chen H, Xu Y. Alterations of Functional Connectivity in Stroke Patients With Basal Ganglia Damage and Cognitive Impairment. Front Neurol 2020; 11:980. [PMID: 33013648 PMCID: PMC7511868 DOI: 10.3389/fneur.2020.00980] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/28/2020] [Indexed: 01/01/2023] Open
Abstract
Background: Stroke with basal ganglia damage (SBG) is a neurological disorder characterized by cognitive impairment. The neurobiological mechanism of cognitive impairment in stroke patients with basal ganglia damage (SBG patients) remains unclear. This study aimed to explore the underlying neurobiological mechanism of cognitive impairment in SBG patients using resting-state functional magnetic resonance imaging (rs-fMRI). Methods: The differences in functional connectivity (FC) between 14 SBG patients (average age: 61.00 ± 7.45 years) and 21 healthy controls (HC) (average age: 60.67 ± 6.95 years) were examined using voxel-mirrored homotopic connectivity (VMHC) and degree centrality (DC). Moreover, we compared the cognitive functions of SBG patients with HC using the Chinese Revised Wechsler Adult Intelligence Scale (WAIS-RC) and Wechsler Memory Scale (WMS). Results: Full-scale intelligence quotient (FIQ) (t = 2.810, p < 0.010) and memory quotient (MQ) (t = 2.920, p < 0.010) scores of SBG patients were significantly lower than those of HC. Compared with HC, significantly decreased VMHC values in the bilateral angular gyrus, supramarginal gyrus, inferior frontal gyrus, middle temporal gyrus, hippocampus, precuneus, precentral gyrus, and middle occipital gyrus and decreased DC values in the right supramarginal gyrus, bilateral angular gyrus, and right postcentral gyrus were observed in SBG patients. Moreover, the VMHC values in the angular gyrus, inferior frontal gyrus, supramarginal gyrus, and middle temporal gyrus and the DC values in the right supramarginal gyrus were significantly correlated with cognitive functions in all participants. Conclusion: Our findings may provide a neural basis for cognitive impairments in SBG patients. Furthermore, local abnormalities of functional networks and interhemispheric interaction deficits may provide new ideas and insights for understanding and treating SBG patients' cognitive impairments.
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Affiliation(s)
- Guanqun Yao
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Jing Li
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Sha Liu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Jiaojian Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Xiaohua Cao
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Xinrong Li
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Long Cheng
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
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28
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Yin M, Liu Y, Zhang L, Zheng H, Peng L, Ai Y, Luo J, Hu X. Effects of rTMS Treatment on Cognitive Impairment and Resting-State Brain Activity in Stroke Patients: A Randomized Clinical Trial. Front Neural Circuits 2020; 14:563777. [PMID: 33117131 PMCID: PMC7561423 DOI: 10.3389/fncir.2020.563777] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/07/2020] [Indexed: 12/13/2022] Open
Abstract
Background Repetitive transcranial magnetic stimulation (rTMS) has been employed for motor function rehabilitation for stroke patients, but its effects on post-stroke cognitive impairment (PSCI) remains controversial. Objective To identify the effects of rTMS intervention on PSCI patients and its potential neural correlates to behavioral improvements. Methods We recruited 34 PSCI patients for 20 sessions of 10 Hz rTMS or no-stim control treatments over the left dorsal lateral prefrontal cortex (DLPFC). Cognitive function was evaluated with the Montreal Cognitive Assessment Scale, Victoria Stroop Test, Rivermead Behavior Memory Test, and Activities of Daily Living (ADL) assessed with the Modified Barthel Index. 14 patients received functional MRI scan, a useful non-invasive technique of determining how structurally segregated and functionally specialized brain areas were interconnected, which was reflected by blood oxygenation level–dependent signals. The amplitude of low-frequency fluctuation (ALFF) and functional connectivity (FC) were applied as the analytical approaches, which were used to measure the resting-state brain activity and functional connection. Results rTMS improved cognitive functions and ADLs for PSCI patients relative to patients who received no-stim control treatment. The cognitive improvements correlated to increased ALFF of the left medial prefrontal cortex, and increased FC of right medial prefrontal cortex and right ventral anterior cingulate cortex. Conclusion 10 Hz rTMS at DLPFC could improve cognitive function and quality of life for PSCI patients, which is associated with an altered frontal cortical activity. Clinical Registration Chinese Clinical Trial Registry, ChiCTR-IPR-17011908, http://www.chictr.org.cn/index.aspx.
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Affiliation(s)
- Mingyu Yin
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuanwen Liu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Liying Zhang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haiqing Zheng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lingrong Peng
- Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yinan Ai
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jing Luo
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiquan Hu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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29
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Wang R, Liu N, Tao YY, Gong XQ, Zheng J, Yang C, Yang L, Zhang XM. The Application of rs-fMRI in Vascular Cognitive Impairment. Front Neurol 2020; 11:951. [PMID: 33041965 PMCID: PMC7517303 DOI: 10.3389/fneur.2020.00951] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/22/2020] [Indexed: 02/05/2023] Open
Abstract
The incidence of vascular cognitive impairment (VCI) has been increasing for years and has become a major disabling factor in middle-aged and elderly populations. The pathogenesis of VCI is unclear, and there are no standard diagnostic criteria. Resting-state functional magnetic resonance imaging (rs-fMRI) can be used to detect spontaneous brain functional activity in a resting state, which facilitates in-depth investigation of the pathogenesis of VCI and provides an objective reference for early diagnosis, differential diagnosis, and prognostic evaluation. This article mainly reviews the principle and analysis of rs-fMRI data, as well as the progress of its application for VCI diagnosis.
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Affiliation(s)
- Ran Wang
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Nian Liu
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yun-Yun Tao
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xue-Qin Gong
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jing Zheng
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Cui Yang
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Lin Yang
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xiao-Ming Zhang
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Chen H, Shi M, Zhang H, Zhang YD, Geng W, Jiang L, Wang Z, Chen YC, Yin X. Different Patterns of Functional Connectivity Alterations Within the Default-Mode Network and Sensorimotor Network in Basal Ganglia and Pontine Stroke. Med Sci Monit 2019; 25:9585-9593. [PMID: 31838483 PMCID: PMC6929567 DOI: 10.12659/msm.918185] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The aim of this study was to investigate whether patients with basal ganglia stroke and patients with pontine stroke have different types of functional connectivity (FC) alterations in the early chronic phase. Material/Methods We included 14 patients with pontine stroke, 17 patients with basal ganglia stroke, and 20 well-matched healthy controls (HCs). All of them underwent resting-state functional magnetic resonance imaging (rs-fMRI) scanning. The independent component analysis (ICA) approach was applied to extract information regarding the default-mode network (DMN), including anterior DMN (aDMN) and posterior DMN (pDMN) components and the sensorimotor network (SMN). Results Compared with HCs, patients with basal ganglia stroke exhibited significantly reduced FC in the left precuneus of the pDMN, right supplementary motor area (SMA), and right superior frontal gyrus (SFG) of the SMN. Additionally, FC in the left medial prefrontal gyrus (MFG) of the aDMN, right precuneus and right posterior cingulate cortex (PCC) of the pDMN, and left middle cingulate gyrus (mid-CC) of the SMN decreased in patients with pontine stroke. Conclusions The different patterns of FC damage in patients with basal ganglia stroke and patients with pontine stroke in the early chronic phase may provide a new method for investigating lesion-induced network plasticity.
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Affiliation(s)
- Huiyou Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Mengye Shi
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Hong Zhang
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Ying-Dong Zhang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Wen Geng
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Liang Jiang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Zhengqian Wang
- Department of Radiology, Lianshui County People's Hospital, Huai'an, Jiangsu, China (mainland)
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
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31
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Puig J, Blasco G, Alberich-Bayarri A, Schlaug G, Deco G, Biarnes C, Navas-Martí M, Rivero M, Gich J, Figueras J, Torres C, Daunis-I-Estadella P, Oramas-Requejo CL, Serena J, Stinear CM, Kuceyeski A, Soriano-Mas C, Thomalla G, Essig M, Figley CR, Menon B, Demchuk A, Nael K, Wintermark M, Liebeskind DS, Pedraza S. Resting-State Functional Connectivity Magnetic Resonance Imaging and Outcome After Acute Stroke. Stroke 2019; 49:2353-2360. [PMID: 30355087 DOI: 10.1161/strokeaha.118.021319] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose- Physiological effects of stroke are best assessed over entire brain networks rather than just focally at the site of structural damage. Resting-state functional magnetic resonance imaging can map functional-anatomic networks by analyzing spontaneously correlated low-frequency activity fluctuations across the brain, but its potential usefulness in predicting functional outcome after acute stroke remains unknown. We assessed the ability of resting-state functional magnetic resonance imaging to predict functional outcome after acute stroke. Methods- We scanned 37 consecutive reperfused stroke patients (age, 69±14 years; 14 females; 3-day National Institutes of Health Stroke Scale score, 6±5) on day 3 after symptom onset. After imaging preprocessing, we used a whole-brain mask to calculate the correlation coefficient matrices for every paired region using the Harvard-Oxford probabilistic atlas. To evaluate functional outcome, we applied the modified Rankin Scale at 90 days. We used region of interest analyses to explore the functional connectivity between regions and graph-computation analysis to detect differences in functional connectivity between patients with good functional outcome (modified Rankin Scale score ≤2) and those with poor outcome (modified Rankin Scale score >2). Results- Patients with good outcome had greater functional connectivity than patients with poor outcome. Although 3-day National Institutes of Health Stroke Scale score was the most accurate independent predictor of 90-day modified Rankin Scale (84.2%), adding functional connectivity increased accuracy to 94.7%. Preserved bilateral interhemispheric connectivity between the anterior inferior temporal gyrus and superior frontal gyrus and decreased connectivity between the caudate and anterior inferior temporal gyrus in the left hemisphere had the greatest impact in favoring good prognosis. Conclusions- These data suggest that information about functional connectivity from resting-state functional magnetic resonance imaging may help predict 90-day stroke outcome.
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Affiliation(s)
- Josep Puig
- From the Imaging Research Unit, Department of Radiology (Girona Biomedical Research Institute) Girona Biomedical Research Institute, Diagnostic Imaging Institute (IDI) (J.P., G.B., C.B., M.N.-M., C.L.O.-R., S.P.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Gerard Blasco
- From the Imaging Research Unit, Department of Radiology (Girona Biomedical Research Institute) Girona Biomedical Research Institute, Diagnostic Imaging Institute (IDI) (J.P., G.B., C.B., M.N.-M., C.L.O.-R., S.P.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Angel Alberich-Bayarri
- Quantitative Imaging Biomarkers In Medicine, La Fe Health Research Institute, La Fe Polytechnics and University Hospital, Valencia, Spain (A.A.-B.)
| | - Gottfried Schlaug
- Neuroimaging and Stroke Recovery Laboratory, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (G.S.)
| | - Gustavo Deco
- Center for Brain and Cognition, Universitat Pompeu Fabra, Barcelona, Spain (G.D.).,ICREA Institut Catalan de Recerca i Estudis Avançats, Barcelona, Spain (G.D.)
| | - Carles Biarnes
- From the Imaging Research Unit, Department of Radiology (Girona Biomedical Research Institute) Girona Biomedical Research Institute, Diagnostic Imaging Institute (IDI) (J.P., G.B., C.B., M.N.-M., C.L.O.-R., S.P.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Marian Navas-Martí
- From the Imaging Research Unit, Department of Radiology (Girona Biomedical Research Institute) Girona Biomedical Research Institute, Diagnostic Imaging Institute (IDI) (J.P., G.B., C.B., M.N.-M., C.L.O.-R., S.P.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Mireia Rivero
- Department of Neurology, Girona Biomedical Research Institute (M.R., J.G., J.S.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Jordi Gich
- Department of Neurology, Girona Biomedical Research Institute (M.R., J.G., J.S.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Jaume Figueras
- Department of Rehabilitation (J.F., C.T.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Cristina Torres
- Department of Rehabilitation (J.F., C.T.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Pepus Daunis-I-Estadella
- Department of Computer Science, Applied Mathematics, and Statistics, University of Girona, Spain (P.D.-i.-E.)
| | - Celia L Oramas-Requejo
- From the Imaging Research Unit, Department of Radiology (Girona Biomedical Research Institute) Girona Biomedical Research Institute, Diagnostic Imaging Institute (IDI) (J.P., G.B., C.B., M.N.-M., C.L.O.-R., S.P.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Joaquín Serena
- Department of Neurology, Girona Biomedical Research Institute (M.R., J.G., J.S.), Dr Josep Trueta University Hospital, Girona, Spain
| | - Cathy M Stinear
- Department of Medicine, Centre for Brain Research, University of Auckland, New Zealand (C.M.S.)
| | - Amy Kuceyeski
- Department of Radiology, Weill Cornell Medical College, NY (A.K.)
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-Instituto de Investigación Biomédica de Bellvitge, Hospitalet del Llobregat, Barcelona, Spain (C.S.-M.).,Centro de Investigación en Salud Mental, Barcelona, Spain (C.S.-M.).,Department of Psychobiology and Methodology in Health Sciences, Universitat Autonoma de Barcelona, Spain (C.S.-M.)
| | - Götz Thomalla
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (G.T.)
| | - Marco Essig
- Department of Radiology, University of Manitoba, Winnipeg, Canada (M.E., C.R.F.)
| | - Chase R Figley
- Department of Radiology, University of Manitoba, Winnipeg, Canada (M.E., C.R.F.)
| | - Bijoy Menon
- Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta, Canada (B.M., A.D.)
| | - Andrew Demchuk
- Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta, Canada (B.M., A.D.)
| | - Kambiz Nael
- Department of Radiology, Icahn School of Medicine at Mount Sinai, NY (K.N.)
| | - Max Wintermark
- Neuroradiology Division, Department of Radiology, Stanford University, Palo Alto, CA (M.W.)
| | - David S Liebeskind
- Neurovascular Imaging Research Core and University of California Los Angeles Stroke Center, Los Angeles, CA (D.S.L.)
| | - Salvador Pedraza
- From the Imaging Research Unit, Department of Radiology (Girona Biomedical Research Institute) Girona Biomedical Research Institute, Diagnostic Imaging Institute (IDI) (J.P., G.B., C.B., M.N.-M., C.L.O.-R., S.P.), Dr Josep Trueta University Hospital, Girona, Spain
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Zhao W, Gao X, Qiu S, Gao B, Gao S, Zhang X, Kang D, Han W, Dai P, Yuan Y. A subunit of V-ATPases, ATP6V1B2, underlies the pathology of intellectual disability. EBioMedicine 2019; 45:408-421. [PMID: 31257146 PMCID: PMC6642280 DOI: 10.1016/j.ebiom.2019.06.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/06/2019] [Accepted: 06/18/2019] [Indexed: 01/21/2023] Open
Abstract
Background Dominant deafness-onychodystrophy (DDOD) syndrome is a rare disorder mainly characterized by severe deafness, onychodystrophy and brachydactyly. We previously identified c.1516C > T (p.Arg506X) in ATP6V1B2 as cause of DDOD syndrome, accounting for all cases of this genetic disorder. Clinical follow-up of DDOD syndrome patients with cochlear implantation revealed the language rehabilitation was unsatisfactory although the implanted cochlea worked well, which indicates there might be learning and memory problems in DDOD syndrome patients. However, the underlying mechanisms were unknown. Methods atp6v1b2 knockdown zebrafish and Atp6v1b2 c.1516C > T knockin mice were constructed to explore the phenotypes and related mechanism. In mutant mice, auditory brainstem response test and cochlear morphology analysis were performed to evaluate the auditory function. Behavioral tests were used to investigate various behavioral and cognitive domains. Resting-state functional magnetic resonance imaging was used to evaluate functional connectivity in the mouse brain. Immunofluorescence, Western blot, and co-immunoprecipitation were performed to examine the expression and interactions between the subunits of V-ATPases. Findings atp6v1b2 knockdown zebrafish showed developmental defects in multiple organs and systems. However, Atp6v1b2 c.1516C > T knockin mice displayed obvious cognitive defects but normal hearing and cochlear morphology. Impaired hippocampal CA1 region and weaker interaction between the V1E and B2 subunits in Atp6v1b2Arg506X//Arg506X mice were observed. Interpretation Our study extends the phenotypic range of DDOD syndrome. The impaired hippocampal CA1 region may be the pathological basis of the behavioral defects in mutant mice. The molecular mechanism underlying V-ATPases dysfunction involves a weak interaction between subunits, although the assembly of V-ATPases can still take place.
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Affiliation(s)
- Weihao Zhao
- Department of Otolaryngology, Head and Neck Surgery, Chinese PLA General Hospital, 28# Fuxing Road, Beijing 100853, China; Department of Otolaryngology General Hospital of Tibet Military Region, Lhasa 850007, China
| | - Xue Gao
- Department of Otolaryngology, Head and Neck Surgery, Chinese PLA General Hospital, 28# Fuxing Road, Beijing 100853, China; Department of Otolaryngology, PLA Rocket Force Characteristic Medical Center, 16# XinWai Da Jie, Beijing 100088, China
| | - Shiwei Qiu
- Department of Otolaryngology, Head and Neck Surgery, Chinese PLA General Hospital, 28# Fuxing Road, Beijing 100853, China
| | - Bo Gao
- Department of Otolaryngology, Head and Neck Surgery, Chinese PLA General Hospital, 28# Fuxing Road, Beijing 100853, China
| | - Song Gao
- Department of Otolaryngology, Head and Neck Surgery, Chinese PLA General Hospital, 28# Fuxing Road, Beijing 100853, China
| | - Xin Zhang
- Department of Otolaryngology, Head and Neck Surgery, Chinese PLA General Hospital, 28# Fuxing Road, Beijing 100853, China
| | - Dongyang Kang
- Department of Otolaryngology, Head and Neck Surgery, Chinese PLA General Hospital, 28# Fuxing Road, Beijing 100853, China
| | - Weiju Han
- Department of Otolaryngology, Head and Neck Surgery, Chinese PLA General Hospital, 28# Fuxing Road, Beijing 100853, China.
| | - Pu Dai
- Department of Otolaryngology, Head and Neck Surgery, Chinese PLA General Hospital, 28# Fuxing Road, Beijing 100853, China.
| | - Yongyi Yuan
- Department of Otolaryngology, Head and Neck Surgery, Chinese PLA General Hospital, 28# Fuxing Road, Beijing 100853, China.
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Chi NF, Ku HL, Chen DYT, Tseng YC, Chen CJ, Lin YC, Hsieh YC, Chan L, Chiou HY, Hsu CY, Hu CJ. Cerebral Motor Functional Connectivity at the Acute Stage: An Outcome Predictor of Ischemic Stroke. Sci Rep 2018; 8:16803. [PMID: 30429535 PMCID: PMC6235876 DOI: 10.1038/s41598-018-35192-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 10/16/2018] [Indexed: 12/17/2022] Open
Abstract
Sixty-seven patients with first acute ischemic stroke onset between 3 to 7 days and 25 age- and sex- matched controls were analyzed for the performance of a resting-state functional MRI to investigate whether the functional connectivity (FC) of the motor network in acute ischemic stroke is independently associated with functional outcomes. The FC of cortical motor network and default mode network was analyzed. The FC was compared between controls, patients with favorable outcomes (modified Rankin Scale, mRS ≤1), and patients with unfavorable outcomes (mRS ≥2) at 3 months. Of the 67 patients, 23 (34%) exhibited unfavorable outcomes. In multivariate analysis, the FC between ipsilesional primary motor cortex (M1) and contralesional dorsal premotor area (PMd) ≤0.63, were independently associated with unfavorable outcomes (odds ratio = 6.32, P = 0.032), whereas the FC of default mode network was not different between groups. The interhemispheric FC of the motor network is an independent predictor of functional outcomes in patients with acute ischemic stroke.
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Affiliation(s)
- Nai-Fang Chi
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Neurology, Stroke Center, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Brain and Consciousness Research Center, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Lun Ku
- Brain and Consciousness Research Center, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - David Yen-Ting Chen
- Brain and Consciousness Research Center, Taipei Medical University, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ying-Chi Tseng
- Brain and Consciousness Research Center, Taipei Medical University, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chi-Jen Chen
- Brain and Consciousness Research Center, Taipei Medical University, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ying-Chin Lin
- Department of Family Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan.,Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Chen Hsieh
- The PhD Program of Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Lung Chan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Neurology, Stroke Center, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan
| | - Hung-Yi Chiou
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,School of Public Health, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chung Y Hsu
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Chaur-Jong Hu
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. .,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. .,Department of Neurology, Stroke Center, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan. .,Graduate Institute of Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
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Liang S, Jiang X, Zhang Q, Duan S, Zhang T, Huang Q, Sun X, Liu H, Dong J, Liu W, Tao J, Zhao S, Nie B, Chen L, Shan B. Abnormal Metabolic Connectivity in Rats at the Acute Stage of Ischemic Stroke. Neurosci Bull 2018; 34:715-724. [PMID: 30083891 PMCID: PMC6129253 DOI: 10.1007/s12264-018-0266-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 05/18/2018] [Indexed: 01/29/2023] Open
Abstract
Stroke at the acute stage is a major cause of disability in adults, and is associated with dysfunction of brain networks. However, the mechanisms underlying changes in brain connectivity in stroke are far from fully elucidated. In the present study, we investigated brain metabolism and metabolic connectivity in a rat ischemic stroke model of middle cerebral artery occlusion (MCAO) at the acute stage using 18F-fluorodeoxyglucose positron emission tomography. Voxel-wise analysis showed decreased metabolism mainly in the ipsilesional hemisphere, and increased metabolism mainly in the contralesional cerebellum. We used further metabolic connectivity analysis to explore the brain metabolic network in MCAO. Compared to sham controls, rats with MCAO showed most significantly reduced nodal and local efficiency in the ipsilesional striatum. In addition, the MCAO group showed decreased metabolic central connection of the ipsilesional striatum with the ipsilesional cerebellum, ipsilesional hippocampus, and bilateral hypothalamus. Taken together, the present study demonstrated abnormal metabolic connectivity in rats at the acute stage of ischemic stroke, which might provide insight into clinical research.
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Affiliation(s)
- Shengxiang Liang
- College of Physical Science and Technology, Zhengzhou University, Zhengzhou, 450001, China
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
| | - Xiaofeng Jiang
- School of Public Health and Family Medicine, Capital Medical University, Beijing, 100068, China
| | - Qingqing Zhang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
| | - Shaofeng Duan
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Tianhao Zhang
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Qi Huang
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Xi Sun
- College of Physical Science and Technology, Zhengzhou University, Zhengzhou, 450001, China
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
| | - Hua Liu
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Jie Dong
- College of Physical Science and Technology, Zhengzhou University, Zhengzhou, 450001, China
| | - Weilin Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
| | - Shujun Zhao
- College of Physical Science and Technology, Zhengzhou University, Zhengzhou, 450001, China.
| | - Binbin Nie
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China.
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing, 100049, China.
- CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, 200031, China.
| | - Lidian Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
| | - Baoci Shan
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
- CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
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Boyd LA, Hayward KS, Ward NS, Stinear CM, Rosso C, Fisher RJ, Carter AR, Leff AP, Copland DA, Carey LM, Cohen LG, Basso DM, Maguire JM, Cramer SC. Biomarkers of Stroke Recovery: Consensus-Based Core Recommendations from the Stroke Recovery and Rehabilitation Roundtable. Neurorehabil Neural Repair 2018; 31:864-876. [PMID: 29233071 DOI: 10.1177/1545968317732680] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The most difficult clinical questions in stroke rehabilitation are "What is this patient's potential for recovery?" and "What is the best rehabilitation strategy for this person, given her/his clinical profile?" Without answers to these questions, clinicians struggle to make decisions regarding the content and focus of therapy, and researchers design studies that inadvertently mix participants who have a high likelihood of responding with those who do not. Developing and implementing biomarkers that distinguish patient subgroups will help address these issues and unravel the factors important to the recovery process. The goal of the present paper is to provide a consensus statement regarding the current state of the evidence for stroke recovery biomarkers. Biomarkers of motor, somatosensory, cognitive and language domains across the recovery timeline post-stroke are considered; with focus on brain structure and function, and exclusion of blood markers and genetics. We provide evidence for biomarkers that are considered ready to be included in clinical trials, as well as others that are promising but not ready and so represent a developmental priority. We conclude with an example that illustrates the utility of biomarkers in recovery and rehabilitation research, demonstrating how the inclusion of a biomarker may enhance future clinical trials. In this way, we propose a way forward for when and where we can include biomarkers to advance the efficacy of the practice of, and research into, rehabilitation and recovery after stroke.
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Affiliation(s)
- Lara A Boyd
- 1 Department of Physical Therapy & the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Kathryn S Hayward
- 2 Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Nick S Ward
- 3 Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
| | - Cathy M Stinear
- 4 Department of Medicine and Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Charlotte Rosso
- 5 Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, France; AP-HP, Stroke Unit, Pitié-Salpêtrière Hospital, France
| | - Rebecca J Fisher
- 6 Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| | - Alexandre R Carter
- 7 Department of Neurology, Washington University in Saint Louis, St Louis, MO, USA
| | - Alex P Leff
- 8 Department of Brain Repair and Rehabilitation, Institute of Neurology & Institute of Cognitive Neuroscience, University College London, Queens Square, London, UK
| | - David A Copland
- 9 School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, Australia; and University of Queensland Centre for Clinical Research, Brisbane, Australia
| | - Leeanne M Carey
- 10 School of Allied Health, College of Science, Health and Engineering, La Trobe, University, Bundoora, Australia; and Neurorehabilitation and Recovery, Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Leonardo G Cohen
- 11 Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
| | - D Michele Basso
- 12 School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Jane M Maguire
- 13 Faculty of Health, University of Technology Sydney, Ultimo, Sydney, Australia
| | - Steven C Cramer
- 14 University of California, Irvine, CA, USA; Depts. Neurology, Anatomy & Neurobiology, and Physical Medicine & Rehabilitation, Irvine, CA, USA
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36
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Decreased functional connectivity within the default-mode network in acute brainstem ischemic stroke. Eur J Radiol 2018; 105:221-226. [PMID: 30017284 DOI: 10.1016/j.ejrad.2018.06.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/18/2018] [Accepted: 06/21/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE Ischemic stroke within the brainstem is associated with an increased risk of cognitive dysfunction. This study aimed to explore the integrity of a default-mode network (DMN) and its relationship with clinical variables in patients with acute ischemic brainstem stroke using an independent component analysis (ICA) approach. MATERIALS AND METHODS Twenty-one patients with acute ischemic brainstem stroke and 25 well-matched healthy subjects were enrolled in this study and underwent resting-state functional magnetic resonance imaging. The ICA was adopted to extract the DMN, including its anterior and posterior components. Pearson correlation analyses were performed to investigate the relationship between DMN connectivity and clinical variables. RESULTS Compared with healthy controls, patients with acute ischemic stroke showed significantly decreased functional connectivity in the right medial prefrontal cortex (mPFC) and right precuneus within the anterior and posterior DMN, respectively. After correcting for age, sex, and education, hypoconnectivity in the right mPFC and right precuneus was negatively correlated with higher homocysteine in patients with stroke (r = -0.592, p = 0.010 and r = -0.491, p = 0.039, respectively). CONCLUSION The finding of decreased functional connectivity within the DMN of patients with acute brainstem stroke provides novel insight into the neural mechanisms that underlie cognitive impairment following ischemic insult to this brain region.
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Zhao Z, Wu J, Fan M, Yin D, Tang C, Gong J, Xu G, Gao X, Yu Q, Yang H, Sun L, Jia J. Altered intra- and inter-network functional coupling of resting-state networks associated with motor dysfunction in stroke. Hum Brain Mapp 2018; 39:3388-3397. [PMID: 29691945 DOI: 10.1002/hbm.24183] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 03/20/2018] [Accepted: 04/06/2018] [Indexed: 12/18/2022] Open
Abstract
Motor functions are supported through functional integration across the extended motor system network. Individuals following stroke often show deficits on motor performance requiring coordination of multiple brain networks; however, the assessment of connectivity patterns after stroke was still unclear. This study aimed to investigate the changes in intra- and inter-network functional connectivity (FC) of multiple networks following stroke and further correlate FC with motor performance. Thirty-three left subcortical chronic stroke patients and 34 healthy controls underwent resting-state functional magnetic resonance imaging. Eleven resting-state networks were identified via independent component analysis (ICA). Compared with healthy controls, the stroke group showed abnormal FC within the motor network (MN), visual network (VN), dorsal attention network (DAN), and executive control network (ECN). Additionally, the FC values of the ipsilesional inferior parietal lobule (IPL) within the ECN were negatively correlated with the Fugl-Meyer Assessment (FMA) scores (hand + wrist). With respect to inter-network interactions, the ipsilesional frontoparietal network (FPN) decreased FC with the MN and DAN; the contralesional FPN decreased FC with the ECN, but it increased FC with the default mode network (DMN); and the posterior DMN decreased FC with the VN. In sum, this study demonstrated the coexistence of intra- and inter-network alterations associated with motor-visual attention and high-order cognitive control function in chronic stroke, which might provide insights into brain network plasticity following stroke.
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Affiliation(s)
- Zhiyong Zhao
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, 200062, China
| | - Jie Wu
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, 200062, China
| | - Mingxia Fan
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, 200062, China
| | - Dazhi Yin
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Chaozheng Tang
- Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Jiayu Gong
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, 200062, China
| | - Guojun Xu
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, 200062, China
| | - Xinjie Gao
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, 200062, China
| | - Qiurong Yu
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, 200062, China
| | - Hao Yang
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, 200062, China
| | - Limin Sun
- Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Jie Jia
- Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai, 200040, China
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38
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Boyd LA, Hayward KS, Ward NS, Stinear CM, Rosso C, Fisher RJ, Carter AR, Leff AP, Copland DA, Carey LM, Cohen LG, Basso DM, Maguire JM, Cramer SC. Biomarkers of stroke recovery: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable. Int J Stroke 2018; 12:480-493. [PMID: 28697711 DOI: 10.1177/1747493017714176] [Citation(s) in RCA: 225] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The most difficult clinical questions in stroke rehabilitation are "What is this patient's potential for recovery?" and "What is the best rehabilitation strategy for this person, given her/his clinical profile?" Without answers to these questions, clinicians struggle to make decisions regarding the content and focus of therapy, and researchers design studies that inadvertently mix participants who have a high likelihood of responding with those who do not. Developing and implementing biomarkers that distinguish patient subgroups will help address these issues and unravel the factors important to the recovery process. The goal of the present paper is to provide a consensus statement regarding the current state of the evidence for stroke recovery biomarkers. Biomarkers of motor, somatosensory, cognitive and language domains across the recovery timeline post-stroke are considered; with focus on brain structure and function, and exclusion of blood markers and genetics. We provide evidence for biomarkers that are considered ready to be included in clinical trials, as well as others that are promising but not ready and so represent a developmental priority. We conclude with an example that illustrates the utility of biomarkers in recovery and rehabilitation research, demonstrating how the inclusion of a biomarker may enhance future clinical trials. In this way, we propose a way forward for when and where we can include biomarkers to advance the efficacy of the practice of, and research into, rehabilitation and recovery after stroke.
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Affiliation(s)
- Lara A Boyd
- 1 Department of Physical Therapy & the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Kathryn S Hayward
- 2 Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Nick S Ward
- 3 Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
| | - Cathy M Stinear
- 4 Department of Medicine and Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Charlotte Rosso
- 5 Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,6 AP-HP, Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Paris, France
| | - Rebecca J Fisher
- 7 Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| | - Alexandre R Carter
- 8 Department of Neurology, Washington University in Saint Louis, St Louis, MO, USA
| | - Alex P Leff
- 9 Department of Brain Repair and Rehabilitation, Institute of Neurology & Institute of Cognitive Neuroscience, University College London, Queens Square, London, UK
| | - David A Copland
- 10 School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, Australia; and University of Queensland Centre for Clinical Research, Brisbane, Australia
| | - Leeanne M Carey
- 11 School of Allied Health, College of Science, Health and Engineering, La Trobe, University, Bundoora, Australia; and Neurorehabilitation and Recovery, Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Leonardo G Cohen
- 12 Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
| | - D Michele Basso
- 13 School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Jane M Maguire
- 14 Faculty of Health, University of Technology, Ultimo, Sydney, Australia
| | - Steven C Cramer
- 15 University of California, Irvine, CA, USA; Depts. Neurology, Anatomy & Neurobiology, and Physical Medicine & Rehabilitation, Irvine, CA, USA
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He J, Zhao C, Liu W, Huang J, Liang S, Chen L, Tao J. Neurochemical changes in the hippocampus and prefrontal cortex associated with electroacupuncture for learning and memory impairment. Int J Mol Med 2017; 41:709-716. [PMID: 29207061 PMCID: PMC5752233 DOI: 10.3892/ijmm.2017.3287] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 10/27/2017] [Indexed: 01/19/2023] Open
Abstract
Electroacupuncture (EA) has been widely used to treat cognitive impairment following cerebral ischemia. However, the functional mechanisms of EA have not been fully elucidated. The aim of the present study was to investigate whether EA at the GV 20 and DU 24 acupoints can improve the learning and memory ability via alteration of the neurochemical metabolism in the hippocampus (HPC) and prefrontal cortex (PFC) of rats with ischemia and reperfusion (I/R) injury. Sprague-Dawley male rats were randomly divided into three groups, namely the sham group (n=12), the middle cerebral artery occlusion (MCAO) group (n=12) and the EA treatment (MCAO + EA) group (n=12). MCAO was performed to establish the left focal cerebral I/R injury model, and the GV 20 and DU 24 acupoints were then stimulated with EA for 30 min per time, once daily, for 7 consecutive days. The Morris water maze (MWM) test was used to assess learning and memory ability. T2-weighted imaging was used to assess the cerebral infarct volume. Magnetic resonance spectroscopy was used to assess neurochemical metabolism of HPC and PFC. The neurological scores of the MCAO + EA group were significantly reduced compared with those of the MCAO group 7 days after EA treatment (P<0.01). The escape latency of the MWM test in the MCAO + EA group was found to be shorter compared with that in the MCAO group (P<0.01). The number of rats crossing through the platform area was significantly higher in the MCAO + EA group compared with that in the MCAO group (P<0.01). The cerebral infarct volume was also decreased in the MCAO + EA group compared with the MCAO group (P<0.05). The ratios of N-acetylaspartate (NAA)/creatine (Cr) and choline (Cho)/Cr of left-to-right HPC were increased in the MCAO + EA group compared with the MCAO group; however, the ratio of glutamate (Glu)/Cr did not change significantly (P>0.05). The ratios of NAA/Cr, Cho/Cr and Glu/Cr of left-to-right PFC were elevated (P<0.05). In conclusion, EA at the GV 20 and DU 24 acupoints may ameliorate learning and memory ability, possibly through increasing the levels of NAA and Cho in the HPC and PFC of rats with I/R injury.
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Affiliation(s)
- Jian He
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Congkuai Zhao
- Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian 350003, P.R. China
| | - Weilin Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Jia Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Shengxiang Liang
- College of Physical Science and Technology, Zhengzhou University, Zhengzhou, Henan 450001, P.R. China
| | - Lidian Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
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40
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Siegel JS, Shulman GL, Corbetta M. Measuring functional connectivity in stroke: Approaches and considerations. J Cereb Blood Flow Metab 2017; 37:2665-2678. [PMID: 28541130 PMCID: PMC5536814 DOI: 10.1177/0271678x17709198] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Recent research has demonstrated the importance of global changes to the functional organization of brain network following stroke. Resting functional magnetic resonance imaging (R-fMRI) is a non-invasive tool that enables the measurement of functional connectivity (FC) across the entire brain while placing minimal demands on the subject. For these reasons, it is a uniquely appealing tool for studying the distant effects of stroke. However, R-fMRI studies rely on a number of premises that cannot be assumed without careful validation in the context of stroke. Here, we describe strategies to identify and mitigate confounds specific to R-fMRI research in cerebrovascular disease. Five main topics are discussed: (a) achieving adequate co-registration of lesioned brains, (b) identifying and removing hemodynamic lags in resting BOLD, (c) identifying other vascular disruptions that affect the resting BOLD signal, (d) selecting an appropriate control cohort, and (e) acquiring sufficient fMRI data to reliably identify FC changes. For each topic, we provide guidelines for steps to improve the interpretability and reproducibility of FC-stroke research. We include a table of confounds and approaches to identify and mitigate each. Our recommendations extend to any research using R-fMRI to study diseases that might alter cerebrovascular flow and dynamics or brain anatomy.
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Affiliation(s)
- Joshua S Siegel
- 1 Department of Neurology, Washington University School of Medicine, St. Louis, USA
| | - Gordon L Shulman
- 1 Department of Neurology, Washington University School of Medicine, St. Louis, USA
| | - Maurizio Corbetta
- 1 Department of Neurology, Washington University School of Medicine, St. Louis, USA.,2 Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, USA.,3 Department of Psychology, Washington University School of Medicine, St. Louis, USA.,4 Department of Biomedical Engineering, Washington University School of Medicine, St. Louis, USA.,5 Department of Neuroscience, University of Padua, Padua, Italy
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41
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Liu J, Wang Q, Liu F, Song H, Liang X, Lin Z, Hong W, Yang S, Huang J, Zheng G, Tao J, Chen LD. Altered functional connectivity in patients with post-stroke memory impairment: A resting fMRI study. Exp Ther Med 2017; 14:1919-1928. [PMID: 28962104 PMCID: PMC5609161 DOI: 10.3892/etm.2017.4751] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 02/17/2017] [Indexed: 11/20/2022] Open
Abstract
Post-stroke memory dysfunction (PMD) is one of the most common forms of cognitive impairment among stroke survivors. However, only a limited number of studies have directly investigated the neural mechanisms associated with memory decline. The aim of the present study was to identify dynamic changes in the functional organization of the default mode network (DMN) and the dorsal attention network of patients with PMD. A total of 27 patients with PMD who experienced a stroke in the right hemisphere were enrolled in the current study, along with 27 healthy control subjects matched by age, sex, and educational level. A behavioral examination and functional magnetic resonance imaging scan were performed. The data were analyzed using an independent component analysis method. The results revealed a significantly increased functional connectivity between the DMN and prefrontal cortex (left middle/inferior frontal and left precentral gyri), temporal regions (left superior temporal gyrus), and bilateral and posterior cingulate gyri/precuneus (P<0.001). There was also a significantly decreased functional connectivity between the DMN and right middle temporal gyrus, left uvula, and right inferior parietal lobule, and between the dorsal attention network and prefrontal cortex (left precentral/inferior and right inferior/middle frontal gyri), right inferior parietal gyrus, and right insula (P<0.001). These results suggest that the stroke affected both the lesioned and contralesional hemispheres. The prefrontal cortex, temporal regions, insula, and posterior cingulate gyrus/precuneus serve a crucial role in memory processing.
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Affiliation(s)
- Jiao Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China.,Fujian Rehabilitation Tech Co-innovation Center, Fuzhou, Fujian 350122, P.R. China
| | - Qin Wang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Feiwen Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Haiyan Song
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Xiaofeng Liang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Zhengkun Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Wenjun Hong
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Shanli Yang
- Fujian University of Traditional Chinese Medicine Subsidiary Rehabilitation Hospital, Fuzhou, Fujian 350003, P.R. China
| | - Jia Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China.,Fujian Rehabilitation Tech Co-innovation Center, Fuzhou, Fujian 350122, P.R. China
| | - Guohua Zheng
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China.,Key Laboratory of Motor Rehabilitation of Fujian, Fuzhou, Fujian 350003, P.R. China.,Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, Fujian 350000, P.R. China
| | - Li-Dian Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China.,Key Laboratory of Motor Rehabilitation of Fujian, Fuzhou, Fujian 350003, P.R. China.,Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, Fujian 350000, P.R. China
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42
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Zhang Y, Wang L, Yang J, Yan R, Zhang J, Sang L, Li P, Liu H, Qiu M. Abnormal functional networks in resting-state of the sub-cortical chronic stroke patients with hemiplegia. Brain Res 2017; 1663:51-58. [PMID: 28214523 DOI: 10.1016/j.brainres.2017.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 12/31/2016] [Accepted: 02/12/2017] [Indexed: 10/20/2022]
Abstract
The aim of this study is to identify the properties of the motor network and the default-mode network (DMN) of the sub-cortical chronic stroke patients, and to study the relationship between the network connectivity and the neurological scales of the stroke patients. Twenty-eight chronic stroke patients (28-77days post-stroke) and twenty-eight healthy control subjects (HCs) were recruited. Independent component analysis (ICA) was performed to obtain the motor network and the DMN. Two sample t-tests was used to compare the differences of the motor network and the DMN between the patients and HCs. Additionally, correlations between the network connectivity and the behavioral scores of the stroke patients were studied. Compared with the HCs, the motor network connectivity of the stroke patients was significantly increased in the contralesional superior parietal lobule, but decreased in ipsilesional M1. The DMN connectivity of the stroke patients was significantly increased in the contralesional middle frontal gyrus, but decreased in bilateral precuneus, ipsilesional supramarginal and angular gyrus. Moreover, the motor network connectivity of the contralesional superior parietal lobule was positively correlated with the Fugl-Meyer assessment (FMA) score of the stroke patients. Our results showed abnormal motor network and DMN during the resting-state of the stroke patients, suggesting that resting-state network connectivity could serve as biomarkers for future stroke studies. Brain-behavior relationships could be taken into account while evaluating stroke patients.
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Affiliation(s)
- Ye Zhang
- Department of Medical Image, College of Biomedical Engineering, Third Military Medical University, Chongqing, China
| | - Li Wang
- Department of Medical Image, College of Biomedical Engineering, Third Military Medical University, Chongqing, China
| | - Jun Yang
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Rubing Yan
- Department of Rehabilitation, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Jingna Zhang
- Department of Medical Image, College of Biomedical Engineering, Third Military Medical University, Chongqing, China
| | - Linqiong Sang
- Department of Medical Image, College of Biomedical Engineering, Third Military Medical University, Chongqing, China
| | - Pengyue Li
- Department of Medical Image, College of Biomedical Engineering, Third Military Medical University, Chongqing, China
| | - Hongliang Liu
- Department of Rehabilitation, Southwest Hospital, Third Military Medical University, Chongqing, China.
| | - Mingguo Qiu
- Department of Medical Image, College of Biomedical Engineering, Third Military Medical University, Chongqing, China.
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Electroacupuncture Regulates Hippocampal Synaptic Plasticity via miR-134-Mediated LIMK1 Function in Rats with Ischemic Stroke. Neural Plast 2017; 2017:9545646. [PMID: 28116173 PMCID: PMC5237739 DOI: 10.1155/2017/9545646] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/03/2016] [Indexed: 11/17/2022] Open
Abstract
MircoRNAs (miRs) have been implicated in learning and memory, by regulating LIM domain kinase (LIMK1) to induce synaptic-dendritic plasticity. The study aimed to investigate whether miRNAs/LIMK1 signaling was involved in electroacupuncture- (EA-) mediated synaptic-dendritic plasticity in a rat model of middle cerebral artery occlusion induced cognitive deficit (MICD). Compared to untreatment or non-acupoint-EA treatment, EA at DU20 and DU24 acupoints could shorten escape latency and increase the frequency of crossing platform in Morris water maze test. T2-weighted imaging showed that the MICD rat brain lesions were located in cortex, hippocampus, corpus striatum, and thalamus regions and injured volumes were reduced after EA. Furthermore, we found that the density of dendritic spine and the number of synapses in the hippocampal CA1 pyramidal cells were obviously reduced at Day 14 after MICD. However, synaptic-dendritic loss could be rescued after EA. Moreover, the synaptic-dendritic plasticity was associated with increases of the total LIMK1 and phospho-LIMK1 levels in hippocampal CA1 region, wherein EA decreased the expression of miR-134, negatively regulating LIMK1 to enhance synaptic-dendritic plasticity. Therefore, miR-134-mediated LIMK1 was involved in EA-induced hippocampal synaptic plasticity, which served as a contributor to improving learning and memory during the recovery stage of ischemic stroke.
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44
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Wu X, Kirov II, Gonen O, Ge Y, Grossman RI, Lui YW. MR Imaging Applications in Mild Traumatic Brain Injury: An Imaging Update. Radiology 2016; 279:693-707. [PMID: 27183405 DOI: 10.1148/radiol.16142535] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Mild traumatic brain injury (mTBI), also commonly referred to as concussion, affects millions of Americans annually. Although computed tomography is the first-line imaging technique for all traumatic brain injury, it is incapable of providing long-term prognostic information in mTBI. In the past decade, the amount of research related to magnetic resonance (MR) imaging of mTBI has grown exponentially, partly due to development of novel analytical methods, which are applied to a variety of MR techniques. Here, evidence of subtle brain changes in mTBI as revealed by these techniques, which are not demonstrable by conventional imaging, will be reviewed. These changes can be considered in three main categories of brain structure, function, and metabolism. Macrostructural and microstructural changes have been revealed with three-dimensional MR imaging, susceptibility-weighted imaging, diffusion-weighted imaging, and higher order diffusion imaging. Functional abnormalities have been described with both task-mediated and resting-state blood oxygen level-dependent functional MR imaging. Metabolic changes suggesting neuronal injury have been demonstrated with MR spectroscopy. These findings improve understanding of the true impact of mTBI and its pathogenesis. Further investigation may eventually lead to improved diagnosis, prognosis, and management of this common and costly condition. (©) RSNA, 2016.
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Affiliation(s)
- Xin Wu
- From the Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, 660 First Ave, 4th Floor, New York, NY 10016
| | - Ivan I Kirov
- From the Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, 660 First Ave, 4th Floor, New York, NY 10016
| | - Oded Gonen
- From the Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, 660 First Ave, 4th Floor, New York, NY 10016
| | - Yulin Ge
- From the Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, 660 First Ave, 4th Floor, New York, NY 10016
| | - Robert I Grossman
- From the Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, 660 First Ave, 4th Floor, New York, NY 10016
| | - Yvonne W Lui
- From the Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, 660 First Ave, 4th Floor, New York, NY 10016
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45
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Siegel JS, Snyder AZ, Ramsey L, Shulman GL, Corbetta M. The effects of hemodynamic lag on functional connectivity and behavior after stroke. J Cereb Blood Flow Metab 2016; 36:2162-2176. [PMID: 26661223 PMCID: PMC5363662 DOI: 10.1177/0271678x15614846] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/02/2015] [Accepted: 10/06/2015] [Indexed: 01/22/2023]
Abstract
Stroke disrupts the brain's vascular supply, not only within but also outside areas of infarction. We investigated temporal delays (lag) in resting state functional magnetic resonance imaging signals in 130 stroke patients scanned two weeks, three months and 12 months post stroke onset. Thirty controls were scanned twice at an interval of three months. Hemodynamic lag was determined using cross-correlation with the global gray matter signal. Behavioral performance in multiple domains was assessed in all patients. Regional cerebral blood flow and carotid patency were assessed in subsets of the cohort using arterial spin labeling and carotid Doppler ultrasonography. Significant hemodynamic lag was observed in 30% of stroke patients sub-acutely. Approximately 10% of patients showed lag at one-year post-stroke. Hemodynamic lag corresponded to gross aberrancy in functional connectivity measures, performance deficits in multiple domains and local and global perfusion deficits. Correcting for lag partially normalized abnormalities in measured functional connectivity. Yet post-stroke FC-behavior relationships in the motor and attention systems persisted even after hemodynamic delays were corrected. Resting state fMRI can reliably identify areas of hemodynamic delay following stroke. Our data reveal that hemodynamic delay is common sub-acutely, alters functional connectivity, and may be of clinical importance.
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Affiliation(s)
- Joshua S Siegel
- Departments of Neurology, Washington University School of Medicine, Washington University, St. Louis, MO, USA
| | - Abraham Z Snyder
- Departments of Neurology, Washington University School of Medicine, Washington University, St. Louis, MO, USA.,Mallinckrodt Institute of Radiology, Washington University School of Medicine, Washington University, St. Louis, MO, USA
| | - Lenny Ramsey
- Departments of Neurology, Washington University School of Medicine, Washington University, St. Louis, MO, USA
| | - Gordon L Shulman
- Departments of Neurology, Washington University School of Medicine, Washington University, St. Louis, MO, USA
| | - Maurizio Corbetta
- Departments of Neurology, Washington University School of Medicine, Washington University, St. Louis, MO, USA.,Mallinckrodt Institute of Radiology, Washington University School of Medicine, Washington University, St. Louis, MO, USA.,Anatomy & Neurobiology at Washington University School of Medicine, Washington University, St. Louis, MO, USA
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46
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Short-term Internet-search practicing modulates brain activity during recollection. Neuroscience 2016; 335:82-90. [PMID: 27555549 DOI: 10.1016/j.neuroscience.2016.08.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 08/15/2016] [Accepted: 08/16/2016] [Indexed: 02/06/2023]
Abstract
Internet-searching behaviors may change ways in which we find, store and consider information. In this study, we tested the effect of short-term Internet-search practicing on recollection processes. Fifty-nine human subjects with valid data (Experimental group, 43; Control group, 16) completed procedures involving a pre-test, 6days of practicing, and a post-test. Behavioral and imaging results were obtained and within- and between-group comparisons were made at pre-test and post-test times. With respect to behavioral performance, six days of practicing was associated with improved behavioral performance during Internet searching: subjects in the experimental group showed shorter response times (RTs) and similar accuracy rates during recollection at post-test as compared to pre-test. During imaging and as compared to pre-test data, subjects in the experimental group showed during post-test recall relatively decreased brain activations bilaterally in the middle frontal and temporal gyri. Such findings were not observed in the control group. The findings suggest that six days of practicing Internet searching may improve the efficiency of Internet searching without influencing the accuracy of recollection, with neuroimaging results implicating cortical regions involved in long-term memory and executive processing.
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Peng CY, Chen YC, Cui Y, Zhao DL, Jiao Y, Tang TY, Ju S, Teng GJ. Regional Coherence Alterations Revealed by Resting-State fMRI in Post-Stroke Patients with Cognitive Dysfunction. PLoS One 2016; 11:e0159574. [PMID: 27454170 PMCID: PMC4959733 DOI: 10.1371/journal.pone.0159574] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 07/04/2016] [Indexed: 11/19/2022] Open
Abstract
Objectives Post-stroke cognitive dysfunction greatly influences patients’ quality of life after stroke. However, its neurophysiological basis remains unknown. This study utilized resting-state functional magnetic resonance imaging (fMRI) to investigate the alterations in regional coherence in patients after subcortical stroke. Methods Resting-state fMRI measurements were acquired from 16 post-stroke patients with poor cognitive function (PSPC), 16 post-stroke patients with good cognitive function (PSGC) and 30 well-matched healthy controls (HC). Regional homogeneity (ReHo) was used to detect alterations in regional coherence. Abnormalities in regional coherence correlated with scores on neuropsychological scales. Results Compared to the HC and the PSGC, the PSPC showed remarkably decreased ReHo in the bilateral anterior cingulate cortex and the left posterior cingulate cortex/precuneus. ReHo in the bilateral anterior cingulate cortex positively correlated with the scores on the Symbol Digit Modalities Test (r = 0.399, P = 0.036) and the Complex Figure Test-delayed recall subtest (r = 0.397, P = 0.036) in all post-stroke patients. Moreover, ReHo in the left posterior cingulate cortex/precuneus positively correlated with the scores on the Forward Digit Span Test (r = 0.485, P = 0.009) in all post-stroke patients. Conclusions Aberrant regional coherence was observed in the anterior and posterior cingulate cortices in post-stroke patients with cognitive dysfunction. ReHo could represent a promising indicator of neurobiological deficiencies in post-stroke patients.
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Affiliation(s)
- Cheng-Yu Peng
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, Jiangsu, China
- Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Ying Cui
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, Jiangsu, China
- Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, China
| | - Deng-Ling Zhao
- Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, China
| | - Yun Jiao
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, Jiangsu, China
| | - Tian-Yu Tang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, Jiangsu, China
| | - Shenghong Ju
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, Jiangsu, China
- Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, China
| | - Gao-Jun Teng
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, Jiangsu, China
- Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, China
- * E-mail:
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Japee S, Holiday K, Satyshur MD, Mukai I, Ungerleider LG. A role of right middle frontal gyrus in reorienting of attention: a case study. Front Syst Neurosci 2015; 9:23. [PMID: 25784862 PMCID: PMC4347607 DOI: 10.3389/fnsys.2015.00023] [Citation(s) in RCA: 312] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 02/11/2015] [Indexed: 12/29/2022] Open
Abstract
The right middle fontal gyrus (MFG) has been proposed to be a site of convergence of the dorsal and ventral attention networks, by serving as a circuit-breaker to interrupt ongoing endogenous attentional processes in the dorsal network and reorient attention to an exogenous stimulus. Here, we probed the contribution of the right MFG to both endogenous and exogenous attention by comparing performance on an orientation discrimination task of a patient with a right MFG resection and a group of healthy controls. On endogenously cued trials, participants were shown a central cue that predicted with 90% accuracy the location of a subsequent peri-threshold Gabor patch stimulus. On exogenously cued trials, a cue appeared briefly at one of two peripheral locations, followed by a variable inter-stimulus interval (ISI; range 0–700 ms) and a Gabor patch in the same or opposite location as the cue. Behavioral data showed that for endogenous, and short ISI exogenous trials, valid cues facilitated responses compared to invalid cues, for both the patient and controls. However, at long ISIs, the patient exhibited difficulty in reverting to top-down attentional control, once the facilitatory effect of the exogenous cue had dissipated. When explicitly cued during long ISIs to attend to both stimulus locations, the patient was able to engage successfully in top-down control. This result indicates that the right MFG may play an important role in reorienting attention from exogenous to endogenous attentional control. Resting state fMRI data revealed that the right superior parietal lobule and right orbitofrontal cortex, showed significantly higher correlations with a left MFG seed region (a region tightly coupled with the right MFG in controls) in the patient relative to controls. We hypothesize that this paradoxical increase in cortical coupling represents a compensatory mechanism in the patient to offset the loss of function of the resected tissue in right prefrontal cortex.
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Affiliation(s)
- Shruti Japee
- Lab of Brain and Cognition, National Institute of Mental Health, National Institutes of Health Bethesda, MD, USA
| | - Kelsey Holiday
- Lab of Brain and Cognition, National Institute of Mental Health, National Institutes of Health Bethesda, MD, USA
| | | | - Ikuko Mukai
- Laureate Institute for Brain Research Tulsa, OK, USA
| | - Leslie G Ungerleider
- Lab of Brain and Cognition, National Institute of Mental Health, National Institutes of Health Bethesda, MD, USA
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