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Liew SL, Zavaliangos-Petropulu A, Schweighofer N, Jahanshad N, Lang CE, Lohse KR, Banaj N, Barisano G, Baugh LA, Bhattacharya AK, Bigjahan B, Borich MR, Boyd LA, Brodtmann A, Buetefisch CM, Byblow WD, Cassidy JM, Charalambous CC, Ciullo V, Conforto AB, Craddock RC, Dula AN, Egorova N, Feng W, Fercho KA, Gregory CM, Hanlon CA, Hayward KS, Holguin JA, Hordacre B, Hwang DH, Kautz SA, Khlif MS, Kim B, Kim H, Kuceyeski A, Lo B, Liu J, Lin D, Lotze M, MacIntosh BJ, Margetis JL, Mohamed FB, Nordvik JE, Petoe MA, Piras F, Raju S, Ramos-Murguialday A, Revill KP, Roberts P, Robertson AD, Schambra HM, Seo NJ, Shiroishi MS, Soekadar SR, Spalletta G, Stinear CM, Suri A, Tang WK, Thielman GT, Thijs VN, Vecchio D, Ward NS, Westlye LT, Winstein CJ, Wittenberg GF, Wong KA, Yu C, Wolf SL, Cramer SC, Thompson PM. Smaller spared subcortical nuclei are associated with worse post-stroke sensorimotor outcomes in 28 cohorts worldwide. Brain Commun 2021; 3:fcab254. [PMID: 34805997 PMCID: PMC8598999 DOI: 10.1093/braincomms/fcab254] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 11/17/2022] Open
Abstract
Up to two-thirds of stroke survivors experience persistent sensorimotor impairments. Recovery relies on the integrity of spared brain areas to compensate for damaged tissue. Deep grey matter structures play a critical role in the control and regulation of sensorimotor circuits. The goal of this work is to identify associations between volumes of spared subcortical nuclei and sensorimotor behaviour at different timepoints after stroke. We pooled high-resolution T1-weighted MRI brain scans and behavioural data in 828 individuals with unilateral stroke from 28 cohorts worldwide. Cross-sectional analyses using linear mixed-effects models related post-stroke sensorimotor behaviour to non-lesioned subcortical volumes (Bonferroni-corrected, P < 0.004). We tested subacute (≤90 days) and chronic (≥180 days) stroke subgroups separately, with exploratory analyses in early stroke (≤21 days) and across all time. Sub-analyses in chronic stroke were also performed based on class of sensorimotor deficits (impairment, activity limitations) and side of lesioned hemisphere. Worse sensorimotor behaviour was associated with a smaller ipsilesional thalamic volume in both early (n = 179; d = 0.68) and subacute (n = 274, d = 0.46) stroke. In chronic stroke (n = 404), worse sensorimotor behaviour was associated with smaller ipsilesional putamen (d = 0.52) and nucleus accumbens (d = 0.39) volumes, and a larger ipsilesional lateral ventricle (d = -0.42). Worse chronic sensorimotor impairment specifically (measured by the Fugl-Meyer Assessment; n = 256) was associated with smaller ipsilesional putamen (d = 0.72) and larger lateral ventricle (d = -0.41) volumes, while several measures of activity limitations (n = 116) showed no significant relationships. In the full cohort across all time (n = 828), sensorimotor behaviour was associated with the volumes of the ipsilesional nucleus accumbens (d = 0.23), putamen (d = 0.33), thalamus (d = 0.33) and lateral ventricle (d = -0.23). We demonstrate significant relationships between post-stroke sensorimotor behaviour and reduced volumes of deep grey matter structures that were spared by stroke, which differ by time and class of sensorimotor measure. These findings provide additional insight into how different cortico-thalamo-striatal circuits support post-stroke sensorimotor outcomes.
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Affiliation(s)
- Sook-Lei Liew
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
- Keck School of Medicine, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Artemis Zavaliangos-Petropulu
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, USA
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Nicolas Schweighofer
- Biokinesiology and Physical Therapy, Ostrow School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Catherine E Lang
- Departments of Physical Therapy, Washington University School of Medicine, St. Louis, MO, USA
- Department of Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Keith R Lohse
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Giuseppe Barisano
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, USA
- Laboratory of Neuro Imaging, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lee A Baugh
- Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
- Sioux Falls VA Health Care System, Sioux Falls, SD, USA
- Center for Brain and Behavior Research, Vermillion, SD, USA
- Sanford Research, Sioux Falls, SD, USA
| | - Anup K Bhattacharya
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Bavrina Bigjahan
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Michael R Borich
- Department of Rehabilitation Medicine, Emory University, Atlanta, GA, USA
| | - Lara A Boyd
- Department of Physical Therapy & the Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Amy Brodtmann
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, VIC, Australia
- Eastern Cognitive Disorders Clinic, Monash University, Melbourne, VIC, Australia
| | - Cathrin M Buetefisch
- Department of Rehabilitation Medicine, Emory University, Atlanta, GA, USA
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA
- Department of Radiology, Emory University, Atlanta, GA, USA
| | - Winston D Byblow
- Department of Exercise Sciences and Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Jessica M Cassidy
- Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Charalambos C Charalambous
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
- Center for Neuroscience and Integrative Brain Research (CENIBRE), University of Nicosia Medical School, Nicosia, Cyprus
| | - Valentina Ciullo
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Adriana B Conforto
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Richard C Craddock
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Adrienne N Dula
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Natalia Egorova
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Wuwei Feng
- Department of Health Sciences & Research, Medical University of South Carolina, Charleston, SC, USA
| | - Kelene A Fercho
- Civil Aerospace Medical Institute, US Federal Aviation Administration, Oklahoma City, OK, USA
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
| | - Chris M Gregory
- Department of Health Sciences & Research, Medical University of South Carolina, Charleston, SC, USA
| | - Colleen A Hanlon
- Cancer Biology, Wake Forest School of Medicine, Winston Salem, NC, USA
- College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
| | - Kathryn S Hayward
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, VIC, Australia
- Department of Physiotherapy, University of Melbourne, Heidelberg, VIC, Australia
- NHMRC CRE in Stroke Rehabilitation and Brain Recovery, University of Melbourne, Heidelberg, VIC, Australia
| | - Jess A Holguin
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Brenton Hordacre
- Innovation, IMPlementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Darryl H Hwang
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Steven A Kautz
- Department of Health Sciences & Research, Medical University of South Carolina, Charleston, SC, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Mohamed Salah Khlif
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, VIC, Australia
| | - Bokkyu Kim
- Department of Physical Therapy Education, College of Health Professions, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Hosung Kim
- Keck School of Medicine, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Amy Kuceyeski
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Bethany Lo
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Jingchun Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - David Lin
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Martin Lotze
- Department of Diagnostic Radiology, University Medicine Greifswald, Greifswald, Germany
| | - Bradley J MacIntosh
- Hurvitz Brain Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - John L Margetis
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Feroze B Mohamed
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Matthew A Petoe
- Bionics Institute, Melbourne, VIC, Australia
- Department of Medicine and Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Sharmila Raju
- Department of Neurology, New York University Langone, New York, NY, USA
| | - Ander Ramos-Murguialday
- TECNALIA, Basque Research and Technology Alliance (BRTA), Health Division, San Sebastian Donostia, Spain
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Kate P Revill
- Facility for Education and Research in Neuroscience, Emory University, Atlanta, GA, USA
| | - Pamela Roberts
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
- Department of Physical Medicine and Rehabilitation, Cedars-Sinai, Los Angeles, CA, USA
- California Rehabilitation Institute, Los Angeles, CA, USA
| | - Andrew D Robertson
- Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Heidi M Schambra
- Department of Neurology, New York University Langone, New York, NY, USA
| | - Na Jin Seo
- Department of Health Sciences & Research, Medical University of South Carolina, Charleston, SC, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
- Department of Rehabilitation Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Mark S Shiroishi
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Surjo R Soekadar
- Clinical Neurotechnology Laboratory, Department of Psychiatry and Psychotherapy, Charité - University Medicine Berlin, Berlin, Germany
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
- Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Cathy M Stinear
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Anisha Suri
- Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Wai Kwong Tang
- Department of Psychiatry, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China
| | - Gregory T Thielman
- Department of Physical Therapy and Neuroscience, University of the Sciences, Philadelphia, PA, USA
| | - Vincent N Thijs
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, VIC, Australia
- Department of Neurology, Austin Health, Heidelberg, VIC, Australia
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Nick S Ward
- UCL Queen Square Institute of Neurology, London, UK
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Carolee J Winstein
- Biokinesiology and Physical Therapy, Ostrow School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - George F Wittenberg
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
- Neurology, Department of Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Kristin A Wong
- Department of Physical Medicine & Rehabilitation, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Chunshui Yu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Steven L Wolf
- Division of Physical Therapy Education, Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Division of Physical Therapy Education, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Division of Physical Therapy Education, Department of Cell Biology, Emory University School of Medicine, Atlanta, GA, USA
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, USA
| | - Steven C Cramer
- California Rehabilitation Institute, Los Angeles, CA, USA
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
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