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Stein A, Thorstensen JR, Ho JM, Ashley DP, Iyer KK, Barlow KM. Attention Please! Unravelling the Link Between Brain Network Connectivity and Cognitive Attention Following Acquired Brain Injury: A Systematic Review of Structural and Functional Measures. Brain Connect 2024; 14:4-38. [PMID: 38019047 DOI: 10.1089/brain.2023.0067] [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] [Indexed: 11/30/2023] Open
Abstract
Traumatic brain injury (TBI) and stroke are the most common causes of acquired brain injury (ABI), annually affecting 69 million and 15 million people, respectively. Following ABI, the relationship between brain network disruption and common cognitive issues including attention dysfunction is heterogenous. Using PRISMA guidelines, we systematically reviewed 43 studies published by February 2023 that reported correlations between attention and connectivity. Across all ages and stages of recovery, following TBI, greater attention was associated with greater structural efficiency within/between executive control network (ECN), salience network (SN), and default mode network (DMN) and greater functional connectivity (fc) within/between ECN and DMN, indicating DMN interference. Following stroke, greater attention was associated with greater structural connectivity (sc) within ECN; or greater fc within the dorsal attention network (DAN). In childhood ABI populations, decreases in structural network segregation were associated with greater attention. Longitudinal recovery from TBI was associated with normalization of DMN activity, and in stroke, normalization of DMN and DAN activity. Results improve clinical understanding of attention-related connectivity changes after ABI. Recommendations for future research include increased use of electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) to measure connectivity at the point of care, standardized attention and connectivity outcome measures and analysis pipelines, detailed reporting of patient symptomatology, and casual analysis of attention-related connectivity using brain stimulation.
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Affiliation(s)
- Athena Stein
- Child Health Research Centre, The University of Queensland, South Brisbane, Australia
| | - Jacob R Thorstensen
- Child Health Research Centre, The University of Queensland, South Brisbane, Australia
- School of Biomedical Sciences, The University of Queensland, St Lucia, Australia
| | - Jonathan M Ho
- Child Health Research Centre, The University of Queensland, South Brisbane, Australia
| | - Daniel P Ashley
- Child Health Research Centre, The University of Queensland, South Brisbane, Australia
| | - Kartik K Iyer
- Child Health Research Centre, The University of Queensland, South Brisbane, Australia
- Brain Modelling Group, QIMR Berghofer Medical Research Institute, Herston, Australia
| | - Karen M Barlow
- Child Health Research Centre, The University of Queensland, South Brisbane, Australia
- Queensland Pediatric Rehabilitation Service, Queensland Children's Hospital, South Brisbane, Australia
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Dimova V, Welte-Jzyk C, Kronfeld A, Korczynski O, Baier B, Koirala N, Steenken L, Kollmann B, Tüscher O, Brockmann MA, Birklein F, Muthuraman M. Brain connectivity networks underlying resting heart rate variability in acute ischemic stroke. Neuroimage Clin 2023; 41:103558. [PMID: 38142520 PMCID: PMC10788522 DOI: 10.1016/j.nicl.2023.103558] [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: 09/14/2023] [Revised: 12/18/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
Acute strokes can affect heart rate variability (HRV), the mechanisms how are not well understood. We included 42 acute stroke patients (2-7 days after ischemic stroke, mean age 66 years, 16 women). For analysis of HRV, 20 matched controls (mean age 60.7, 10 women) were recruited. HRV was assessed at rest, in a supine position and individual breathing rhythmus for 5 min. The coefficient of variation (VC), the root mean square of successive differences (RMSSD), the powers of low (LF, 0.04-0.14 Hz) and high (HF, 0.15-0.50 Hz) frequency bands were extracted. HRV parameters were z-transformed related to age- and sex-matched normal subjects. Z-values < -1 indicate reduced HRV. Acute stroke lesions were marked on diffusion-weighted images employing MRIcroN and co-registered to a T1-weighted structural volume-dataset. Using independent component analysis (ICA), stroke lesions were related to HRV. Subsequently, we used the ICA-derived lesion pattern as a seed and estimated the connectivity between these brain regions and seven common functional networks, which were obtained from 50 age-matched healthy subjects (mean age 68.9, 27 women). Especially, LF and VC were frequently reduced in patients. ICA revealed one covarying lesion pattern for LF and one similar for VC, predominantly affecting the right hemisphere. Activity in brain areas corresponding to these lesions mainly impact on limbic (r = 0.55 ± 0.08) and salience ventral attention networks (0.61 ± 0.10) in the group with reduced LF power (z-score < -1), but on control and default mode networks in the group with physiological LF power (z-score > -1). No different connectivity could be found for the respective VC groups. Our results suggest that HRV alteration after acute stroke might be due to affecting resting-state brain networks.
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Affiliation(s)
- Violeta Dimova
- Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Claudia Welte-Jzyk
- Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Andrea Kronfeld
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Oliver Korczynski
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bernhard Baier
- Edith-Stein Fachklinik for Neurorehabilitation, Bad Bergzabern, Germany
| | - Nabin Koirala
- Haskins Laboratories, Yale University, New Haven, CT 06511, USA
| | - Livia Steenken
- Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bianca Kollmann
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany; Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany; Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Institute for Molecular Biology (IMB), Mainz, Germany
| | - Marc A Brockmann
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Frank Birklein
- Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Muthuraman Muthuraman
- Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Neural Engineering with Signal Analytics and Artificial Intelligence, Department of Neurology, University of Würzburg, Würzburg, Germany.
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Soleimani B, Dallasta I, Das P, Kulasingham JP, Girgenti S, Simon JZ, Babadi B, Marsh EB. Altered directional functional connectivity underlies post-stroke cognitive recovery. Brain Commun 2023; 5:fcad149. [PMID: 37288315 PMCID: PMC10243775 DOI: 10.1093/braincomms/fcad149] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 03/24/2023] [Accepted: 05/04/2023] [Indexed: 06/09/2023] Open
Abstract
Cortical ischaemic strokes result in cognitive deficits depending on the area of the affected brain. However, we have demonstrated that difficulties with attention and processing speed can occur even with small subcortical infarcts. Symptoms appear independent of lesion location, suggesting they arise from generalized disruption of cognitive networks. Longitudinal studies evaluating directional measures of functional connectivity in this population are lacking. We evaluated six patients with minor stroke exhibiting cognitive impairment 6-8 weeks post-infarct and four age-similar controls. Resting-state magnetoencephalography data were collected. Clinical and imaging evaluations of both groups were repeated 6- and 12 months later. Network Localized Granger Causality was used to determine differences in directional connectivity between groups and across visits, which were correlated with clinical performance. Directional connectivity patterns remained stable across visits for controls. After the stroke, inter-hemispheric connectivity between the frontoparietal cortex and the non-frontoparietal cortex significantly increased between visits 1 and 2, corresponding to uniform improvement in reaction times and cognitive scores. Initially, the majority of functional links originated from non-frontal areas contralateral to the lesion, connecting to ipsilesional brain regions. By visit 2, inter-hemispheric connections, directed from the ipsilesional to the contralesional cortex significantly increased. At visit 3, patients demonstrating continued favourable cognitive recovery showed less reliance on these inter-hemispheric connections. These changes were not observed in those without continued improvement. Our findings provide supporting evidence that the neural basis of early post-stroke cognitive dysfunction occurs at the network level, and continued recovery correlates with the evolution of inter-hemispheric connectivity.
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Affiliation(s)
- Behrad Soleimani
- Department of Electrical and Computer Engineering, University of Maryland, College Park, MD 20742, USA
- Institute for Systems Research, University of Maryland, College Park, MD 20740, USA
| | - Isabella Dallasta
- Department of Neurology, the Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Proloy Das
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Joshua P Kulasingham
- Department of Electrical Engineering, Linköping University, SE-581 83 Linköping, Sweden
| | - Sophia Girgenti
- Department of Neurology, the Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Jonathan Z Simon
- Department of Electrical and Computer Engineering, University of Maryland, College Park, MD 20742, USA
- Institute for Systems Research, University of Maryland, College Park, MD 20740, USA
- Department of Biology, University of Maryland, College Park, MD 20742, USA
| | - Behtash Babadi
- Department of Electrical and Computer Engineering, University of Maryland, College Park, MD 20742, USA
- Institute for Systems Research, University of Maryland, College Park, MD 20740, USA
| | - Elisabeth B Marsh
- Department of Neurology, the Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
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Altered Effective Connectivity of the Primary Motor Cortex in Transient Ischemic Attack. Neural Plast 2022; 2022:2219993. [PMID: 36437903 PMCID: PMC9699783 DOI: 10.1155/2022/2219993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/02/2022] [Accepted: 09/19/2022] [Indexed: 11/19/2022] Open
Abstract
Objective This study is aimed at exploring alteration in motor-related effective connectivity in individuals with transient ischemic attack (TIA). Methods A total of 48 individuals with TIA and 41 age-matched and sex-matched healthy controls (HCs) were recruited for this study. The participants were scanned using MRI, and their clinical characteristics were collected. To investigate motor-related effective connectivity differences between individuals with TIA and HCs, the bilateral primary motor cortex (M1) was used as the regions of interest (ROIs) to perform a whole-brain Granger causality analysis (GCA). Furthermore, partial correlation was used to evaluate the relationship between GCA values and the clinical characteristics of individuals with TIA. Results Compared with HCs, individuals with TIA demonstrated alterations in the effective connectivity between M1 and widely distributed brain regions involved in motor, visual, auditory, and sensory integration. In addition, GCA values were significantly correlated with high- and low-density lipoprotein cholesterols in individuals with TIA. Conclusion This study provides important evidence for the alteration of motor-related effective connectivity in TIA, which reflects the abnormal information flow between different brain regions. This could help further elucidate the pathological mechanisms of motor impairment in individuals with TIA and provide a new perspective for future early diagnosis and intervention for TIA.
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Hortobágyi T, Vetrovsky T, Balbim GM, Sorte Silva NCB, Manca A, Deriu F, Kolmos M, Kruuse C, Liu-Ambrose T, Radák Z, Váczi M, Johansson H, Dos Santos PCR, Franzén E, Granacher U. The impact of aerobic and resistance training intensity on markers of neuroplasticity in health and disease. Ageing Res Rev 2022; 80:101698. [PMID: 35853549 DOI: 10.1016/j.arr.2022.101698] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine the effects of low- vs. high-intensity aerobic and resistance training on motor and cognitive function, brain activation, brain structure, and neurochemical markers of neuroplasticity and the association thereof in healthy young and older adults and in patients with multiple sclerosis, Parkinson's disease, and stroke. DESIGN Systematic review and robust variance estimation meta-analysis with meta-regression. DATA SOURCES Systematic search of MEDLINE, Web of Science, and CINAHL databases. RESULTS Fifty studies with 60 intervention arms and 2283 in-analyses participants were included. Due to the low number of studies, the three patient groups were combined and analyzed as a single group. Overall, low- (g=0.19, p = 0.024) and high-intensity exercise (g=0.40, p = 0.001) improved neuroplasticity. Exercise intensity scaled with neuroplasticity only in healthy young adults but not in healthy older adults or patient groups. Exercise-induced improvements in neuroplasticity were associated with changes in motor but not cognitive outcomes. CONCLUSION Exercise intensity is an important variable to dose and individualize the exercise stimulus for healthy young individuals but not necessarily for healthy older adults and neurological patients. This conclusion warrants caution because studies are needed that directly compare the effects of low- vs. high-intensity exercise on neuroplasticity to determine if such changes are mechanistically and incrementally linked to improved cognition and motor function.
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Affiliation(s)
- Tibor Hortobágyi
- Center for Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands; Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary; Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Hungary; Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany; Hungarian University of Sports Science, Department of Kinesiology, Budapest, Hungary.
| | - Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Guilherme Moraes Balbim
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Nárlon Cássio Boa Sorte Silva
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Andrea Manca
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy; Unit of Endocrinology, Nutritional and Metabolic Disorders, AOU Sassari, Sassari, Italy
| | - Mia Kolmos
- Neurovascular Research Unit, Department of Neurology, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Christina Kruuse
- Neurovascular Research Unit, Department of Neurology, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Zsolt Radák
- Research Center of Molecular Exercise Science, Hungarian University of Sport Science, Budapest, Hungary
| | - Márk Váczi
- Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Hungary
| | - Hanna Johansson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | | | - Erika Franzén
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
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