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Olafson ER, Sperber C, Jamison KW, Bowren MD, Boes AD, Andrushko JW, Borich MR, Boyd LA, Cassidy JM, Conforto AB, Cramer SC, Dula AN, Geranmayeh F, Hordacre B, Jahanshad N, Kautz SA, Tavenner BP, MacIntosh BJ, Piras F, Robertson AD, Seo NJ, Soekadar SR, Thomopoulos SI, Vecchio D, Weng TB, Westlye LT, Winstein CJ, Wittenberg GF, Wong KA, Thompson PM, Liew SL, Kuceyeski AF. Data-driven biomarkers better associate with stroke motor outcomes than theory-based biomarkers. Brain Commun 2024; 6:fcae254. [PMID: 39171205 PMCID: PMC11336660 DOI: 10.1093/braincomms/fcae254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 05/27/2024] [Accepted: 07/30/2024] [Indexed: 08/23/2024] Open
Abstract
Chronic motor impairments are a leading cause of disability after stroke. Previous studies have associated motor outcomes with the degree of damage to predefined structures in the motor system, such as the corticospinal tract. However, such theory-based approaches may not take full advantage of the information contained in clinical imaging data. The present study uses data-driven approaches to model chronic motor outcomes after stroke and compares the accuracy of these associations to previously-identified theory-based biomarkers. Using a cross-validation framework, regression models were trained using lesion masks and motor outcomes data from 789 stroke patients from the Enhancing NeuroImaging Genetics through Meta Analysis (ENIGMA) Stroke Recovery Working Group. Using the explained variance metric to measure the strength of the association between chronic motor outcomes and imaging biomarkers, we compared theory-based biomarkers, like lesion load to known motor tracts, to three data-driven biomarkers: lesion load of lesion-behaviour maps, lesion load of structural networks associated with lesion-behaviour maps, and measures of regional structural disconnection. In general, data-driven biomarkers had stronger associations with chronic motor outcomes accuracy than theory-based biomarkers. Data-driven models of regional structural disconnection performed the best of all models tested (R 2 = 0.210, P < 0.001), performing significantly better than the theory-based biomarkers of lesion load of the corticospinal tract (R 2 = 0.132, P < 0.001) and of multiple descending motor tracts (R 2 = 0.180, P < 0.001). They also performed slightly, but significantly, better than other data-driven biomarkers including lesion load of lesion-behaviour maps (R 2 = 0.200, P < 0.001) and lesion load of structural networks associated with lesion-behaviour maps (R 2 = 0.167, P < 0.001). Ensemble models - combining basic demographic variables like age, sex, and time since stroke - improved the strength of associations for theory-based and data-driven biomarkers. Combining both theory-based and data-driven biomarkers with demographic variables improved predictions, and the best ensemble model achieved R 2 = 0.241, P < 0.001. Overall, these results demonstrate that out-of-sample associations between chronic motor outcomes and data-driven imaging features, particularly when lesion data is represented in terms of structural disconnection, are stronger than associations between chronic motor outcomes and theory-based biomarkers. However, combining both theory-based and data-driven models provides the most robust associations.
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Affiliation(s)
- Emily R Olafson
- Department of Radiology, Weill Cornell Medicine, New York City, NY 10021, USA
| | - Christoph Sperber
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern 3012, Switzerland
| | - Keith W Jamison
- Department of Radiology, Weill Cornell Medicine, New York City, NY 10021, USA
| | - Mark D Bowren
- Department of Neurology, Carver College of Medicine, Iowa City, IA 52242, USA
| | - Aaron D Boes
- Department of Neurology, Carver College of Medicine, Iowa City, IA 52242, USA
- Department of Psychiatry, Carver College of Medicine, Iowa City, IA 52242, USA
- Department of Pediatrics, Carver College of Medicine, Iowa City, IA 52242, USA
| | - Justin W Andrushko
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, United Kingdom
| | - Michael R Borich
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Lara A Boyd
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Jessica M Cassidy
- Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Adriana B Conforto
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paolo 05652-900, Brazil
- Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil
| | - Steven C Cramer
- Department Neurology, UCLA, California Rehabilitation Institute, Los Angeles, CA 90033, USA
| | - Adrienne N Dula
- Department of Neurology, Dell Medical School at The University of Texas Austin, Austin, TX 78712, USA
| | - Fatemeh Geranmayeh
- Clinical Language and Cognition Group, Department of Brain Sciences, Imperial College London, London W12 0HS, United Kingdom
| | - Brenton Hordacre
- Innovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide 5000, Australia
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Charleston, SC 29425, USA
| | - Steven A Kautz
- Department of Health Sciences & Research, Medical University of South Carolina, Charleston, SC 29425, USA
- Ralph H. Johnson VA Health Care System, Charleston, SC 29425, USA
| | - Bethany P Tavenner
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90033, USA
| | - Bradley J MacIntosh
- Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
- Computational Radiology and Artificial Intelligence (CRAI), Department of Physics and Computational Radiology, Clinic for Radiology and Nuclear Medicine, Oslo University Hospital, Oslo 0372, Norway
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome 00179, Italy
| | - Andrew D Robertson
- Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
- Schlegel-UW Research Institute for Aging, Waterloo, ON N2J 0E2, Canada
| | - Na Jin Seo
- Department of Health Sciences & Research, Medical University of South Carolina, Charleston, SC 29425, USA
- Ralph H. Johnson VA Health Care System, Charleston, SC 29425, USA
- Department of Rehabilitation Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Surjo R Soekadar
- Department of Psychiatry and Neurosciences, Charité Campus Mitte (CCM), Charité—Universitätsmedizin Berlin, Berlin 10117, Germany
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Charleston, SC 29425, USA
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome 00179, Italy
| | - Timothy B Weng
- Department of Neurology, Dell Medical School at The University of Texas Austin, Austin, TX 78712, USA
- Department of Diagnostic Medicine, Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Oslo 0372, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo 0372, Norway
| | - Carolee J Winstein
- Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90033, USA
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - George F Wittenberg
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA
- GRECC, HERL, Department of Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15213, USA
| | - Kristin A Wong
- Department of Physical Medicine & Rehabilitation, Dell Medical School, University of Texas at Austin, Austin, TX 78712, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Charleston, SC 29425, USA
| | - Sook-Lei Liew
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA 90033, USA
| | - Amy F Kuceyeski
- Department of Radiology, Weill Cornell Medicine, New York City, NY 10021, USA
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Li Q, Hu S, Mo Y, Chen H, Meng C, Zhan L, Li M, Quan X, Gao Y, Cheng L, Hao Z, Jia X, Liang Z. Regional homogeneity alterations in multifrequency bands in patients with basal ganglia stroke: A resting-state functional magnetic resonance imaging study. Front Aging Neurosci 2022; 14:938646. [PMID: 36034147 PMCID: PMC9403766 DOI: 10.3389/fnagi.2022.938646] [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: 05/07/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe aim of this study was to investigate the spontaneous regional neural activity abnormalities in patients with acute basal ganglia ischemic stroke (BGIS) using a multifrequency bands regional homogeneity (ReHo) method and to explore whether the alteration of ReHo values was associated with clinical characteristics.MethodsIn this study, 34 patients with acute BGIS and 44 healthy controls (HCs) were recruited. All participants were examined by resting-state functional magnetic resonance imaging (rs-fMRI). The ReHo method was used to detect the alterations of spontaneous neural activities in patients with acute BGIS. A two-sample t-test comparison was performed to compare the ReHo value between the two groups, and a Pearson correlation analysis was conducted to assess the relationship between the regional neural activity abnormalities and clinical characteristics.ResultsCompared with the HCs, the patients with acute BGIS showed increased ReHo in the left caudate and subregions such as the right caudate and left putamen in conventional frequency bands. In the slow-5 frequency band, patients with BGIS showed decreased ReHo in the left medial cingulum of BGIS compared to the HCs and other subregions such as bilateral caudate and left putamen. No brain regions with ReHo alterations were found in the slow-4 frequency band. Moreover, we found that the ReHo value of left caudate was positively correlated with the NIHSS score.ConclusionOur findings revealed the alterations of ReHo in patients with acute BGIS in a specific frequency band and provided a new insight into the pathogenesis mechanism of BGIS. This study demonstrated the frequency-specific characteristics of ReHo in patients with acute BGIS, which may have a positive effect on the future neuroimaging studies.
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Affiliation(s)
- Qianqian Li
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Su Hu
- School of Teacher Education, Zhejiang Normal University, Jinhua, China
| | - Yingmin Mo
- The Cadre Ward in Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Hao Chen
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Chaoguo Meng
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Linlin Zhan
- Faculty of Western Languages, Heilongjiang University, Harbin, China
| | - Mengting Li
- School of Teacher Education, Zhejiang Normal University, Jinhua, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Xuemei Quan
- Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yanyan Gao
- School of Teacher Education, Zhejiang Normal University, Jinhua, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Lulu Cheng
- School of Foreign Studies, China University of Petroleum (East China), Qingdao, China
- Shanghai Center for Research in English Language Education, Shanghai International Studies University, Shanghai, China
| | - Zeqi Hao
- School of Teacher Education, Zhejiang Normal University, Jinhua, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Xize Jia
- School of Teacher Education, Zhejiang Normal University, Jinhua, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Zhijian Liang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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He CF, Xue WJ, Xu XD, Wang JT, Wang XR, Feng Y, Zhou HG, Guo JC. Knockdown of NRSF Alleviates Ischemic Brain Injury and Microvasculature Defects in Diabetic MCAO Mice. Front Neurol 2022; 13:869220. [PMID: 35645950 PMCID: PMC9136417 DOI: 10.3389/fneur.2022.869220] [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: 02/17/2022] [Accepted: 04/04/2022] [Indexed: 11/26/2022] Open
Abstract
Diabetes is one of the well-established risk factors of stroke and is associated with a poor outcome in patients with stroke. Previous studies have shown that the expression of neuron restrictive silencer factor (NRSF) is elevated in diabetes as well as ischemic stroke. However, the role of NRSF in regulating an outcome of diabetic ischemic stroke has not been completely understood. Here, we hypothesized that diabetes-induced NRSF elevation can aggravate brain injury and cognition impairment in ischemic stroke. The diabetic ischemic stroke mice model was established by 8 weeks of high-fat-diet feeding and 5 days of streptozotocin injection followed by 30 min of middle cerebral artery occlusion (MCAO). We found that diabetes enhanced the MCAO-induced elevation of NRSF in the hippocampus in accompany with an elevation of its corepressors, HDAC1, and mSin3A, and decrease of β-TrCP. By using histological/immunofluorescence staining and neurobehavioral testing, our results showed that the brain damage and learning/memory impairment were aggravated in diabetic ischemic mice but significantly attenuated after stereotaxic injection of NRSF-shRNA. Meanwhile, by performing whole-brain clearing with PEGASOS, microvascular reconstruction, western blotting, and ELISA, we found that NRSF-shRNA markedly alleviated the vasculature disorders and rescued the suppression of NRP-1, VEGF, and VEGFR2 in the hippocampus of diabetic ischemic mice. Therefore, our results demonstrated for the first time that the elevation of hippocampal NRSF plays an important role in alleviating brain injury and cognitive disabilities in diabetic ischemic mice, potentially via the reduction of NRP-1/VEGF signaling.
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Affiliation(s)
- Cheng-Feng He
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Department of Translational Neuroscience, Jing'an District Centre Hospital of Shanghai, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Wen-Jiao Xue
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Department of Translational Neuroscience, Jing'an District Centre Hospital of Shanghai, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Xiao-Die Xu
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Department of Translational Neuroscience, Jing'an District Centre Hospital of Shanghai, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Jian-Tao Wang
- Department of Geriatric Neurology of Huashan Hospital, National Clinical Research Center for Aging and Medicine, Fudan University, Shanghai, China
| | - Xin-Ru Wang
- Department of Geriatric Neurology of Huashan Hospital, National Clinical Research Center for Aging and Medicine, Fudan University, Shanghai, China
| | - Yi Feng
- State Key Laboratory of Medical Neurobiology, Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
- *Correspondence: Yi Feng
| | - Hou-Guang Zhou
- Department of Geriatric Neurology of Huashan Hospital, National Clinical Research Center for Aging and Medicine, Fudan University, Shanghai, China
- Hou-Guang Zhou
| | - Jing-Chun Guo
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Department of Translational Neuroscience, Jing'an District Centre Hospital of Shanghai, Institutes of Brain Science, Fudan University, Shanghai, China
- Jing-Chun Guo
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McKeown ME, Prasad A, Kobsa J, Top I, Snider SB, Kidwell C, Campbell BCV, Davis SM, Donnan GA, Lev M, Sheth KN, Petersen N, Kimberly WT, Bevers MB. Midline Shift Greater than 3 mm Independently Predicts Outcome After Ischemic Stroke. Neurocrit Care 2022; 36:46-51. [PMID: 34494212 PMCID: PMC8813904 DOI: 10.1007/s12028-021-01341-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/24/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Cerebral edema is associated with worse outcome after acute stroke; however, the minimum clinically relevant threshold remains unknown. This study aimed to identify the minimal degree of midline shift (MLS) that predicts outcome in a cohort encompassing a broad range of patients with acute stroke. METHODS Patient-level data from six acute stroke clinical trials were combined with endovascular thrombectomy registries from two academic referral centers, generating a combined cohort of 1977 patients. MLS was extracted from the original trial data or measured on computed tomography or magnetic resonance imaging that was obtained a median of 47.0 h (interquartile range 27.0-75.1 h) after stroke onset. Logistic regression was performed to identify predictors of poor outcome and the minimal clinically relevant MLS threshold. RESULTS The presence of MLS was a predictor of poor outcome, independent of baseline clinical and demographic factors (adjusted odds ratio 4.46, 95% confidence interval 3.56-5.59, p < 0.001). Examining the full range of MLS values identified, a value of greater than 3 mm was the critical threshold that significantly predicted poor outcome (adjusted odds ratio 3.20 [1.31-7.82], p = 0.011). CONCLUSIONS These results show that the presence of MLS predicts poor outcome and, specifically, MLS value greater than 3 mm is an important threshold across a variety of clinical settings. These findings may have relevance for the design and interpretation of future trials for antiedema therapies.
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Affiliation(s)
- Morgan E McKeown
- Division of Neurocritical Care, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA
| | - Ayush Prasad
- Division of Neurocritical Care and Emergency Neurology, Yale New Haven Hospital, New Haven, CT, USA
| | - Jessica Kobsa
- Division of Neurocritical Care and Emergency Neurology, Yale New Haven Hospital, New Haven, CT, USA
| | - Ilayda Top
- Division of Neurocritical Care and Emergency Neurology, Yale New Haven Hospital, New Haven, CT, USA
| | - Samuel B Snider
- Division of Neurocritical Care, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA
| | - Chelsea Kidwell
- Division of Cerebrovascular Diseases and Stroke, University of Arizona, Tucson, AZ, USA
| | - Bruce C V Campbell
- Department of Medicine and Neurology, Melbourne Brain Center at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Stephen M Davis
- Department of Medicine and Neurology, Melbourne Brain Center at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Geoffrey A Donnan
- Department of Medicine and Neurology, Melbourne Brain Center at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Michael Lev
- Division of Emergency Radiology and Emergency Neuroradiology, Massachusetts General Hospital, Boston, MA, USA
| | - Kevin N Sheth
- Division of Neurocritical Care and Emergency Neurology, Yale New Haven Hospital, New Haven, CT, USA
| | - Nils Petersen
- Division of Neurocritical Care and Emergency Neurology, Yale New Haven Hospital, New Haven, CT, USA
| | - W Taylor Kimberly
- Division of Neurocritical Care, Massachusetts General Hospital, Boston, MA, USA
| | - Matthew B Bevers
- Division of Neurocritical Care, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
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Lunney JK, Van Goor A, Walker KE, Hailstock T, Franklin J, Dai C. Importance of the pig as a human biomedical model. Sci Transl Med 2021; 13:eabd5758. [PMID: 34818055 DOI: 10.1126/scitranslmed.abd5758] [Citation(s) in RCA: 242] [Impact Index Per Article: 80.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Joan K Lunney
- Animal Parasitic Diseases Laboratory, BARC, NEA, ARS, USDA, Beltsville, MD 20705, USA
| | - Angelica Van Goor
- Animal Parasitic Diseases Laboratory, BARC, NEA, ARS, USDA, Beltsville, MD 20705, USA
| | - Kristen E Walker
- Animal Parasitic Diseases Laboratory, BARC, NEA, ARS, USDA, Beltsville, MD 20705, USA
| | - Taylor Hailstock
- Animal Parasitic Diseases Laboratory, BARC, NEA, ARS, USDA, Beltsville, MD 20705, USA
| | - Jasmine Franklin
- Animal Parasitic Diseases Laboratory, BARC, NEA, ARS, USDA, Beltsville, MD 20705, USA
| | - Chaohui Dai
- Animal Parasitic Diseases Laboratory, BARC, NEA, ARS, USDA, Beltsville, MD 20705, USA.,College of Animal Science and Technology, Yangzhou University, Yangzhou, Jiangsu 225009, China
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