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Tang Z, Zhao Y, Sun X, Liu Y, Su W, Liu T, Zhang X, Zhang H. Evidence that robot-assisted gait training modulates neuroplasticity after stroke: An fMRI pilot study based on graph theory analysis. Brain Res 2024:149113. [PMID: 38972627 DOI: 10.1016/j.brainres.2024.149113] [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: 05/03/2024] [Revised: 06/10/2024] [Accepted: 07/04/2024] [Indexed: 07/09/2024]
Abstract
OBJECTIVES To investigate alterations of whole-brain network after stroke and therapeutic mechanisms of robot-assisted gait training (RAGT). METHODS 21 S patients and 20 healthy subjects were enrolled, with the stroke patients randomized to either control group (n = 11) or robot group (n = 10), and resting-state functional magnetic resonance imaging data were collected. The global network metrics were obtained using graph theory analysis and compared between stroke patients and healthy subjects, and the effect of the RAGT on the whole-brain networks was explored. RESULTS Compared to healthy subjects, area under the curve (AUC) for small-worldness (σ), clustering coefficient (Cp), global efficiency (Eg) and mean local efficiency (Eloc) were significantly lower in stroke patients, whereas AUC for characteristic path length (Lp) were significantly higher. Compared with the control group, patients in robot group showed significant improvement in lower limb motor function, balance function and walking function after intervention, with a significant reduction in the AUC of Cp. Moreover, the improvement of walking function was positively correlated with the changes of AUC of σ and Eg, and negatively correlated with the changes of AUC of Cp. CONCLUSIONS Small-worldness and network efficiency were significantly reduced after stroke, whereas RAGT decreased characteristic path length and promoted normalization of the whole-brain network, and this change was associated with improvement in walking function. Our findings reveal the mechanism by which RAGT regulates network reorganization and neuroplasticity after stroke.
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Affiliation(s)
- Zhiqing Tang
- School of Rehabilitation, Capital Medical University, Beijing, China; Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Yaxian Zhao
- Department of Cardiac Surgery, Peking University International Hospital, Beijing, China
| | - Xinting Sun
- School of Rehabilitation, Capital Medical University, Beijing, China; Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Ying Liu
- School of Rehabilitation, Capital Medical University, Beijing, China; Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Wenlong Su
- School of Rehabilitation, Capital Medical University, Beijing, China; Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China; University of Health and Rehabilitation Sciences, Shandong Province, China
| | - Tianhao Liu
- School of Rehabilitation, Capital Medical University, Beijing, China; Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Xiaonian Zhang
- School of Rehabilitation, Capital Medical University, Beijing, China; Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Hao Zhang
- School of Rehabilitation, Capital Medical University, Beijing, China; Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China; Cheeloo College of Medicine, Shandong University, Shandong Province, China; University of Health and Rehabilitation Sciences, Shandong Province, China.
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Yu P, Dong R, Wang X, Tang Y, Liu Y, Wang C, Zhao L. Neuroimaging of motor recovery after ischemic stroke - functional reorganization of motor network. Neuroimage Clin 2024; 43:103636. [PMID: 38950504 DOI: 10.1016/j.nicl.2024.103636] [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: 03/10/2024] [Revised: 06/01/2024] [Accepted: 06/27/2024] [Indexed: 07/03/2024]
Abstract
The long-term motor outcome of acute stroke patients may be correlated to the reorganization of brain motor network. Abundant neuroimaging studies contribute to understand the pathological changes and recovery of motor networks after stroke. In this review, we summarized how current neuroimaging studies have increased understanding of reorganization and plasticity in post stroke motor recovery. Firstly, we discussed the changes in the motor network over time during the motor-activation and resting states, as well as the overall functional integration trend of the motor network. These studies indicate that the motor network undergoes dynamic bilateral hemispheric functional reorganization, as well as a trend towards network randomization. In the second part, we summarized the current study progress in the application of neuroimaging technology to early predict the post-stroke motor outcome. In the third part, we discuss the neuroimaging techniques commonly used in the post-stroke recovery. These methods provide direct or indirect visualization patterns to understand the neural mechanisms of post-stroke motor recovery, opening up new avenues for studying spontaneous and treatment-induced recovery and plasticity after stroke.
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Affiliation(s)
- Pei Yu
- School of Acupuncture and Massage, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Ruoyu Dong
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Xiao Wang
- School of Acupuncture and Massage, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yuqi Tang
- School of Acupuncture and Massage, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yaning Liu
- School of Acupuncture and Massage, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Can Wang
- School of Acupuncture and Massage, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Ling Zhao
- School of Acupuncture and Massage, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
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3
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Wei Y, Wang P, Zhang Y, Miao P, Liu J, Wei S, Wang X, Wang Y, Wu L, Han S, Wei Y, Wang K, Cheng J, Wang C. Altered static and dynamic cerebellar-cerebral functional connectivity in acute pontine infarction. Cereb Cortex 2024; 34:bhae182. [PMID: 38741271 DOI: 10.1093/cercor/bhae182] [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: 03/03/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 05/16/2024] Open
Abstract
This study investigates abnormalities in cerebellar-cerebral static and dynamic functional connectivity among patients with acute pontine infarction, examining the relationship between these connectivity changes and behavioral dysfunction. Resting-state functional magnetic resonance imaging was utilized to collect data from 45 patients within seven days post-pontine infarction and 34 normal controls. Seed-based static and dynamic functional connectivity analyses identified divergences in cerebellar-cerebral connectivity features between pontine infarction patients and normal controls. Correlations between abnormal functional connectivity features and behavioral scores were explored. Compared to normal controls, left pontine infarction patients exhibited significantly increased static functional connectivity within the executive, affective-limbic, and motor networks. Conversely, right pontine infarction patients demonstrated decreased static functional connectivity in the executive, affective-limbic, and default mode networks, alongside an increase in the executive and motor networks. Decreased temporal variability of dynamic functional connectivity was observed in the executive and default mode networks among left pontine infarction patients. Furthermore, abnormalities in static and dynamic functional connectivity within the executive network correlated with motor and working memory performance in patients. These findings suggest that alterations in cerebellar-cerebral static and dynamic functional connectivity could underpin the behavioral dysfunctions observed in acute pontine infarction patients.
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Affiliation(s)
- Ying Wei
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Erqi District, Zhengzhou 450052, China
| | - Peipei Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Erqi District, Zhengzhou 450052, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Erqi District, Zhengzhou 450052, China
| | - Peifang Miao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Erqi District, Zhengzhou 450052, China
| | - Jingchun Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin 300052, China
| | - Sen Wei
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Erqi District, Zhengzhou 450052, China
| | - Xin Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Erqi District, Zhengzhou 450052, China
| | - Yingying Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Erqi District, Zhengzhou 450052, China
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, China
| | - Luobing Wu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Erqi District, Zhengzhou 450052, China
- Department of Radiology, The First Affiliated Hospital of Henan University of Science and Technology, No. 24 Jinghua Road, Jianxi District, Luoyang 471003, China
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Erqi District, Zhengzhou 450052, China
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Erqi District, Zhengzhou 450052, China
| | - Kaiyu Wang
- GE Healthcare MR Research, Tongji South Road, Daxing District, Beijing 100176, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Erqi District, Zhengzhou 450052, China
| | - Caihong Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Erqi District, Zhengzhou 450052, China
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França LGS, Ciarrusta J, Gale-Grant O, Fenn-Moltu S, Fitzgibbon S, Chew A, Falconer S, Dimitrova R, Cordero-Grande L, Price AN, Hughes E, O'Muircheartaigh J, Duff E, Tuulari JJ, Deco G, Counsell SJ, Hajnal JV, Nosarti C, Arichi T, Edwards AD, McAlonan G, Batalle D. Neonatal brain dynamic functional connectivity in term and preterm infants and its association with early childhood neurodevelopment. Nat Commun 2024; 15:16. [PMID: 38331941 PMCID: PMC10853532 DOI: 10.1038/s41467-023-44050-z] [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: 02/28/2023] [Accepted: 11/28/2023] [Indexed: 02/10/2024] Open
Abstract
Brain dynamic functional connectivity characterises transient connections between brain regions. Features of brain dynamics have been linked to emotion and cognition in adult individuals, and atypical patterns have been associated with neurodevelopmental conditions such as autism. Although reliable functional brain networks have been consistently identified in neonates, little is known about the early development of dynamic functional connectivity. In this study we characterise dynamic functional connectivity with functional magnetic resonance imaging (fMRI) in the first few weeks of postnatal life in term-born (n = 324) and preterm-born (n = 66) individuals. We show that a dynamic landscape of brain connectivity is already established by the time of birth in the human brain, characterised by six transient states of neonatal functional connectivity with changing dynamics through the neonatal period. The pattern of dynamic connectivity is atypical in preterm-born infants, and associated with atypical social, sensory, and repetitive behaviours measured by the Quantitative Checklist for Autism in Toddlers (Q-CHAT) scores at 18 months of age.
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Affiliation(s)
- Lucas G S França
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- Department of Computer and Information Sciences, Faculty of Engineering and Environment, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Judit Ciarrusta
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Oliver Gale-Grant
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Sunniva Fenn-Moltu
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Sean Fitzgibbon
- Oxford Centre for Functional Magnetic Resonance Imaging of the Brain, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, OX3 9DU, UK
| | - Andrew Chew
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Shona Falconer
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Ralica Dimitrova
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Lucilio Cordero-Grande
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, 28040, Madrid, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Anthony N Price
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Emer Hughes
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Jonathan O'Muircheartaigh
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, SE1 1UL, UK
| | - Eugene Duff
- Oxford Centre for Functional Magnetic Resonance Imaging of the Brain, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, OX3 9DU, UK
- Department of Brain Sciences, Imperial College London, London, W12 0BZ, UK
- UK Dementia Research Institute at Imperial College London, London, W12 0BZ, UK
| | - Jetro J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, 20500, Turku, Finland
- Turku Collegium for Science and Medicine and Technology, University of Turku, 20500, Turku, Finland
- Department of Psychiatry, University of Turku and Turku University Hospital, 20500, Turku, Finland
| | - Gustavo Deco
- Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, Pompeu Fabra University, 08002, Barcelona, Spain
- Catalan Institution for Research and Advanced Studies, 08010, Barcelona, Spain
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103, Leipzig, Germany
- School of Psychological Sciences, Monash University, Melbourne, VIC, 3010, Australia
| | - Serena J Counsell
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Joseph V Hajnal
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Chiara Nosarti
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
| | - Tomoki Arichi
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, SE1 1UL, UK
- Department of Paediatric Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, SE1 7EH, UK
- Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK
| | - A David Edwards
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, SE1 1UL, UK
| | - Grainne McAlonan
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
| | - Dafnis Batalle
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK.
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK.
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Bernardes TS, Santos KCS, Nascimento MR, Filho CANES, Bazan R, Pereira JM, de Souza LAPS, Luvizutto GJ. Effects of anodal transcranial direct current stimulation over motor cortex on resting-state brain activity in the early subacute stroke phase: A power spectral density analysis. Clin Neurol Neurosurg 2024; 237:108134. [PMID: 38335706 DOI: 10.1016/j.clineuro.2024.108134] [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: 09/27/2023] [Revised: 01/06/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024]
Abstract
INTRODUCTION Despite promising results, the effects of transcranial direct current stimulation (tDCS) in the early stages of stroke and its impact on brain activity have been poorly studied. Therefore, this study aimed to investigate the effect of tDCS applied over the ipsilesional motor cortex on resting-state brain activity in the early subacute phase of stroke. METHODS This is a pilot, randomized, double-blind, proof-of-concept study. The patients with stroke were randomly assigned into two groups: anodal tDCS (A-tDCS) or sham tDCS (S-tDCS). For A-tDCS, the anode was placed over the ipsilesional motor cortex, while the cathode was placed over the left or right supraorbital area (Fp2 for left stroke or Fp1 for right stroke). For the real stimulation, a constant current of 1.0 mA was delivered for 20 min and then ramped down linearly for 30 s, maintaining a resistance below 10 kΩ. For the sham stimulation, the stimulator was turned on, and the current intensity was gradually increased for 30 s, tapered off over 30 s, and maintained for 30 min without stimulation. Each stimulation was performed for three consecutive sessions with an interval of 1 h between them. The primary outcome was spectral electroencephalography (EEG) analysis based on the Power Spectral Density (PSD) determined by EEG records of areas F3, F4, C3, C4, P3, and P4. Brain Vision Analyzer software processed the signals, EEG power spectral density (PSD) was calculated before and after stimulation, and alpha, beta, delta, and theta power were analyzed. The secondary outcomes included hemodynamic variables based on the difference between baseline (D0) and post-intervention session (D1) values of systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), respiratory rate (RR) and peripheral oxygen saturation (SPO2). Mann-Whitney test was used to compare position measurements of two independent samples; Fisher's exact test was used to compare two proportions; paired Wilcoxon signed-rank test was used to compare the median differences in the within-group comparison, and Spearman correlations matrix among spectral power analysis between EEG bands was performed to verify consistency of occurrence of oscillations. Statistical significance was set at P < 0.05. RESULTS An increase in PSD in the alpha frequency in the P4 region was observed after the intervention in the A-tDCS group, as compared to the placebo group (before = 6.13; after = 10.45; p < 0.05). In the beta frequency, an increase in PSD was observed in P4 (before = 4.40; after = 6.79; p < 0.05) and C4 (before = 4.43; after = 6.94; p < 0.05) after intervention in the A-tDCS group. There was a reduction in PSD at delta frequency in C3 (before = 293.8; after = 58.6; p < 0.05) after intervention in the A-tDCS group. In addition, it was observed a strong relationship between alpha and theta power in the A-tDCS group before and after intervention. However, the sham group showed correlations between more power bands (alpha and theta, alpha and delta, and delta and theta) after intervention. There was no difference in hemodynamic variables between the intra- (before and after stimulation) and inter-groups (mean difference). CONCLUSION Anodal tDCS over the ipsilesional motor cortex had significant effects on the brain electrical activity in the early subacute stroke phase, increasing alpha and beta wave activities in sensorimotor regions while reducing slow delta wave activity in motor regions. These findings highlight the potential of anodal tDCS as a therapeutic intervention in the early stroke phase.
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Affiliation(s)
- Tiago Soares Bernardes
- Department of Medicine, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Kelly Cristina Sousa Santos
- Department of Applied Physical Therapy, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Monalisa Resende Nascimento
- Department of Applied Physical Therapy, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | | | - Rodrigo Bazan
- Department of Neurology, Psychology, and Psychiatry, Botucatu Medical School (UNESP), Botucatu, SP, Brazil
| | - Janser Moura Pereira
- Statistical Department, Universidade Federal de Uberlândia (UFU), Uberlândia, MG, Brazil
| | | | - Gustavo José Luvizutto
- Department of Applied Physical Therapy, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil.
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Katsurayama M, Silva LS, de Campos BM, Avelar WM, Cendes F, Yasuda CL. Disruption of Resting-State Functional Connectivity in Acute Ischemic Stroke: Comparisons Between Right and Left Hemispheric Insults. Brain Topogr 2024:10.1007/s10548-024-01033-7. [PMID: 38302770 DOI: 10.1007/s10548-024-01033-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 01/01/2024] [Indexed: 02/03/2024]
Abstract
Few resting-state functional magnetic resonance imaging (RS-fMRI) studies evaluated the impact of acute ischemic changes on cerebral functional connectivity (FC) and its relationship with functional outcomes after acute ischemic stroke (AIS), considering the side of lesions. To characterize alterations of FC of patients with AIS by analyzing 12 large-scale brain networks (NWs) with RS-fMRI. Additionally, we evaluated the impact of the side (right (RH) or left (LH) hemisphere) of insult on the disruption of brain NWs. 38 patients diagnosed with AIS (17 RH and 21 LH) who performed 3T MRI scans up to 72 h after stroke were compared to 44 healthy controls. Images were processed and analyzed with the software toolbox UF2C with SPM12. For the first level, we generated individual matrices based on the time series extraction from 70 regions of interest (ROIs) from 12 functional NWs, constructing Pearson's cross-correlation; the second-level analysis included an analysis of covariance (ANCOVA) to investigate differences between groups. The statistical significance was determined with p < 0.05, after correction for multiple comparisons with false discovery rate (FDR) correction. Overall, individuals with LH insults developed poorer clinical outcomes after six months. A widespread pattern of lower FC was observed in the presence of LH insults, while a contralateral pattern of increased FC was identified in the group with RH insults. Our findings suggest that LH stroke causes a severe and widespread pattern of reduction of brain networks' FC, presumably related to the impairment in their long-term recovery.
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Affiliation(s)
- Marilise Katsurayama
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil
| | - Lucas Scárdua Silva
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil
| | - Brunno Machado de Campos
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil
| | - Wagner Mauad Avelar
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil
| | - Fernando Cendes
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil
| | - Clarissa Lin Yasuda
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil.
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7
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Tang CW, Zich C, Quinn AJ, Woolrich MW, Hsu SP, Juan CH, Lee IH, Stagg CJ. Post-stroke upper limb recovery is correlated with dynamic resting-state network connectivity. Brain Commun 2024; 6:fcae011. [PMID: 38344655 PMCID: PMC10853981 DOI: 10.1093/braincomms/fcae011] [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: 02/02/2023] [Revised: 11/25/2023] [Accepted: 01/22/2024] [Indexed: 03/02/2024] Open
Abstract
Motor recovery is still limited for people with stroke especially those with greater functional impairments. In order to improve outcome, we need to understand more about the mechanisms underpinning recovery. Task-unbiased, blood flow-independent post-stroke neural activity can be acquired from resting brain electrophysiological recordings and offers substantial promise to investigate physiological mechanisms, but behaviourally relevant features of resting-state sensorimotor network dynamics have not yet been identified. Thirty-seven people with subcortical ischaemic stroke and unilateral hand paresis of any degree were longitudinally evaluated at 3 weeks (early subacute) and 12 weeks (late subacute) after stroke. Resting-state magnetoencephalography and clinical scores of motor function were recorded and compared with matched controls. Magnetoencephalography data were decomposed using a data-driven hidden Markov model into 10 time-varying resting-state networks. People with stroke showed statistically significantly improved Action Research Arm Test and Fugl-Meyer upper extremity scores between 3 weeks and 12 weeks after stroke (both P < 0.001). Hidden Markov model analysis revealed a primarily alpha-band ipsilesional resting-state sensorimotor network which had a significantly increased life-time (the average time elapsed between entering and exiting the network) and fractional occupancy (the occupied percentage among all networks) at 3 weeks after stroke when compared with controls. The life-time of the ipsilesional resting-state sensorimotor network positively correlated with concurrent motor scores in people with stroke who had not fully recovered. Specifically, this relationship was observed only in ipsilesional rather in contralesional sensorimotor network, default mode network or visual network. The ipsilesional sensorimotor network metrics were not significantly different from controls at 12 weeks after stroke. The increased recruitment of alpha-band ipsilesional resting-state sensorimotor network at subacute stroke served as functionally correlated biomarkers exclusively in people with stroke with not fully recovered hand paresis, plausibly reflecting functional motor recovery processes.
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Affiliation(s)
- Chih-Wei Tang
- Institute of Brain Science, Brain Research Center, National Yang Ming Chiao Tung University, Taipei City 112, Taiwan
- Department of Neurology, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
| | - Catharina Zich
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford, Oxford OX3 9DU, UK
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford, OX1 3TH, UK
| | - Andrew J Quinn
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford, Oxford OX3 9DU, UK
- Department of Psychiatry, Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX3 7JX, UK
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham B15 2TT, UK
| | - Mark W Woolrich
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford, Oxford OX3 9DU, UK
- Department of Psychiatry, Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX3 7JX, UK
| | - Shih-Pin Hsu
- Institute of Brain Science, Brain Research Center, National Yang Ming Chiao Tung University, Taipei City 112, Taiwan
| | - Chi-Hung Juan
- Institute of Cognitive Neuroscience, National Central University, Taoyuan City 320, Taiwan
| | - I Hui Lee
- Institute of Brain Science, Brain Research Center, National Yang Ming Chiao Tung University, Taipei City 112, Taiwan
- Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, Taipei City 112, Taiwan
| | - Charlotte J Stagg
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford, Oxford OX3 9DU, UK
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford, OX1 3TH, UK
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8
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Ti CHE, Hu C, Yuan K, Chu WCW, Tong RKY. Uncovering the Neural Mechanisms of Inter-Hemispheric Balance Restoration in Chronic Stroke Through EMG-Driven Robot Hand Training: Insights From Dynamic Causal Modeling. IEEE Trans Neural Syst Rehabil Eng 2024; 32:1-11. [PMID: 38051622 DOI: 10.1109/tnsre.2023.3339756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
EMG-driven robot hand training can facilitate motor recovery in chronic stroke patients by restoring the interhemispheric balance between motor networks. However, the underlying mechanisms of reorganization between interhemispheric regions remain unclear. This study investigated the effective connectivity (EC) between the ventral premotor cortex (PMv), supplementary motor area (SMA), and primary motor cortex (M1) using Dynamic Causal Modeling (DCM) during motor tasks with the paretic hand. Nineteen chronic stroke subjects underwent 20 sessions of EMG-driven robot hand training, and their Action Reach Arm Test (ARAT) showed significant improvement ( β =3.56, [Formula: see text]). The improvement was correlated with the reduction of inhibitory coupling from the contralesional M1 to the ipsilesional M1 (r=0.58, p=0.014). An increase in the laterality index was only observed in homotopic M1, but not in the premotor area. Additionally, we identified an increase in resting-state functional connectivity (FC) between bilateral M1 ( β =0.11, p=0.01). Inter-M1 FC demonstrated marginal positive relationships with ARAT scores (r=0.402, p=0.110), but its changes did not correlate with ARAT improvements. These findings suggest that the improvement of hand functions brought about by EMG-driven robot hand training was driven explicitly by task-specific reorganization of motor networks. Particularly, the restoration of interhemispheric balance was induced by a reduction in interhemispheric inhibition from the contralesional M1 during motor tasks of the paretic hand. This finding sheds light on the mechanistic understanding of interhemispheric balance and functional recovery induced by EMG-driven robot training.
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9
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Fox-Hesling J, Wisseman D, Kantak S. Noninvasive cerebellar stimulation and behavioral interventions: A crucial synergy for post-stroke motor rehabilitation. NeuroRehabilitation 2024; 54:521-542. [PMID: 38943401 DOI: 10.3233/nre-230371] [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: 07/01/2024]
Abstract
BACKGROUND Improvement of functional movements after supratentorial stroke occurs through spontaneous biological recovery and training-induced reorganization of remnant neural networks. The cerebellum, through its connectivity with the cortex, brainstem and spinal cord, is actively engaged in both recovery and reorganization processes within the cognitive and sensorimotor systems. Noninvasive cerebellar stimulation (NiCBS) offers a safe, clinically feasible and potentially effective way to modulate the excitability of spared neural networks and promote movement recovery after supratentorial stroke. NiCBS modulates cerebellar connectivity to the cerebral cortex and brainstem, as well as influences the sensorimotor and frontoparietal networks. OBJECTIVE Our objective was twofold: (a) to conduct a scoping review of studies that employed NiCBS to influence motor recovery and learning in individuals with stroke, and (b) to present a theory-driven framework to inform the use of NiCBS to target distinct stroke-related deficits. METHODS A scoping review of current research up to August 2023 was conducted to determine the effect size of NiCBS effect on movement recovery of upper extremity function, balance, walking and motor learning in humans with stroke. RESULTS Calculated effect sizes were moderate to high, offering promise for improving upper extremity, balance and walking outcomes after stroke. We present a conceptual framework that capitalizes on cognitive-motor specialization of the cerebellum to formulate a synergy between NiCBS and behavioral interventions to target specific movement deficits. CONCLUSION NiCBS enhances recovery of upper extremity impairments, balance and walking after stroke. Physiologically-informed synergies between NiCBS and behavioral interventions have the potential to enhance recovery. Finally, we propose future directions in neurophysiological, behavioral, and clinical research to move NiCBS through the translational pipeline and augment motor recovery after stroke.
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Affiliation(s)
| | - Darrell Wisseman
- Moss Rehabilitation, Elkins Park, PA, USA
- Department of Physical Therapy, Arcadia University, Glenside, PA, USA
| | - Shailesh Kantak
- Moss Rehabilitation Research Institute, Elkins Park, PA, USA
- Department of Physical Therapy, Arcadia University, Glenside, PA, USA
- Department of Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, PA, USA
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10
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Qu H, Zeng F, Tang Y, Shi B, Wang Z, Chen X, Wang J. The clinical effects of brain-computer interface with robot on upper-limb function for post-stroke rehabilitation: a meta-analysis and systematic review. Disabil Rehabil Assist Technol 2024; 19:30-41. [PMID: 35450498 DOI: 10.1080/17483107.2022.2060354] [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: 11/19/2021] [Accepted: 03/26/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Many recent clinical studies have suggested that the combination of brain-computer interfaces (BCIs) can induce neurological recovery and improvement in motor function. In this review, we performed a systematic review and meta-analysis to evaluate the clinical effects of BCI-robot systems. METHODS The articles published from January 2010 to December 2020 have been searched by using the databases (EMBASE, PubMed, CINAHL, EBSCO, Web of Science and manual search). The single-group studies were qualitatively described, and only the controlled-trial studies were included for the meta-analysis. The mean difference (MD) of Fugl-Meyer Assessment (FMA) scores were pooled and the random-effects model method was used to perform the meta-analysis. The PRISMA criteria were followed in current review. RESULTS A total of 897 records were identified, eight single-group studies and 11 controlled-trial studies were included in our review. The systematic analysis indicated that the BCI-robot systems had a significant improvement on motor function recovery. The meta-analysis showed there were no statistic differences between BCI-robot groups and robot groups, neither in the immediate effects nor long-term effects (p > 0.05). CONCLUSION The use of BCI-robot systems has significant improvement on the motor function recovery of hemiparetic upper-limb, and there is a sustaining effect. The meta-analysis showed no statistical difference between the experimental group (BCI-robot) and the control group (robot). However, there are a few shortcomings in the experimental design of existing studies, more clinical trials need to be conducted, and the experimental design needs to be more rigorous.Implications for RehabilitationIn this review, we evaluated the clinical effects of brain-computer interface with robot on upper-limb function for post-stroke rehabilitation. After we screened the databases, 19 articles were included in this review. These articles all clinical trial research, they all used non-invasive brain-computer interfaces and upper-limb robot.We conducted the systematic review with nine articles, the result indicated that the BCI-robot system had a significant improvement on motor function recovery. Eleven articles were included for the meta-analysis, the result showed there were no statistic differences between BCI-robot groups and robot groups, neither in the immediate effects nor long-term effects.We thought the result of meta-analysis which showed no statistic difference was probably caused by the heterogenicity of clinical trial designs of these articles.We thought the BCI-robot systems are promising strategies for post-stroke rehabilitation. And we gave several suggestions for further research: (1) The experimental design should be more rigorous, and describe the experimental designs in detail, especially the control group intervention, to make the experiment replicability. (2) New evaluation criteria need to be established, more objective assessment such as biomechanical assessment, fMRI should be utilised as the primary outcome. (3) More clinical studies with larger sample size, novel external devices, and BCI systems need to be conducted to investigate the differences between BCI-robot system and other interventions. (4) Further research could shift the focus to the patients who are in subacute stage, to explore if the early BCI training can make a positive impact on cerebral cortical recovery.
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Affiliation(s)
- Hao Qu
- Institute of Robotics and Intelligent Systems, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Feixiang Zeng
- Department of Rehabilitation Medicine, HuiZhou Third People's Hospital, Huizhou, China
| | - Yongbin Tang
- Institute of Robotics and Intelligent Systems, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Bin Shi
- Institute of Robotics and Intelligent Systems, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Zhijun Wang
- Department of Rehabilitation Medicine, FoShan Fifth People's Hospital, Guangdong, China
| | - Xiaokai Chen
- Department of Rehabilitation Medicine, HuiZhou Third People's Hospital, Huizhou, China
| | - Jing Wang
- Institute of Robotics and Intelligent Systems, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
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11
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Snyder DB, Beardsley SA, Hyngstrom AS, Schmit BD. Cortical effects of wrist tendon vibration during an arm tracking task in chronic stroke survivors: An EEG study. PLoS One 2023; 18:e0266586. [PMID: 38127998 PMCID: PMC10735026 DOI: 10.1371/journal.pone.0266586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
The purpose of this study was to characterize changes in cortical activity and connectivity in stroke survivors when vibration is applied to the wrist flexor tendons during a visuomotor tracking task. Data were collected from 10 chronic stroke participants and 10 neurologically-intact controls while tracking a target through a figure-8 pattern in the horizontal plane. Electroencephalography (EEG) was used to measure cortical activity (beta band desynchronization) and connectivity (beta band task-based coherence) with movement kinematics and performance error also being recorded during the task. All participants came into our lab on two separate days and performed three blocks (16 trials each, 48 total trials) of tracking, with the middle block including vibration or sham applied at the wrist flexor tendons. The order of the sessions (Vibe vs. Sham) was counterbalanced across participants to prevent ordering effects. During the Sham session, cortical activity increased as the tracking task progressed (over blocks). This effect was reduced when vibration was applied to controls. In contrast, vibration increased cortical activity during the vibration period in participants with stroke. Cortical connectivity increased during vibration, with larger effect sizes in participants with stroke. Changes in tracking performance, standard deviation of hand speed, were observed in both control and stroke groups. Overall, EEG measures of brain activity and connectivity provided insight into effects of vibration on brain control of a visuomotor task. The increases in cortical activity and connectivity with vibration improved patterns of activity in people with stroke. These findings suggest that reactivation of normal cortical networks via tendon vibration may be useful during physical rehabilitation of stroke patients.
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Affiliation(s)
- Dylan B. Snyder
- Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Scott A. Beardsley
- Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Allison S. Hyngstrom
- Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin, United States of America
| | - Brian D. Schmit
- Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
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12
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Sharma V, Páscoa dos Santos F, Verschure PFMJ. Patient-specific modeling for guided rehabilitation of stroke patients: the BrainX3 use-case. Front Neurol 2023; 14:1279875. [PMID: 38099071 PMCID: PMC10719856 DOI: 10.3389/fneur.2023.1279875] [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: 08/22/2023] [Accepted: 11/06/2023] [Indexed: 12/17/2023] Open
Abstract
BrainX3 is an interactive neuroinformatics platform that has been thoughtfully designed to support neuroscientists and clinicians with the visualization, analysis, and simulation of human neuroimaging, electrophysiological data, and brain models. The platform is intended to facilitate research and clinical use cases, with a focus on personalized medicine diagnostics, prognostics, and intervention decisions. BrainX3 is designed to provide an intuitive user experience and is equipped to handle different data types and 3D visualizations. To enhance patient-based analysis, and in keeping with the principles of personalized medicine, we propose a framework that can assist clinicians in identifying lesions and making patient-specific intervention decisions. To this end, we are developing an AI-based model for lesion identification, along with a mapping of tract information. By leveraging the patient's lesion information, we can gain valuable insights into the structural damage caused by the lesion. Furthermore, constraining whole-brain models with patient-specific disconnection masks can allow for the detection of mesoscale excitatory-inhibitory imbalances that cause disruptions in macroscale network properties. Finally, such information has the potential to guide neuromodulation approaches, assisting in the choice of candidate targets for stimulation techniques such as Transcranial Ultrasound Stimulation (TUS), which modulate E-I balance, potentiating cortical reorganization and the restoration of the dynamics and functionality disrupted due to the lesion.
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Affiliation(s)
- Vivek Sharma
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
| | - Francisco Páscoa dos Santos
- Eodyne Systems S.L., Barcelona, Spain
- Department of Information and Communication Technologies, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Paul F. M. J. Verschure
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
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13
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Guder S, Sadeghi F, Zittel S, Quandt F, Choe C, Bönstrup M, Cheng B, Thomalla G, Gerloff C, Schulz R. Disability and persistent motor deficits are linked to structural crossed cerebellar diaschisis in chronic stroke. Hum Brain Mapp 2023; 44:5336-5345. [PMID: 37471691 PMCID: PMC10543354 DOI: 10.1002/hbm.26434] [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: 04/23/2023] [Revised: 06/15/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023] Open
Abstract
Brain imaging has significantly contributed to our understanding of the cerebellum being involved in recovery after non-cerebellar stroke. Due to its connections with supratentorial brain networks, acute stroke can alter the function and structure of the contralesional cerebellum, known as crossed cerebellar diaschisis (CCD). Data on the spatially precise distribution of structural CCD and their implications for persistent deficits after stroke are notably limited. In this cross-sectional study, structural MRI and clinical data were analyzed from 32 chronic stroke patients, at least 6 months after the event. We quantified lobule-specific contralesional atrophy, as a surrogate of structural CCD, in patients and healthy controls. Volumetric data were integrated with clinical scores of disability and motor deficits. Diaschisis-outcome models were adjusted for the covariables age, lesion volume, and damage to the corticospinal tract. We found that structural CCD was evident for the whole cerebellum, and particularly for lobules V and VI. Lobule VI diaschisis was significantly correlated with clinical scores, that is, volume reductions in contralesional lobule VI were associated with higher levels of disability and motor deficits. Lobule V and the whole cerebellum did not show similar diaschisis-outcome relationships across the spectrum of the clinical scores. These results provide novel insights into stroke-related cerebellar plasticity and might thereby promote lobule VI as a key area prone to structural CCD and potentially involved in recovery and residual motor functioning.
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Affiliation(s)
- Stephanie Guder
- Department of NeurologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Fatemeh Sadeghi
- Department of NeurologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Simone Zittel
- Department of NeurologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Fanny Quandt
- Department of NeurologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Chi‐un Choe
- Department of NeurologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Marlene Bönstrup
- Department of NeurologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
- Department of NeurologyUniversity Medical Center LeipzigLeipzigGermany
| | - Bastian Cheng
- Department of NeurologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Götz Thomalla
- Department of NeurologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Christian Gerloff
- Department of NeurologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Robert Schulz
- Department of NeurologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
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14
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Feitosa JA, Casseb RF, Camargo A, Brandao AF, Li LM, Castellano G. Graph analysis of cortical reorganization after virtual reality-based rehabilitation following stroke: a pilot randomized study. Front Neurol 2023; 14:1241639. [PMID: 37869147 PMCID: PMC10587561 DOI: 10.3389/fneur.2023.1241639] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/22/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction Stroke is the leading cause of functional disability worldwide. With the increase of the global population, motor rehabilitation of stroke survivors is of ever-increasing importance. In the last decade, virtual reality (VR) technologies for rehabilitation have been extensively studied, to be used instead of or together with conventional treatments such as physiotherapy or occupational therapy. The aim of this work was to evaluate the GestureCollection VR-based rehabilitation tool in terms of the brain changes and clinical outcomes of the patients. Methods Two groups of chronic patients underwent a rehabilitation treatment with (experimental) or without (control) complementation with GestureCollection. Functional magnetic resonance imaging exams and clinical assessments were performed before and after the treatment. A functional connectivity graph-based analysis was used to assess differences between the connections and in the network parameters strength and clustering coefficient. Results Patients in both groups showed improvement in clinical scales, but there were more increases in functional connectivity in the experimental group than in the control group. Discussion The experimental group presented changes in the connections between the frontoparietal and the somatomotor networks, associative cerebellum and basal ganglia, which are regions associated with reward-based motor learning. On the other hand, the control group also had results in the somatomotor network, in its ipsilateral connections with the thalamus and with the motor cerebellum, which are regions more related to a purely mechanical activity. Thus, the use of the GestureCollection system was successfully shown to promote neuroplasticity in several motor-related areas.
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Affiliation(s)
- Jamille Almeida Feitosa
- Gleb Wataghin Institute of Physics, University of Campinas – UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology – BRAINN, Campinas, Brazil
| | - Raphael Fernandes Casseb
- Brazilian Institute of Neuroscience and Neurotechnology – BRAINN, Campinas, Brazil
- Neuroimaging Laboratory, Department of Neurology, University of Campinas – UNICAMP, Campinas, Brazil
| | - Alline Camargo
- Neuroimaging Laboratory, Department of Neurology, University of Campinas – UNICAMP, Campinas, Brazil
| | - Alexandre Fonseca Brandao
- Gleb Wataghin Institute of Physics, University of Campinas – UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology – BRAINN, Campinas, Brazil
| | - Li Min Li
- Brazilian Institute of Neuroscience and Neurotechnology – BRAINN, Campinas, Brazil
- Neuroimaging Laboratory, Department of Neurology, University of Campinas – UNICAMP, Campinas, Brazil
| | - Gabriela Castellano
- Gleb Wataghin Institute of Physics, University of Campinas – UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology – BRAINN, Campinas, Brazil
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15
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Spadone S, de Pasquale F, Chiacchiaretta P, Pavone L, Capotosto P, Delli Pizzi S, Digiovanni A, Sensi SL, Committeri G, Baldassarre A. Reduced Segregation of Brain Networks in Spatial Neglect After Stroke. Brain Connect 2023; 13:464-472. [PMID: 36128806 DOI: 10.1089/brain.2021.0184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background/Purpose: To investigate the association between the degree of spatial neglect and the changes of brain system segregation (SyS; i.e., the ratio of the extent to which brain networks interact internally and with each other) after stroke. Methods: A cohort of 20 patients with right hemisphere lesion was submitted to neuropsychological assessment as well as to resting-state functional magnetic resonance imaging session at acute stage after stroke. The severity of spatial neglect was quantified using the Center of Cancellation (CoC) scores of the Bells cancellation test. For each patient, resting-state functional connectivity (FC) matrices were assessed by implementing a brain parcellation of nine networks that included the visual network, dorsal attention network (DAN), ventral attention network (VAN), sensorimotor network (SMN), auditory network, cingulo-opercular network, language network, frontoparietal network, and default mode network (DMN). For each patient and each network, we then computed the SyS derived by subtracting the between-network FC from the within-network FC (normalized by the within-network FC). Finally, for each network, the CoC scores were correlated with the SyS. Results: The correlational analyses indicated a negative association between CoC and SyS in the DAN, VAN, SMN, and DMN (q < 0.05 false discovery rate [FDR]-corrected). Patients with more severe spatial neglect exhibited lower SyS and vice versa. Conclusion: The loss of segregation in multiple and specific networks provides a functional framework for the deficits in spatial and nonspatial attention and motor/exploratory ability observed in neglect patients.
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Affiliation(s)
- Sara Spadone
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | | | - Piero Chiacchiaretta
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | | | - Paolo Capotosto
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Stefano Delli Pizzi
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Anna Digiovanni
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Stefano L Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Giorgia Committeri
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Antonello Baldassarre
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
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16
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de Pasquale F, Chiacchiaretta P, Pavone L, Sparano A, Capotosto P, Grillea G, Committeri G, Baldassarre A. Brain Topological Reorganization Associated with Visual Neglect After Stroke. Brain Connect 2023; 13:473-486. [PMID: 34269620 PMCID: PMC10618825 DOI: 10.1089/brain.2020.0969] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background/Purpose: To identify brain hubs that are behaviorally relevant for neglect after stroke as well as to characterize their functional architecture of communication. Methods: Twenty acute right hemisphere damaged patients underwent neuropsychological and resting-state functional magnetic resonance imaging sessions. Spatial neglect was assessed by means of the Center of Cancellation on the Bells Cancellation Test. For each patient, resting-state functional connectivity matrices were derived by adopting a brain parcellation scheme consisting of 153 nodes. For every node, we extracted its betweenness centrality (BC) defined as the portion of all shortest paths in the connectome involving such node. Then, neglect hubs were identified as those regions showing a high correlation between their BC and neglect scores. Results: A first set of neglect hubs was identified in multiple systems including dorsal attention and ventral attention, default mode, and frontoparietal executive-control networks within the damaged hemisphere as well as in the posterior and anterior cingulate cortex. Such cortical regions exhibited a loss of BC and increased (i.e., less efficient) weighted shortest path length (WSPL) related to severe neglect. Conversely, a second group of neglect hubs found in visual and motor networks, in the undamaged hemisphere, exhibited a pathological increase of BC and reduction of WSPL associated with severe neglect. Conclusion: The topological reorganization of the brain in neglect patients might reflect a maladaptive shift in processing spatial information from higher level associative-control systems to lower level visual and sensory-motor processing areas after a right hemisphere lesion.
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Affiliation(s)
| | - Piero Chiacchiaretta
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | | | | | - Paolo Capotosto
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | | | - Giorgia Committeri
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Antonello Baldassarre
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
- IRCCS NEUROMED, Pozzilli, Italy
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Reibelt A, Quandt F, Schulz R. Posterior parietal cortical areas and recovery after motor stroke: a scoping review. Brain Commun 2023; 5:fcad250. [PMID: 37810465 PMCID: PMC10551853 DOI: 10.1093/braincomms/fcad250] [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: 05/24/2023] [Revised: 08/25/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023] Open
Abstract
Brain imaging and electrophysiology have significantly enhanced our current understanding of stroke-related changes in brain structure and function and their implications for recovery processes. In the motor domain, most studies have focused on key motor areas of the frontal lobe including the primary and secondary motor cortices. Time- and recovery-dependent alterations in regional anatomy, brain activity and inter-regional connectivity have been related to recovery. In contrast, the involvement of posterior parietal cortical areas in stroke recovery is poorly understood although these regions are similarly important for important aspects of motor functioning in the healthy brain. Just in recent years, the field has increasingly started to explore to what extent posterior parietal cortical areas might undergo equivalent changes in task-related activation, regional brain structure and inter-regional functional and structural connectivity after stroke. The aim of this scoping review is to give an update on available data covering these aspects and thereby providing novel insights into parieto-frontal interactions for systems neuroscience stroke recovery research in the upper limb motor domain.
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Affiliation(s)
- Antonia Reibelt
- Experimental Electrophysiology and Neuroimaging Lab, Department of Neurology, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany
| | - Fanny Quandt
- Experimental Electrophysiology and Neuroimaging Lab, Department of Neurology, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany
| | - Robert Schulz
- Experimental Electrophysiology and Neuroimaging Lab, Department of Neurology, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany
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18
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Huang Y, Lin R, Li H, Xu Y, Tian F, Ma L, Liu X, Ma S, Li X, Lai Z, Bai C, He W, Ma Q, Wang J, Zhu N. Protocol for a single-blind randomized clinical trial to test the efficacy of bilateral transcranial magnetic stimulation on upper extremity motor function in patients recovering from stroke. Trials 2023; 24:601. [PMID: 37735708 PMCID: PMC10515042 DOI: 10.1186/s13063-023-07584-7] [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: 04/19/2023] [Accepted: 08/14/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND No consensus currently exists regarding the optimal protocol for repetitive transcranial magnetic stimulation (rTMS) treatment of upper-extremity motor dysfunction after stroke. Studies have shown that combined low- and high-frequency stimulation (LF-HF-rTMS) of the bilateral cerebral hemispheres is more effective than sham stimulation or stimulation of one cerebral hemisphere alone in treating motor dysfunction in the subacute stage of stroke. The efficacy of this protocol in the convalescence phase of stroke has rarely been reported, and its mechanism of action has not been clarified. In this study, we designed a prospective, single-blind, randomized controlled trial to investigate the efficacy and safety of different stimulation regimens for the treatment of upper extremity motor disorders in patients with convalescent stage stroke and aimed to explore the underlying mechanisms based on biomarkers such as brain-derived neurotrophic factor (BDNF). METHODS Seventy-six subjects will be randomly divided into combined, low-frequency, high-frequency, and control groups based on the proportion of 1:1:1:1, with 19 cases in each group. All groups will have conventional rehabilitation, on top of which the combined group will receive 1 Hz rTMS in the unaffected hemisphere and 10 Hz rTMS in the affected hemisphere. The low-frequency group will be administered 1 Hz rTMS in the unaffected hemisphere and sham stimulation in the contralateral hemisphere. The high-frequency group will be administered 10 Hz rTMS in the affected hemisphere and contralateral sham stimulation. The control group will receive bilateral sham stimulation. Assessments will be performed at baseline, after 2 weeks of treatment, and at post-treatment follow-up at week 6. The primary outcomes are FMA-UE (Fugl-Meyer assessment-upper extremity), latency, and serum BDNF levels. The secondary outcomes are the National Institute of Health Stroke Scale (NIHSS), Brunnstrom staging (BS), modified Ashworth scale (MAS), Modified Barthel Index (MBI), central motor conduction time (CMCT), precursor proteins of mature BDNF (proBDNF), and matrix metalloproteinase-9 (MMP-9) levels. Adverse events, such as headaches and seizures, will be recorded throughout the study. DISCUSSION The findings of this study will help develop optimal stimulation protocols for motor recovery in stroke patients and identify biomarkers that respond to post-stroke motor rehabilitation, for better guidance of clinical treatment. TRIAL REGISTRATION The study protocol was passed by the Medical Research Ethics Committee of the General Hospital of Ningxia Medical University on January 1, 2022 (no. KYLL-2021-1082). It was registered into the Chinese Clinical Trials Registry on May 22, 2022 (no. ChiCTR2200060201). This study is currently in progress.
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Affiliation(s)
- Yuan Huang
- Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Ruizhu Lin
- Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Hongyu Li
- Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Yujuan Xu
- Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Fubao Tian
- Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Liangchen Ma
- Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Xiaoli Liu
- Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Shuming Ma
- Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Xiaolong Li
- Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Zheying Lai
- Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Chuanping Bai
- Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Weichun He
- Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Qi Ma
- Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Jingkai Wang
- Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Ning Zhu
- Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.
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Yoo YJ, Lim SH, Kim Y, Kim JS, Hong BY, Yoon MJ, Rim H, Park GY. Structural Integrity of the Cerebellar Outflow Tract Predicts Long-Term Motor Function After Middle Cerebral Artery Ischemic Stroke. Neurorehabil Neural Repair 2023; 37:554-563. [PMID: 37269119 DOI: 10.1177/15459683231177607] [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: 06/04/2023]
Abstract
BACKGROUND The cerebellum plays a crucial role in functional movement by influencing sensorimotor coordination and learning. However, the effects of cortico-cerebellar connectivity on the recovery of upper extremity motor function after stroke have not been investigated. We hypothesized that the integrity of the cortico-cerebellar connections would be reduced in patients with a subacute middle cerebral artery (MCA) stroke, and that this reduction may help to predict chronic upper extremity motor function. METHODS We retrospectively analyzed the diffusion-tensor imaging of 25 patients with a subacute MCA stroke (mean age: 62.2 ± 2.7 years; 14 females) and 25 age- and sex-matched healthy controls. We evaluated the microstructural integrity of the corticospinal tract (CST), dentatothalamocortical tract (DTCT), and corticopontocerebellar tract (CPCT). Furthermore, we created linear regression models to predict chronic upper extremity motor function based on the structural integrity of each tract. RESULTS In stroke patients, the affected DTCT and CST showed significantly impaired structural integrity compared to unaffected tracts and the tracts in controls. When all models were compared, the model that used the fractional anisotropy (FA) asymmetry indices of CST and DTCT as independent variables best predicted chronic upper extremity motor function (R2 = .506, P = .001). The extent of structural integrity of the CPCT did not significantly differ between hemispheres or groups and was not predictive of motor function. CONCLUSIONS We found evidence that microstructural integrity of the DTCT in the subacute phase of an MCA stroke helped to predict chronic upper extremity motor function, independent of CST status.
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Affiliation(s)
- Yeun Jie Yoo
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Republic of Korea
| | - Seong Hoon Lim
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Republic of Korea
| | - Youngkook Kim
- Department of Rehabilitation Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Republic of Korea
| | - Joon-Sung Kim
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Republic of Korea
| | - Bo Young Hong
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Republic of Korea
| | - Mi-Jeong Yoon
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Republic of Korea
| | - Hanee Rim
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Republic of Korea
| | - Geun-Young Park
- Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Republic of Korea
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20
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Xu G, Huo C, Yin J, Zhong Y, Sun G, Fan Y, Wang D, Li Z. Test-retest reliability of fNIRS in resting-state cortical activity and brain network assessment in stroke patients. BIOMEDICAL OPTICS EXPRESS 2023; 14:4217-4236. [PMID: 37799694 PMCID: PMC10549743 DOI: 10.1364/boe.491610] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/24/2023] [Accepted: 07/05/2023] [Indexed: 10/07/2023]
Abstract
Resting-state functional near infrared spectroscopy (fNIRS) scanning has attracted considerable attention in stroke rehabilitation research in recent years. The aim of this study was to quantify the reliability of fNIRS in cortical activity intensity and brain network metrics among resting-state stroke patients, and to comprehensively evaluate the effects of frequency selection, scanning duration, analysis and preprocessing strategies on test-retest reliability. Nineteen patients with stroke underwent two resting fNIRS scanning sessions with an interval of 24 hours. The haemoglobin signals were preprocessed by principal component analysis, common average reference and haemodynamic modality separation (HMS) algorithm respectively. The cortical activity, functional connectivity level, local network metrics (degree, betweenness and local efficiency) and global network metrics were calculated at 25 frequency scales × 16 time windows. The test-retest reliability of each fNIRS metric was quantified by the intraclass correlation coefficient. The results show that (1) the high-frequency band has higher ICC values than the low-frequency band, and the fNIRS metric is more reliable than at the individual channel level when averaged within the brain region channel, (2) the ICC values of the low-frequency band above the 4-minute scan time are generally higher than 0.5, the local efficiency and global network metrics reach high and excellent reliability levels after 4 min (0.5 < ICC < 0.9), with moderate or even poor reliability for degree and betweenness (ICC < 0.5), (3) HMS algorithm performs best in improving the low-frequency band ICC values. The results indicate that a scanning duration of more than 4 minutes can lead to high reliability of most fNIRS metrics when assessing low-frequency resting brain function in stroke patients. It is recommended to use the global correction method of HMS, and the reporting of degree, betweenness and single channel level should be performed with caution. This paper provides the first comprehensive reference for resting-state experimental design and analysis strategies for fNIRS in stroke rehabilitation.
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Affiliation(s)
- Gongcheng Xu
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Congcong Huo
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Jiahui Yin
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Yanbiao Zhong
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Guoyu Sun
- Changsha Medical University, Changsha, China
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- School of Engineering Medicine, Beihang University, Beijing, China
| | - Daifa Wang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Zengyong Li
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China
- Key Laboratory of Neuro-functional Information and Rehabilitation Engineering of the Ministry of Civil Affairs, Beijing, China
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21
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Lin Y, Jiang Z, Zhan G, Su H, Kang X, Jia J. Brain network characteristics between subacute and chronic stroke survivors in active, imagery, passive movement task: a pilot study. Front Neurol 2023; 14:1143955. [PMID: 37538258 PMCID: PMC10395333 DOI: 10.3389/fneur.2023.1143955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/27/2023] [Indexed: 08/05/2023] Open
Abstract
Background The activation patterns and functional network characteristics between stroke survivors and healthy individuals based on resting-or task-state neuroimaging and neurophysiological techniques have been extensively explored. However, the discrepancy between stroke patients at different recovery stages remains unclear. Objective To investigate the changes in brain connectivity and network topology between subacute and chronic patients, and hope to provide a basis for rehabilitation strategies at different stages after stroke. Methods Fifteen stroke survivors were assigned to the subacute group (SG, N = 9) and chronic group (CG, N = 6). They were asked to perform hand grasping under active, passive, and MI conditions when recording EEG. The Fugl-Meyer Assessment Upper Extremity subscale (FMA_UE), modified Ashworth Scale (MAS), Manual Muscle Test (MMT), grip and pinch strength, modified Barthel Index (MBI), and Berg Balance Scale (BBS) were measured. Results Functional connectivity analyses showed significant interactions on frontal, parietal and occipital lobes connections in each frequency band, particularly in the delta band. The coupling strength of premotor cortex, M1, S1 and several connections linked to frontal, parietal, and occipital lobes in subacute subjects were lower than in chronic subjects in low alpha, high alpha, low beta, and high beta bands. Nodal clustering coefficient (CC) analyses revealed that the CC in chronic subjects was higher than in subacute subjects in the ipsilesional S1 and occipital area, contralesional dorsolateral prefrontal cortex and parietal area. Characteristic path length (CPL) analyses showed that CPL in subacute subjects was lower than in chronic subjects in low beta, high beta, and gamma bands. There were no significant differences between subacute and chronic subjects for small-world property. Conclusion Subacute stroke survivors were characterized by higher transfer efficiency of the entire brain network and weak local nodal effects. Transfer efficiency was reduced, the local nodal role was strengthened, and more neural resources needed to be mobilized to perform motor tasks for chronic survivors. Overall, these results may help to understand the remodeling pattern of the brain network for different post-stroke stages on task conditions and the mechanism of spontaneous recovery.
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Affiliation(s)
- Yifang Lin
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Jing’an District Central Hospital, Shanghai, China
| | - Zewu Jiang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Gege Zhan
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Haolong Su
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - XiaoYang Kang
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Jie Jia
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Jing’an District Central Hospital, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
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22
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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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23
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Xu M, Qian L, Wang S, Cai H, Sun Y, Thakor N, Qi X, Sun Y. Brain network analysis reveals convergent and divergent aberrations between mild stroke patients with cortical and subcortical infarcts during cognitive task performing. Front Aging Neurosci 2023; 15:1193292. [PMID: 37484690 PMCID: PMC10358837 DOI: 10.3389/fnagi.2023.1193292] [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: 03/24/2023] [Accepted: 06/09/2023] [Indexed: 07/25/2023] Open
Abstract
Although consistent evidence has revealed that cognitive impairment is a common sequela in patients with mild stroke, few studies have focused on it, nor the impact of lesion location on cognitive function. Evidence on the neural mechanisms underlying the effects of mild stroke and lesion location on cognitive function is limited. This prompted us to conduct a comprehensive and quantitative study of functional brain network properties in mild stroke patients with different lesion locations. Specifically, an empirical approach was introduced in the present work to explore the impact of mild stroke-induced cognitive alterations on functional brain network reorganization during cognitive tasks (i.e., visual and auditory oddball). Electroencephalogram functional connectivity was estimated from three groups (i.e., 40 patients with cortical infarctions, 48 patients with subcortical infarctions, and 50 healthy controls). Using graph theoretical analysis, we quantitatively investigated the topological reorganization of functional brain networks at both global and nodal levels. Results showed that both patient groups had significantly worse behavioral performance on both tasks, with significantly longer reaction times and reduced response accuracy. Furthermore, decreased global and local efficiency were found in both patient groups, indicating a mild stroke-related disruption in information processing efficiency that is independent of lesion location. Regarding the nodal level, both divergent and convergent node strength distribution patterns were revealed between both patient groups, implying that mild stroke with different lesion locations would lead to complex regional alterations during visual and auditory information processing, while certain robust cognitive processes were independent of lesion location. These findings provide some of the first quantitative insights into the complex neural mechanisms of mild stroke-induced cognitive impairment and extend our understanding of underlying alterations in cognition-related brain networks induced by different lesion locations, which may help to promote post-stroke management and rehabilitation.
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Affiliation(s)
- Mengru Xu
- Key Laboratory for Biomedical Engineering of Ministry of Education of China, Department of Biomedical Engineering, Zhejiang University, Hangzhou, China
| | - Linze Qian
- Key Laboratory for Biomedical Engineering of Ministry of Education of China, Department of Biomedical Engineering, Zhejiang University, Hangzhou, China
| | - Sujie Wang
- Key Laboratory for Biomedical Engineering of Ministry of Education of China, Department of Biomedical Engineering, Zhejiang University, Hangzhou, China
| | - Huaying Cai
- Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yi Sun
- Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Nitish Thakor
- Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
| | - Xuchen Qi
- Department of Neurosurgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Neurosurgery, Shaoxing People's Hospital, Shaoxing, China
| | - Yu Sun
- Key Laboratory for Biomedical Engineering of Ministry of Education of China, Department of Biomedical Engineering, Zhejiang University, Hangzhou, China
- Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- State Key Laboratory of Brain-Machine Intelligence, Zhejiang University, Hangzhou, China
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24
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Tozlu C, Card S, Jamison K, Gauthier SA, Kuceyeski A. Larger lesion volume in people with multiple sclerosis is associated with increased transition energies between brain states and decreased entropy of brain activity. Netw Neurosci 2023; 7:539-556. [PMID: 37397885 PMCID: PMC10312270 DOI: 10.1162/netn_a_00292] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/07/2022] [Indexed: 01/10/2024] Open
Abstract
Quantifying the relationship between the brain's functional activity patterns and its structural backbone is crucial when relating the severity of brain pathology to disability in multiple sclerosis (MS). Network control theory (NCT) characterizes the brain's energetic landscape using the structural connectome and patterns of brain activity over time. We applied NCT to investigate brain-state dynamics and energy landscapes in controls and people with MS (pwMS). We also computed entropy of brain activity and investigated its association with the dynamic landscape's transition energy and lesion volume. Brain states were identified by clustering regional brain activity vectors, and NCT was applied to compute the energy required to transition between these brain states. We found that entropy was negatively correlated with lesion volume and transition energy, and that larger transition energies were associated with pwMS with disability. This work supports the notion that shifts in the pattern of brain activity in pwMS without disability results in decreased transition energies compared to controls, but, as this shift evolves over the disease, transition energies increase beyond controls and disability occurs. Our results provide the first evidence in pwMS that larger lesion volumes result in greater transition energy between brain states and decreased entropy of brain activity.
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Affiliation(s)
- Ceren Tozlu
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Sophie Card
- Horace Greeley High School, Chappaqua, NY, USA
| | - Keith Jamison
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Susan A. Gauthier
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
- Judith Jaffe Multiple Sclerosis Center, Weill Cornell Medicine, New York, NY, USA
- Department of Neurology, Weill Cornell Medical College, New York, NY, USA
| | - Amy Kuceyeski
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
- Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA
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25
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Wang X, Zhou H, Hu Y. Altered neural associations with cognitive and emotional functions in cannabis dependence. Cereb Cortex 2023; 33:8724-8733. [PMID: 37143177 PMCID: PMC10505425 DOI: 10.1093/cercor/bhad153] [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: 11/01/2022] [Revised: 04/14/2023] [Accepted: 04/16/2023] [Indexed: 05/06/2023] Open
Abstract
Negative emotional state has been found to correlate with poor cognitive performance in cannabis-dependent (CD) individuals, but not healthy controls (HCs). To examine the neural substrates underlying such unusual emotion-cognition coupling, we analyzed the behavioral and resting state fMRI data from the Human Connectome Project and found opposite brain-behavior associations in the CD and HC groups: (i) although the cognitive performance was positively correlated with the within-network functional connectivity strength and segregation (i.e. clustering coefficient and local efficiency) of the cognitive network in HCs, these correlations were inversed in CDs; (ii) although the cognitive performance was positively correlated with the within-network Granger effective connectivity strength and integration (i.e. characteristic path length) of the cognitive network in CDs, such associations were not significant in HCs. In addition, we also found that the effective connectivity strength within cognition network mediated the behavioral coupling between emotional state and cognitive performance. These results indicate a disorganization of the cognition network in CDs, and may help improve our understanding of substance use disorder.
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Affiliation(s)
- Xinying Wang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Zijingang Campus, 866 Yuhangtang Road, Hangzhou, Zhejiang Province 310058, China
| | - Hui Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Zijingang Campus, 866 Yuhangtang Road, Hangzhou, Zhejiang Province 310058, China
| | - Yuzheng Hu
- Department of Psychology and Behavioral Sciences, Zhejiang University, Zijingang Campus, 866 Yuhangtang Road, Hangzhou, Zhejiang Province 310058, China
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26
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Ng S, Deverdun J, Lemaitre AL, Giampiccolo D, Bars EL, Moritz-Gasser S, Menjot de Champfleur N, Duffau H, Herbet G. Precuneal gliomas promote behaviorally relevant remodeling of the functional connectome. J Neurosurg 2023; 138:1531-1541. [PMID: 36308476 DOI: 10.3171/2022.9.jns221723] [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: 07/25/2022] [Accepted: 09/08/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The precuneus hosts one of the most complex patterns of functional connectivity in the human brain. However, due to the extreme rarity of neurological lesions specifically targeting this structure, it remains unknown how focal damage to the precuneus may impact resting-state functional connectivity (rsFC) at the brainwide level. The aim of this study was to investigate glioma-induced rsFC modulations and to identify patterns of rsFC remodeling that accounted for the maintenance of cognitive performance after awake-guided surgical excision. METHODS In a unique series of patients with IDH1-mutated low-grade gliomas (LGGs) infiltrating the precuneus who were treated at a single neurosurgical center (Montpellier University Medical Center, 2014-2021), the authors gauged the dynamic modulations induced by tumors on rsFC in comparison with healthy participants. All patients received a preoperative resting-state functional MRI and underwent operation guided by awake cognitive mapping. Connectome multivariate pattern analysis (MVPA), seed-network analysis, and graph theoretical analysis were conducted and correlated to executive neurocognitive scores (i.e., phonological and semantic fluencies, Trail-Making Test [TMT] parts A and B) obtained 3 months after surgery. RESULTS Seventeen patients with focal precuneal infiltration were selected (mean age 38.1 ± 11.2 years) and matched to 17 healthy participants (mean age 40.5 ± 10.4 years) for rsFC analyses. All patients underwent awake cognitive mapping, allowing total resection (n = 3) or subtotal resection (n = 14), with a mean extent of resection of 90.6% ± 7.3%. Using MVPA (cluster threshold: p-false discovery rate corrected < 0.05, voxel threshold: p-uncorrected < 0.001), remote hotspots with significant rsFC changes were identified, including both insulas, the anterior cingulate cortex, superior sensorimotor cortices, and both frontal eye fields. Further seed-network analyses captured 2 patterns of between-network redistribution especially involving hyperconnectivity between the salience, visual, and dorsal attentional networks. Finally, the global efficiency of the salience-visual-dorsal attentional networks was strongly and positively correlated to 3-month postsurgical scores (n = 15) for phonological fluency (r15 = 0.74, p = 0.0027); TMT-A (r15 = 0.65, p = 0.012); TMT-B (r15 = 0.70, p = 0.005); and TMT-B-A (r15 = 0.62, p = 0.018). CONCLUSIONS In patients with LGGs infiltrating the precuneus, remote and distributed functional connectivity modulations in the preoperative setting are associated with better maintenance of cognitive performance after surgery. These findings provide a new vision of the mechanistic principles underlying neural plasticity and cognitive compensation in patients with LGGs.
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Affiliation(s)
- Sam Ng
- Departments of1Neurosurgery and
- 2Team "Neuroplasticity, Stem Cells and Low-grade Gliomas," Institute of Functional Genomics of Montpellier, University of Montpellier, CNRS, INSERM, Montpellier
| | - Jeremy Deverdun
- 3I2FH, Institut d'Imagerie Fonctionnelle Humaine, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- 4Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier
| | - Anne-Laure Lemaitre
- Departments of1Neurosurgery and
- 2Team "Neuroplasticity, Stem Cells and Low-grade Gliomas," Institute of Functional Genomics of Montpellier, University of Montpellier, CNRS, INSERM, Montpellier
| | - Davide Giampiccolo
- 5Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London
- 6Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London; and
- 7Department of Neurosurgery, Institute of Neurosciences, Cleveland Clinic London, United Kingdom
| | - Emmanuelle Le Bars
- 3I2FH, Institut d'Imagerie Fonctionnelle Humaine, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- 4Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier
| | - Sylvie Moritz-Gasser
- Departments of1Neurosurgery and
- 2Team "Neuroplasticity, Stem Cells and Low-grade Gliomas," Institute of Functional Genomics of Montpellier, University of Montpellier, CNRS, INSERM, Montpellier
| | - Nicolas Menjot de Champfleur
- 3I2FH, Institut d'Imagerie Fonctionnelle Humaine, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- 4Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier
| | - Hugues Duffau
- Departments of1Neurosurgery and
- 2Team "Neuroplasticity, Stem Cells and Low-grade Gliomas," Institute of Functional Genomics of Montpellier, University of Montpellier, CNRS, INSERM, Montpellier
| | - Guillaume Herbet
- Departments of1Neurosurgery and
- 2Team "Neuroplasticity, Stem Cells and Low-grade Gliomas," Institute of Functional Genomics of Montpellier, University of Montpellier, CNRS, INSERM, Montpellier
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Lu M, Du Z, Zhao J, Jiang L, Liu R, Zhang M, Xu T, Wei J, Wang W, Xu L, Guo H, Chen C, Yu X, Tan Z, Fang J, Zou Y. Neuroimaging mechanisms of acupuncture on functional reorganization for post-stroke motor improvement: a machine learning-based functional magnetic resonance imaging study. Front Neurosci 2023; 17:1143239. [PMID: 37274194 PMCID: PMC10235506 DOI: 10.3389/fnins.2023.1143239] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/03/2023] [Indexed: 06/06/2023] Open
Abstract
Objective Motor recovery is crucial in stroke rehabilitation, and acupuncture can influence recovery. Neuroimaging and machine learning approaches provide new research directions to explore the brain functional reorganization and acupuncture mechanisms after stroke. We applied machine learning to predict the classification of the minimal clinically important differences (MCID) for motor improvement and identify the neuroimaging features, in order to explore brain functional reorganization and acupuncture mechanisms for motor recovery after stroke. Methods In this study, 49 patients with unilateral motor pathway injury (basal ganglia and/or corona radiata) after ischemic stroke were included and evaluated the motor function by Fugl-Meyer Assessment scores (FMA) at baseline and at 2-week follow-up sessions. Patients were divided by the difference between the twice FMA scores into one group showing minimal clinically important difference (MCID group, n = 28) and the other group with no minimal clinically important difference (N-MCID, n = 21). Machine learning was performed by PRoNTo software to predict the classification of the patients and identify the feature brain regions of interest (ROIs). In addition, a matched group of healthy controls (HC, n = 26) was enrolled. Patients and HC underwent magnetic resonance imaging examination in the resting state and in the acupuncture state (acupuncture at the Yanglingquan point on one side) to compare the differences in brain functional connectivity (FC) and acupuncture effects. Results Through machine learning, we obtained a balance accuracy rate of 75.51% and eight feature ROIs. Compared to HC, we found that the stroke patients with lower FC between these feature ROIs with other brain regions, while patients in the MCID group exhibited a wider range of lower FC. When acupuncture was applied to Yanglingquan (GB 34), the abnormal FC of patients was decreased, with different targets of effects in different groups. Conclusion Feature ROIs identified by machine learning can predict the classification of stroke patients with different motor improvements, and the FC between these ROIs with other brain regions is decreased. Acupuncture can modulate the bilateral cerebral hemispheres to restore abnormal FC via different targets, thereby promoting motor recovery after stroke. Clinical trial registration https://www.chictr.org.cn/showproj.html?proj=37359, ChiCTR1900022220.
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Affiliation(s)
- Mengxin Lu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhongming Du
- Department of Acupuncture, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jiping Zhao
- Department of Acupuncture, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Lan Jiang
- Department of Chinese Medicine, Peking Union Medical College Hospital, Beijing, China
| | - Ruoyi Liu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Muzhao Zhang
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Tianjiao Xu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jingpei Wei
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Wei Wang
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Lingling Xu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Haijiao Guo
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Chen Chen
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xin Yu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhongjian Tan
- Department of Radiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jiliang Fang
- Department of Radiology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yihuai Zou
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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28
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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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29
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Zhu D, Liu Y, Zhao Y, Yan L, Zhu L, Qian F, Wu M. Dynamic changes of resting state functional network following acute ischemic stroke. J Chem Neuroanat 2023; 130:102272. [PMID: 37044352 DOI: 10.1016/j.jchemneu.2023.102272] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/07/2023] [Accepted: 04/09/2023] [Indexed: 04/14/2023]
Abstract
Stroke, the second common cause of death in the world, is commonly considered to the well-known phenomenon of diaschisis. After stroke, regions far from the lesion can show altered neural activity. However, the comprehensive treatment recovery mechanism of acute ischemic stroke remains unclear. This study aims to investigate the impact of comprehensive treatment on resting state brain functional connectivity to reveal the therapeutic mechanism through a three time points study design. Twenty-one acute ischemic stroke patients and twenty matched healthy controls (HC) were included. Resting state functional magnetic resonance imaging (fMRI) and clinical evaluations were assessed in three stages: baseline (less than 72hours after stroke onset), post-first month and post-third month. Amplitude of low-frequency fluctuations (ALFF) and Independent component analysis (ICA) were conducted. We found: 1) stroke patients had decreased ALFF in the right cuneus (one of the important parts of the visual network). After three months, ALFF increased to the normal level; 2) the decreased functional connectivity in the right cuneus within the visual network and restored three months after onset. However, the decreased functional connectivity in the right precuneus within the default mode network restored one month after onset; 3) a significant association was found between the clinical scale score change over time and improvement in the cuneus and precuneus functional connectivity. Our results demonstrate the importance of the cuneus and precuneus within the visual network and default mode network in stroke recovery. These findings suggest that the different restored patterns of neural functional networks may contribute to the neurological function recovery. It has potential applications from stroke onset through rehabilitation because different rehabilitation phase corresponds to specific strategies.
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Affiliation(s)
- Dan Zhu
- Department of General Internal Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yongkang Liu
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yudong Zhao
- Department of General Internal Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Lei Yan
- Department of General Internal Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Lili Zhu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Science, Beijing, China
| | - Fei Qian
- Department of General Internal Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
| | - Minghua Wu
- Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
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30
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Huo C, Xu G, Xie H, Zhao H, Zhang X, Li W, Zhang S, Huo J, Li H, Sun A, Li Z. Effect of High-Frequency rTMS Combined with Bilateral Arm Training on Brain Functional Network in Patients with Chronic Stroke: An fNIRS study. Brain Res 2023; 1809:148357. [PMID: 37011721 DOI: 10.1016/j.brainres.2023.148357] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 03/06/2023] [Accepted: 03/31/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE Neurological evidence for the combinational intervention coupling rTMS with motor training for stroke rehabilitation remains limited. This study aimed to investigate the effects of rTMS combined with bilateral arm training (BAT) on the brain functional reorganization in patients with chronic stroke via functional near-infrared spectroscopy (fNIRS). METHODS Fifteen stroke patients and fifteen age-matched healthy participants were enrolled and underwent single BAT session (s-BAT) and BAT immediately after 5-Hz rTMS over the ipsilesional M1 (rTMS-BAT), measured cerebral haemodynamics by fNIRS. Functional connectivity (FC), the clustering coefficient (Ccoef), and local efficiency (Eloc) were applied to evaluate the functional response to the training paradigms. RESULTS The differences in FC responses to the two training paradigms were more pronounced in stroke patients than in healthy controls. In the resting state, stroke patients exhibited significantly lower FC than controls in both hemispheres. rTMS-BAT induced no significant difference in FC between groups. Compared to the resting state, rTMS-BAT induced significant decreases in Ccoef and Eloc of the contralesional M1 and significant increases in Eloc of the ipsilesional M1 in stroke patients. Additionally, these above two network metrics of the ipsilesional motor area were significantly positively correlated with the motor function of stroke patients. CONCLUSIONS These results suggest that the rTMS-BAT paradigm had additional effects on task-dependent brain functional reorganization. The engagement of the ipsilesional motor area in the functional network was associated with the motor impairment severity of stroke patients. fNIRS-based assessments may provide information about the neural mechanisms underlying combination interventions for stroke rehabilitation.
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31
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Lin S, Wang D, Sang H, Xiao H, Yan K, Wang D, Zhang Y, Yi L, Shao G, Shao Z, Yang A, Zhang L, Sun J. Predicting poststroke dyskinesia with resting-state functional connectivity in the motor network. NEUROPHOTONICS 2023; 10:025001. [PMID: 37025568 PMCID: PMC10072005 DOI: 10.1117/1.nph.10.2.025001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
SIGNIFICANCE Motor function evaluation is essential for poststroke dyskinesia rehabilitation. Neuroimaging techniques combined with machine learning help decode a patient's functional status. However, more research is needed to investigate how individual brain function information predicts the dyskinesia degree of stroke patients. AIM We investigated stroke patients' motor network reorganization and proposed a machine learning-based method to predict the patients' motor dysfunction. APPROACH Near-infrared spectroscopy (NIRS) was used to measure hemodynamic signals of the motor cortex in the resting state (RS) from 11 healthy subjects and 31 stroke patients, 15 with mild dyskinesia (Mild), and 16 with moderate-to-severe dyskinesia (MtS). The graph theory was used to analyze the motor network characteristics. RESULTS The small-world properties of the motor network were significantly different between groups: (1) clustering coefficient, local efficiency, and transitivity: MtS > Mild > Healthy and (2) global efficiency: MtS < Mild < Healthy. These four properties linearly correlated with patients' Fugl-Meyer Assessment scores. Using the small-world properties as features, we constructed support vector machine (SVM) models that classified the three groups of subjects with an accuracy of 85.7%. CONCLUSIONS Our results show that NIRS, RS functional connectivity, and SVM together constitute an effective method for assessing the poststroke dyskinesia degree at the individual level.
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Affiliation(s)
- Shuoshu Lin
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Dan Wang
- Beijing Rehabilitation Hospital of Capital Medical University, Department of Traditional Chinese Medicine, Beijing, China
| | - Haojun Sang
- Chinese Institute for Brain Research, Beijing, China
| | - Hongjun Xiao
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Kecheng Yan
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Dongyang Wang
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Yizheng Zhang
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Li Yi
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Guangjian Shao
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Zhiyong Shao
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Aoran Yang
- Beijing Rehabilitation Hospital of Capital Medical University, Department of Traditional Chinese Medicine, Beijing, China
| | - Lei Zhang
- Chinese Institute for Brain Research, Beijing, China
- Capital Medical University, School of Biomedical Engineering, Beijing, China
| | - Jinyan Sun
- Foshan University, School of Medicine, Foshan, China
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32
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Plautz EJ, Barbay S, Frost SB, Stowe AM, Dancause N, Zoubina EV, Eisner-Janowicz I, Guggenmos DJ, Nudo RJ. Spared Premotor Areas Undergo Rapid Nonlinear Changes in Functional Organization Following a Focal Ischemic Infarct in Primary Motor Cortex of Squirrel Monkeys. J Neurosci 2023; 43:2021-2032. [PMID: 36788028 PMCID: PMC10027035 DOI: 10.1523/jneurosci.1452-22.2023] [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: 07/23/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 02/16/2023] Open
Abstract
Recovery of motor function after stroke is accompanied by reorganization of movement representations in spared cortical motor regions. It is widely assumed that map reorganization parallels recovery, suggesting a causal relationship. We examined this assumption by measuring changes in motor representations in eight male and six female squirrel monkeys in the first few weeks after injury, a time when motor recovery is most rapid. Maps of movement representations were derived using intracortical microstimulation techniques in primary motor cortex (M1), ventral premotor cortex (PMv), and dorsal premotor cortex (PMd) in 14 adult squirrel monkeys before and after a focal infarct in the M1 distal forelimb area. Maps were derived at baseline and at either 2 (n = 7) or 3 weeks (n = 7) postinfarct. In PMv the forelimb maps remained unchanged at 2 weeks but contracted significantly (-42.4%) at 3 weeks. In PMd the forelimb maps expanded significantly (+110.6%) at 2 weeks but contracted significantly (-57.4%) at 3 weeks. Motor deficits were equivalent at both time points. These results highlight two features of plasticity after M1 lesions. First, significant contraction of distal forelimb motor maps in both PMv and PMd is evident by 3 weeks. Second, an unpredictable nonlinear pattern of reorganization occurs in the distal forelimb representation in PMd, first expanding at 2 weeks, and then contracting at 3 weeks postinjury. Together with previous results demonstrating reliable map expansions in PMv several weeks to months after M1 injury, the subacute time period may represent a critical window for the timing of therapeutic interventions.SIGNIFICANCE STATEMENT The relationship between motor recovery and motor map reorganization after cortical injury has rarely been examined in acute/subacute periods. In nonhuman primates, premotor maps were examined at 2 and 3 weeks after injury to primary motor cortex. Although maps are known to expand late after injury, the present study demonstrates early map expansion at 2 weeks (dorsal premotor cortex) followed by contraction at 3 weeks (dorsal and ventral premotor cortex). This nonlinear map reorganization during a time of gradual behavioral recovery suggests that the relationship between map plasticity and motor recovery is much more complex than previously thought. It also suggests that rehabilitative motor training may have its most potent effects during this early dynamic phase of map reorganization.
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Affiliation(s)
- Erik J Plautz
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, Kansas 66160
| | - Scott Barbay
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, Kansas 66160
| | - Shawn B Frost
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, Kansas 66160
| | - Ann M Stowe
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
| | - Numa Dancause
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
| | - Elena V Zoubina
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, Kansas 66160
| | - Ines Eisner-Janowicz
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
| | - David J Guggenmos
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
| | - Randolph J Nudo
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas 66160
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, Kansas 66160
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33
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Cao X, Wang Z, Chen X, Liu Y, Abdoulaye IA, Ju S, Zhang S, Wu S, Wang Y, Guo Y. Changes in Resting-State Neural Activity and Nerve Fibres in Ischaemic Stroke Patients with Hemiplegia. Brain Topogr 2023; 36:255-268. [PMID: 36604349 DOI: 10.1007/s10548-022-00937-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 12/30/2022] [Indexed: 01/07/2023]
Abstract
Many neuroimaging studies have reported that stroke induces abnormal brain activity. However, little is known about resting-state networks (RSNs) and the corresponding white matter changes in stroke patients with hemiplegia. Here, we utilized functional magnetic resonance imaging (fMRI) to measure neural activity and related fibre tracts in 14 ischaemic stroke patients with hemiplegia and 12 healthy controls. Fractional amplitude of low-frequency fluctuations (fALFF) calculation and correlation analyses were used to assess the relationship between regional neural activity and movement scores. Tractography was performed using diffusion tensor imaging (DTI) data to analyse the fibres passing through the regions of interest. Compared with controls, stroke patients showed abnormal functional connectivity (FC) between some brain regions in the RSNs. The fALFF was increased in the contralesional parietal lobe, with the regional fALFF being correlated with behavioural scores in stroke patients. Additionally, the passage of fibres across regions with reduced FC in the RSNs was increased in stroke patients. This study suggests that structural remodelling of functionally relevant white matter tracts is probably an adaptive response that compensates for injury to the brain.
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Affiliation(s)
- Xuejin Cao
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China
| | - Zan Wang
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China
| | - Xiaohui Chen
- Department of Radiology, Affiliated ZhongDa Hospital of Southeast University, Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, China
| | - Yanli Liu
- Department of Rehabilitation, Affiliated ZhongDa Hospital of Southeast University, Nanjing, China
| | - Idriss Ali Abdoulaye
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China
| | - Shenghong Ju
- Department of Radiology, Affiliated ZhongDa Hospital of Southeast University, Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, China
| | - Shiyao Zhang
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China
| | - Shanshan Wu
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China
| | - Yuancheng Wang
- Department of Radiology, Affiliated ZhongDa Hospital of Southeast University, Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, China
| | - Yijing Guo
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China. .,Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, 210009, Jiangsu Province, China.
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34
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Wang L, Wang S, Zhang S, Dou Z, Guo T. Effectiveness and Electrophysiological Mechanisms of Focal Vibration on Upper Limb Motor Dysfunction in Patients with Subacute Stroke: A Randomized Controlled Trial. Brain Res 2023; 1809:148353. [PMID: 36990135 DOI: 10.1016/j.brainres.2023.148353] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023]
Abstract
Upper limb motor dysfunction is a common complication after stroke, which has a negative impact on the daily life of patients. Focal vibration (FV) has been used to improve upper limb motor function in acute and chronic stroke patients, but its application in subacute stroke patients has not been extensively explored. Therefore, the purpose of this study was to explore the therapeutic effect of FV on upper limb motor function in subacute stroke patients and its underlying electrophysiological mechanism. Twenty-nine patients were enrolled and randomized into two groups: control group and vibration group. The control group were treated with conventional therapy including passive and active physical activity training, standing and sitting balance exercises, muscle strength training, hand extension and grasping exercises. The vibration group were given conventional rehabilitation and vibration therapy. A deep muscle stimulator (DMS) with a frequency of 60 Hz and an amplitude of 6 mm was used to provide vibration stimulation, which was sequentially applied along the biceps muscle to the flexor radialis of the affected limb for 10 minutes, once a day, and 6 times a week. Both groups received treatments for 4 consecutive weeks. In the vibration group, the motor evoked potential (MEP) latency and the somatosensory evoked potential (SEP) latency were significantly shortened (P<0.05) immediately after vibration and 30 minutes after vibration; the SEP amplitude and MEP amplitude were significantly increased (P<0.05) immediately after vibration and 30 minutes after vibration. The MEP latency (P=0.001) and SEP N20 latency (P=0.001) were shortened, and the MEP amplitude (P=0.011) and SEP N20 amplitude (P=0.017) were significantly increased after 4 weeks in the vibration group. After 4 consecutive weeks, the vibration group showed significant improvements in Modified Ashworth Scale (MAS) (P=0.037), Brunnstrom stage for upper extremity (BS-UE) (P=0.020), Fugl-Meyer assessment for upper extremity (FMA-UE) (P=0.029), Modified Barthel Index (MBI) (P=0.024), and SEP N20 (P=0.046) compared to the control group. The Brunnstrom stage for hand (BS-H) (P=0.451) did not show significant differences between the two groups. This study showed that FV was effective in improving upper limb motor function in subacute stroke patients. The underlying mechanism of FV may be that it enhances the efficacy of sensory pathways and induces plastic changes in the sensorimotor cortex.
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35
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Asadi B, Fard KR, Ansari NN, Marco Á, Calvo S, Herrero P. The Effect of dry Needling in Chronic Stroke with a complex Network Approach: A Case Study. Clin EEG Neurosci 2023; 54:179-188. [PMID: 35957591 DOI: 10.1177/15500594221120136] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: Dry Needling (DN) has been demonstrated to be effective in improving sensorimotor function and spasticity in patients with chronic stroke. Electroencephalogram (EEG) has been used to analyze if DN has effects on the central nervous system of patients with stroke. There are no studies on how DN works in patients with chronic stroke based on EEG analysis using complex networks. Objective: The aim of this study was to assess how DN works when it is applied in a patient with stroke, using the graph theory. Methods: One session of DN was applied to the spastic brachialis muscle of a 62-year-old man with right hemiplegia after stroke. EEG was used to analyze the effects of DN following metrics that measure the topological configuration: 1) network density, 2) clustering coefficient, 3) average shortest path length, 4) betweenness centrality, and 5) small-worldness. Measurements were taken before and during DN. Results: An improvement of the brain activity was observed in this patient with stroke after the application of DN, which led to variations of local parameters of the brain network in the delta, theta and alpha bands, and inclined towards those of the healthy control bands. Conclusions: This case study showed the positive effects of DN on brain network of a patient with chronic stroke.
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Affiliation(s)
- Borhan Asadi
- Department of Computer Engineering and Information Technology, 185151University of Qom, Qom, Iran
| | - Kheirollah Rahsepar Fard
- Department of Computer Engineering and Information Technology, 185151University of Qom, Qom, Iran
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, 48439Tehran University of Medical Sciences, Tehran, Iran.,Research Center for War-affected People, 48439Tehran University of Medical Sciences, Tehran, Iran
| | - Álvaro Marco
- Department of Electronic Engineering and Communications, Aragon Institute of Engineering Research, 16765University of Zaragoza, Zaragoza, Spain
| | - Sandra Calvo
- Department of Physiatry and Nursing, Faculty of Health Sciences, IIS Aragon, 16765University of Zaragoza, Zaragoza, Spain
| | - Pablo Herrero
- Department of Physiatry and Nursing, Faculty of Health Sciences, IIS Aragon, 16765University of Zaragoza, Zaragoza, Spain
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36
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Li Y, Zhang Y, Zhou W, Li R, Yu J, Gong L, Leng J, Lu F, Hou J, Chen H, Gao Q. Depression mediated the relationships between precentral-subcortical causal links and motor recovery in spinal cord injury patients. Cereb Cortex 2023:7034218. [PMID: 36775985 DOI: 10.1093/cercor/bhad035] [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: 11/15/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 02/14/2023] Open
Abstract
Depression after brain damage may impede the motivation and consequently influence the motor recovery after spinal cord injury (SCI); however, the neural mechanism underlying the psychological effects remains unclear. This study aimed to examine the casual connectivity changes of the emotion-motivation-motor circuit and the potential mediating effects of depression on motor recovery after SCI. Using the resting-state functional magnetic resonance imaging data of 35 SCI patients (24 good recoverers, GR and 11 poor recoverers, PR) and 32 healthy controls (HC), the results from the conditional Granger causality (GC) analysis demonstrated that the GR group exhibited sparser emotion-motivation-motor GC network compared with the HC and PR groups, though the in-/out-degrees of the emotion subnetwork and the motor subnetwork were relatively balanced in the HC and GR group. The PR group showed significantly inhibitory causal links from amygdala to supplementary motor area and from precentral gyrus to nucleus accumbens compared with GR group. Further mediation analysis revealed the indirect effect of the 2 causal connections on motor function recovery via depression severity. Our findings provide further evidence of abnormal causal connectivity in emotion-motivation-motor circuit in SCI patients and highlight the importance of emotion intervention for motor function recovery after SCI.
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Affiliation(s)
- Yan Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, No. 2006, Xiyuan Ave, West Hi-Tech Zone, 611731, P.R. China
| | - Yang Zhang
- The Southwest Hospital, Third Military Medical University, Chongqing, Gaotanyan Road, Shapingba District, 400038, P.R. China
| | - Weiqi Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, No. 2006, Xiyuan Ave, West Hi-Tech Zone, 611731, P.R. China
| | - Rong Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, No. 2006, Xiyuan Ave, West Hi-Tech Zone, 611731, P.R. China
| | - Jiali Yu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, No. 2006, Xiyuan Ave, West Hi-Tech Zone, 611731, P.R. China
| | - Lisha Gong
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, No. 2006, Xiyuan Ave, West Hi-Tech Zone, 611731, P.R. China
| | - Jinsong Leng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, No. 2006, Xiyuan Ave, West Hi-Tech Zone, 611731, P.R. China
| | - Fengmei Lu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, No. 2006, Xiyuan Ave, West Hi-Tech Zone, 611731, P.R. China
| | - Jingming Hou
- The Southwest Hospital, Third Military Medical University, Chongqing, Gaotanyan Road, Shapingba District, 400038, P.R. China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, No. 2006, Xiyuan Ave, West Hi-Tech Zone, 611731, P.R. China.,The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Yihuan Road, Qingyang District, 610072, P.R. China
| | - Qing Gao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, No. 2006, Xiyuan Ave, West Hi-Tech Zone, 611731, P.R. China
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37
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So I, Meusel LAC, Sharma B, Monette GA, Colella B, Wheeler AL, Rabin JS, Mikulis DJ, Green REA. Longitudinal Patterns of Functional Connectivity in Moderate-to-Severe Traumatic Brain Injury. J Neurotrauma 2023; 40:665-682. [PMID: 36367163 DOI: 10.1089/neu.2022.0242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Longitudinal neuroimaging studies aid our understanding of recovery mechanisms in moderate-to-severe traumatic brain injury (TBI); however, there is a dearth of longitudinal functional connectivity research. Our aim was to characterize longitudinal functional connectivity patterns in two clinically important brain networks, the frontoparietal network (FPN) and the default mode network (DMN), in moderate-to-severe TBI. This inception cohort study of prospectively collected longitudinal data used resting-state functional magnetic resonance imaging (fMRI) to characterize functional connectivity patterns in the FPN and DMN. Forty adults with moderate-to-severe TBI (mean ± standard deviation [SD]; age = 39.53 ± 16.49 years, education = 13.92 ± 3.20 years, lowest Glasgow Coma Scale score = 6.63 ± 3.24, sex = 70% male) were scanned at approximately 0.5, 1-1.5, and 3+ years post-injury. Seventeen healthy, uninjured participants (mean ± SD; age = 38.91 ± 15.57 years, education = 15.11 ± 2.71 years, sex = 29% male) were scanned at baseline and approximately 11 months afterwards. Group independent component analyses and linear mixed-effects modeling with linear splines that contained a knot at 1.5 years post-injury were employed to investigate longitudinal network changes, and associations with covariates, including age, sex, and injury severity. In patients with TBI, functional connectivity in the right FPN increased from approximately 0.5 to 1.5 years post-injury (unstandardized estimate = 0.19, standard error [SE] = 0.07, p = 0.009), contained a slope change in the opposite direction, from positive to negative at 1.5 years post-injury (estimate = -0.21, SE = 0.11, p = 0.009), and marginally declined afterwards (estimate = -0.10, SE = 0.06, p = 0.079). Functional connectivity in the DMN increased from approximately 0.5 to 1.5 years (estimate = 0.15, SE = 0.05, p = 0.006), contained a slope change in the opposite direction, from positive to negative at 1.5 years post-injury (estimate = -0.19, SE = 0.08, p = 0.021), and was estimated to decline from 1.5 to 3+ years (estimate = -0.04, SE = 0.04, p = 0.303). Similarly, the left FPN increased in functional connectivity from approximately 0.5 to 1.5 years post-injury (estimate = 0.15, SE = 0.05, p = 0.002), contained a slope change in the opposite direction, from positive to negative at 1.5 years post-injury (estimate = -0.18, SE = 0.07, p = 0.008), and was estimated to decline thereafter (estimate = -0.04, SE = 0.03, p = 0.254). At approximately 0.5 years post-injury, patients showed hypoconnectivity compared with healthy, uninjured participants at baseline. Covariates were not significantly associated in any of the models. Findings of early improvement but a tapering and possible decline in connectivity thereafter suggest that compensatory effects are time-limited. These later reductions in connectivity mirror growing evidence of behavioral and structural decline in chronic moderate-to-severe TBI. Targeting such declines represents a novel avenue of research and offers potential for improving clinical outcomes.
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Affiliation(s)
- Isis So
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,KITE Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
| | - Liesel-Ann C Meusel
- KITE Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
| | - Bhanu Sharma
- KITE Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.,Department of Medical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Georges A Monette
- Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
| | - Brenda Colella
- KITE Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
| | - Anne L Wheeler
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer S Rabin
- Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - David J Mikulis
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Medical Imaging, Toronto Western Hospital-University Health Network, Toronto, Ontario, Canada
| | - Robin E A Green
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,KITE Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
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38
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Kanishka, Jha SK. Compensatory cognition in neurological diseases and aging: A review of animal and human studies. AGING BRAIN 2023; 3:100061. [PMID: 36911258 PMCID: PMC9997140 DOI: 10.1016/j.nbas.2022.100061] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 12/27/2022] Open
Abstract
Specialized individual circuits in the brain are recruited for specific functions. Interestingly, multiple neural circuitries continuously compete with each other to acquire the specialized function. However, the dominant among them compete and become the central neural network for that particular function. For example, the hippocampal principal neural circuitries are the dominant networks among many which are involved in learning processes. But, in the event of damage to the principal circuitry, many times, less dominant networks compensate for the primary network. This review highlights the psychopathologies of functional loss and the aspects of functional recuperation in the absence of the hippocampus.
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Affiliation(s)
- Kanishka
- School of Life Sciences, Jawaharlal Nehru University, New Delhi 110067, India
| | - Sushil K Jha
- School of Life Sciences, Jawaharlal Nehru University, New Delhi 110067, India
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Yuan K, Ti CHE, Wang X, Chen C, Lau CCY, Chu WCW, Tong RKY. Individual electric field predicts functional connectivity changes after anodal transcranial direct-current stimulation in chronic stroke. Neurosci Res 2023; 186:21-32. [PMID: 36220454 DOI: 10.1016/j.neures.2022.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 09/29/2022] [Accepted: 10/04/2022] [Indexed: 11/05/2022]
Abstract
The neuromodulation effect of anodal tDCS is not thoroughly studied, and the heterogeneous profile of stroke individuals with brain lesions would further complicate the stimulation outcomes. This study aimed to investigate the functional changes in sensorimotor areas induced by anodal tDCS and whether individual electric field could predict the functional outcomes. Twenty-five chronic stroke survivors were recruited and divided into tDCS group (n = 12) and sham group (n = 13). Increased functional connectivity (FC) within the surrounding areas of ipsilesional primary motor cortex (M1) was only observed after anodal tDCS. Averaged FC among the ipsilesional sensorimotor regions was observed to be increased after anodal tDCS (t(11) = 2.57, p = 0.026), but not after sham tDCS (t(12) = 0.69, p = 0.50). Partial least square analysis identified positive correlations between electric field (EF) strength normal to the ipsilesional M1 surface and individual FC changes in tDCS group (r = 0.84, p < 0.001) but not in sham group (r = 0.21, p = 0.5). Our results indicated anodal tDCS facilitates the FC within the ipsilesional sensorimotor network in chronic stroke subjects, and individual electric field predicts the functional outcomes.
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Affiliation(s)
- Kai Yuan
- Department of Biomedical Engineering, Faculty of Engineering, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Chun-Hang Eden Ti
- Department of Biomedical Engineering, Faculty of Engineering, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Xin Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Cheng Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Cathy Choi-Yin Lau
- Department of Biomedical Engineering, Faculty of Engineering, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Winnie Chiu-Wing Chu
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Raymond Kai-Yu Tong
- Department of Biomedical Engineering, Faculty of Engineering, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China.
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40
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Potemkin N, Clarkson AN. Non-coding RNAs in stroke pathology, diagnostics, and therapeutics. Neurochem Int 2023; 162:105467. [PMID: 36572063 DOI: 10.1016/j.neuint.2022.105467] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/18/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
Ischemic stroke is a leading cause of death and disability worldwide. Methods to alleviate functional deficits after ischemic stroke focus on restoration of cerebral blood flow to the affected area. However, pharmacological or surgical methods such as thrombolysis and thrombectomy have a narrow effective window. Harnessing and manipulating neurochemical processes of recovery may provide an alternative to these methods. Recently, non-coding RNA (ncRNA) have been increasingly investigated for their contributions to the pathology of diseases and potential for diagnostic and therapeutic applications. Here we will review several ncRNA - H19, MALAT1, ANRIL, NEAT1, pseudogenes, small nucleolar RNA, piwi-interacting RNA and circular RNA - and their involvement in stroke pathology. We also examine these ncRNA as potential diagnostic biomarkers, particularly in circulating blood, and as targets for therapeutic interventions. An important aspect of this is a discussion of potential methods of treatment delivery to allow for targeting of interventions past the blood-brain barrier, including lipid nanoparticles, polymer nanoparticles, and viral and non-viral vectors. Overall, several long non-coding RNA (lncRNA) discussed here have strong implications for the development of pathology and functional recovery after ischemic stroke. LncRNAs H19 and ANRIL show potential as diagnostic biomarkers, while H19 and MALAT1 may prove to be effective therapeutics for both minimising damage as well as promoting recovery. Other ncRNA have also been implicated in ischemic stroke but are currently too poorly understood to make inferences for diagnosis or treatment. Whilst the field of ncRNAs is relatively new, significant work has already highlighted that ncRNAs represent a promising novel investigative tool for understanding stroke pathology, could be used as diagnostic biomarkers, and as targets for therapeutic interventions.
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Affiliation(s)
- Nikita Potemkin
- Department of Anatomy, Brain Health Research Centre and Brain Research New Zealand, University of Otago, Dunedin, 9054, New Zealand.
| | - Andrew N Clarkson
- Department of Anatomy, Brain Health Research Centre and Brain Research New Zealand, University of Otago, Dunedin, 9054, New Zealand.
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41
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Wang H, Xiong X, Zhang K, Wang X, Sun C, Zhu B, Xu Y, Fan M, Tong S, Guo X, Sun L. Motor network reorganization after motor imagery training in stroke patients with moderate to severe upper limb impairment. CNS Neurosci Ther 2022; 29:619-632. [PMID: 36575865 PMCID: PMC9873524 DOI: 10.1111/cns.14065] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/22/2022] [Accepted: 12/06/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Motor imagery training (MIT) has been widely used to improve hemiplegic upper limb function in stroke rehabilitation. The effectiveness of MIT is associated with the functional neuroplasticity of the motor network. Currently, brain activation and connectivity changes related to the motor recovery process after MIT are not well understood. AIM We aimed to investigate the neural mechanisms of MIT in stroke rehabilitation through a longitudinal intervention study design with task-based functional magnetic resonance imaging (fMRI) analysis. METHODS We recruited 39 stroke patients with moderate to severe upper limb motor impairment and randomly assigned them to either the MIT or control groups. Patients in the MIT group received 4 weeks of MIT therapy plus conventional rehabilitation, while the control group only received conventional rehabilitation. The assessment of Fugl-Meyer Upper Limb Scale (FM-UL) and Barthel Index (BI), and fMRI scanning using a passive hand movement task were conducted on all patients before and after treatment. The changes in brain activation and functional connectivity (FC) were analyzed. Pearson's correlation analysis was conducted to evaluate the association between neural functional changes and motor improvement. RESULTS The MIT group achieved higher improvements in FM-UL and BI relative to the control group after the treatment. Passive movement of the affected hand evoked an abnormal bilateral activation pattern in both groups before intervention. A significant Group × Time interaction was found in the contralesional S1 and ipsilesional M1, showing a decrease of activation after intervention specifically in the MIT group, which was negatively correlated with the FM-UL improvement. FC analysis of the ipsilesional M1 displayed the motor network reorganization within the ipsilesional hemisphere, which correlated with the motor score changes. CONCLUSIONS MIT could help decrease the compensatory activation at both hemispheres and reshape the FC within the ipsilesional hemisphere along with functional recovery in stroke patients.
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Affiliation(s)
- Hewei Wang
- Department of Rehabilitation MedicineHuashan Hospital Fudan UniversityShanghaiChina
| | - Xin Xiong
- School of Biomedical EngineeringShanghai Jiaotong UniversityShanghaiChina
| | - Kexu Zhang
- School of Biomedical EngineeringShanghai Jiaotong UniversityShanghaiChina
| | - Xu Wang
- School of Biomedical EngineeringShanghai Jiaotong UniversityShanghaiChina
| | - Changhui Sun
- Department of Rehabilitation MedicineHuashan Hospital Fudan UniversityShanghaiChina
| | - Bing Zhu
- Department of Rehabilitation MedicineHuashan Hospital Fudan UniversityShanghaiChina
| | - Yiming Xu
- Department of Rehabilitation MedicineHuashan Hospital Fudan UniversityShanghaiChina
| | - Mingxia Fan
- Shanghai Key Laboratory of Magnetic ResonanceEast China Normal UniversityShanghaiChina
| | - Shanbao Tong
- School of Biomedical EngineeringShanghai Jiaotong UniversityShanghaiChina
| | - Xiaoli Guo
- School of Biomedical EngineeringShanghai Jiaotong UniversityShanghaiChina
| | - Limin Sun
- Department of Rehabilitation MedicineHuashan Hospital Fudan UniversityShanghaiChina
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Ayasreh S, Jurado I, López-León CF, Montalà-Flaquer M, Soriano J. Dynamic and Functional Alterations of Neuronal Networks In Vitro upon Physical Damage: A Proof of Concept. MICROMACHINES 2022; 13:2259. [PMID: 36557557 PMCID: PMC9782595 DOI: 10.3390/mi13122259] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/06/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
There is a growing technological interest in combining biological neuronal networks with electronic ones, specifically for biological computation, human-machine interfacing and robotic implants. A major challenge for the development of these technologies is the resilience of the biological networks to physical damage, for instance, when used in harsh environments. To tackle this question, here, we investigated the dynamic and functional alterations of rodent cortical networks grown in vitro that were physically damaged, either by sequentially removing groups of neurons that were central for information flow or by applying an incision that cut the network in half. In both cases, we observed a remarkable capacity of the neuronal cultures to cope with damage, maintaining their activity and even reestablishing lost communication pathways. We also observed-particularly for the cultures cut in half-that a reservoir of healthy neurons surrounding the damaged region could boost resilience by providing stimulation and a communication bridge across disconnected areas. Our results show the remarkable capacity of neuronal cultures to sustain and recover from damage, and may be inspirational for the development of future hybrid biological-electronic systems.
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Affiliation(s)
- Sàlem Ayasreh
- Departament de Física de la Matèria Condensada, Universitat de Barcelona, E-08028 Barcelona, Spain
- Universitat de Barcelona Institute of Complex Systems (UBICS), E-08028 Barcelona, Spain
| | - Imanol Jurado
- Departament de Física de la Matèria Condensada, Universitat de Barcelona, E-08028 Barcelona, Spain
- Universitat de Barcelona Institute of Complex Systems (UBICS), E-08028 Barcelona, Spain
| | - Clara F. López-León
- Departament de Física de la Matèria Condensada, Universitat de Barcelona, E-08028 Barcelona, Spain
- Universitat de Barcelona Institute of Complex Systems (UBICS), E-08028 Barcelona, Spain
| | - Marc Montalà-Flaquer
- Departament de Física de la Matèria Condensada, Universitat de Barcelona, E-08028 Barcelona, Spain
- Universitat de Barcelona Institute of Complex Systems (UBICS), E-08028 Barcelona, Spain
| | - Jordi Soriano
- Departament de Física de la Matèria Condensada, Universitat de Barcelona, E-08028 Barcelona, Spain
- Universitat de Barcelona Institute of Complex Systems (UBICS), E-08028 Barcelona, Spain
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Yuasa A, Uehara S, Ushizawa K, Toyama T, Gomez-Tames J, Hirata A, Otaka Y. Effects of cerebellar transcranial direct current stimulation on upper limb motor function after stroke: study protocol for the pilot of a randomized controlled trial. Pilot Feasibility Stud 2022; 8:259. [PMCID: PMC9748387 DOI: 10.1186/s40814-022-01223-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
Transcranial direct current stimulation (tDCS) is a technique that can noninvasively modulate neural states in a targeted brain region. As cerebellar activity levels are associated with upper limb motor improvement after stroke, the cerebellum is a plausible target of tDCS. However, the effect of tDCS remains unclear. Here, we designed a pilot study to assess: (1) the feasibility of a study that aims to examine the effects of cerebellar tDCS combined with an intensive rehabilitation approach based on the concept of constraint-induced movement therapy (CIMT) and (2) the preliminary outcome of the combined approach on upper limb motor function in patients with stroke in the chronic stage.
Methods
This pilot study has a double-blind randomized controlled design. Twenty-four chronic stroke patients with mild to moderate levels of upper limb motor impairment will be randomly assigned to an active or sham tDCS group. The participants will receive 20 min of active or sham tDCS to the contralesional cerebellum at the commencement of 4 h of daily intensive training, repeatedly for 5 days per week for 2 weeks. The primary outcomes are recruitment, enrollment, protocol adherence, and retention rates and measures to evaluate the feasibility of the study. The secondary outcome is upper limb motor function which will be evaluated using the Action Research Arm Test, Fugl-Meyer Assessment, for the upper extremity and the Motor Activity Log. Additionally, neurophysiological and neuroanatomical assessments of the cerebellum will be performed using transcranial magnetic stimulation and magnetic resonance imaging. These assessments will be conducted before, at the middle, and after the 2-week intervention, and finally, 1 month after the intervention. Any adverse events that occur during the study will be recorded.
Discussion
Cerebellar tDCS combined with intensive upper limb training may increase the gains of motor improvement when compared to the sham condition. The present study should provide valuable evidence regarding the feasibility of the design and the efficacy of cerebellar tDCS for upper limb motor function in patients with stroke before a future large trial is conducted.
Trial registration
This study has been registered at the Japan Registry of Clinical Trials (jRCTs042200078). Registered 17 December 2020
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Zhu L, Yin H, Wang Y, Yang W, Dong T, Xu L, Hou Z, Shi Q, Shen Q, Lin Z, Zhao H, Xu Y, Chen Y, Wu J, Yu Z, Wen M, Huang J. Disrupted topological organization of the motor execution network in Wilson's disease. Front Neurol 2022; 13:1029669. [PMID: 36479050 PMCID: PMC9721349 DOI: 10.3389/fneur.2022.1029669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/08/2022] [Indexed: 07/25/2023] Open
Abstract
OBJECTIVE There are a number of symptoms associated with Wilson's disease (WD), including motor function damage. The neuropathological mechanisms underlying motor impairments in WD are, however, little understood. In this study, we explored changes in the motor execution network topology in WD. METHODS We conducted resting-state functional magnetic resonance imaging (fMRI) on 38 right-handed individuals, including 23 WD patients and 15 healthy controls of the same age. Based on graph theory, a motor execution network was constructed and analyzed. In this study, global, nodal, and edge topological properties of motor execution networks were compared. RESULTS The global topological organization of the motor execution network in the two groups did not differ significantly across groups. In the cerebellum, WD patients had a higher nodal degree. At the edge level, a cerebello-thalamo-striato-cortical circuit with altered functional connectivity strength in WD patients was observed. Specifically, the strength of the functional connections between the cerebellum and thalamus increased, whereas the cortical-thalamic, cortical-striatum and cortical-cerebellar connections exhibited a decrease in the strength of the functional connection. CONCLUSION There is a disruption of the topology of the motor execution network in WD patients, which may be the potential basis for WD motor dysfunction and may provide important insights into neurobiological research related to WD motor dysfunction.
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Hong W, Du Y, Xu R, Zhang X, Liu Z, Li M, Yu Z, Wang Y, Wang M, Yang B, Sun F, Xu G. Altered cerebellar functional connectivity in chronic subcortical stroke patients. Front Hum Neurosci 2022; 16:1046378. [DOI: 10.3389/fnhum.2022.1046378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/28/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPrevious studies demonstrated that cerebellar subregions are involved in different functions. Especially the cerebellar anterior lobe (CAL) and cerebellar posterior lobe (CPL) have been postulated to primarily account for sensorimotor and cognitive function, respectively. However, the functional connectivity (FC) alterations of CAL and CPL, and their relationships with behavior performance in chronic stroke participants are unclear so far.Materials and methodsThe present study collected resting-state fMRI data from thirty-six subcortical chronic stroke participants and thirty-eight well-matched healthy controls (HCs). We performed the FC analysis with bilateral CAL and CPL as seeds for each participant. Then, we detected the FC difference between the two groups by using a two-sample t-test and evaluated the relationship between the FC and scores of motor and cognitive assessments across all post-stroke participants by using partial correlation analysis.ResultsThe CAL showed increased FCs in the prefrontal cortex, superior/inferior temporal gyrus, and lingual gyrus, while the CPL showed increased FCs in the inferior parietal lobule, precuneus, and cingulum gyrus in the stroke participants compared with HCs. Moreover, the FC alteration in the right CAL and the right CPL were negatively correlated with executive and memory functions across stroke participants, respectively.ConclusionThese findings shed light on the different increased FC alteration patterns of CAL and CPL that help understand the neuro-mechanisms underlying behavior performance in chronic stroke survivors.
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Hu YS, Yue J, Ge Q, Feng ZJ, Wang J, Zang YF. Test-retest reliability of peak location in the sensorimotor network of resting state fMRI for potential rTMS targets. Front Neuroinform 2022; 16:882126. [PMID: 36262839 PMCID: PMC9574049 DOI: 10.3389/fninf.2022.882126] [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: 02/23/2022] [Accepted: 09/15/2022] [Indexed: 11/27/2022] Open
Abstract
Most stroke repetitive transcranial magnetic stimulation (rTMS) studies have used hand motor hotspots as rTMS stimulation targets; in addition, recent studies demonstrated that functional magnetic resonance imaging (fMRI) task activation could be used to determine suitable targets due to its ability to reveal individualized precise and stronger functional connectivity with motor-related brain regions. However, rTMS is unlikely to elicit motor evoked potentials in the affected hemisphere, nor would activity be detected when stroke patients with severe hemiplegia perform an fMRI motor task using the affected limbs. The current study proposed that the peak voxel in the resting-state fMRI (RS-fMRI) motor network determined by independent component analysis (ICA) could be a potential stimulation target. Twenty-one healthy young subjects underwent RS-fMRI at three visits (V1 and V2 on a GE MR750 scanner and V3 on a Siemens Prisma) under eyes-open (EO) and eyes-closed (EC) conditions. Single-subject ICA with different total number of components (20, 30, and 40) were evaluated, and then the locations of peak voxels on the left and right sides of the sensorimotor network (SMN) were identified. While most ICA RS-fMRI studies have been carried out on the group level, that is, Group-ICA, the current study performed individual ICA because only the individual analysis could guide the individual target of rTMS. The intra- (test-retest) and inter-scanner reliabilities of the peak location were calculated. The use of 40 components resulted in the highest test-retest reliability of the peak location in both the left and right SMN compared with that determined when 20 and 30 components were used for both EC and EO conditions. ICA with 40 components might be another way to define a potential target in the SMN for poststroke rTMS treatment.
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Affiliation(s)
- Yun-Song Hu
- Center for Cognition and Brain Disorders, The Affiliated Hospital Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
- Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, China
| | - Juan Yue
- Center for Cognition and Brain Disorders, The Affiliated Hospital Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
- Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, China
| | - Qiu Ge
- Center for Cognition and Brain Disorders, The Affiliated Hospital Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
- Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, China
| | - Zi-Jian Feng
- Center for Cognition and Brain Disorders, The Affiliated Hospital Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
- Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, China
| | - Jue Wang
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
- *Correspondence: Jue Wang
| | - Yu-Feng Zang
- Center for Cognition and Brain Disorders, The Affiliated Hospital Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
- Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, China
- Yu-Feng Zang
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Katsuno Y, Ueki Y, Ito K, Murakami S, Aoyama K, Oishi N, Kan H, Matsukawa N, Nagao K, Tatsumi H. Effects of a new speech support application on intensive speech therapy and changes in functional brain connectivity in patients with post-stroke aphasia. Front Hum Neurosci 2022; 16:870733. [PMID: 36211132 PMCID: PMC9535658 DOI: 10.3389/fnhum.2022.870733] [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: 02/07/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Aphasia is a language disorder that occurs after a stroke and impairs listening, speaking, reading, writing, and calculation skills. Patients with post-stroke aphasia in Japan are increasing due to population aging and the advancement of medical treatment. Opportunities for adequate speech therapy in chronic stroke are limited due to time constraints. Recent studies have reported that intensive speech therapy for a short period of time or continuous speech therapy using high-tech equipment, including speech applications (apps, can improve aphasia even in the chronic stage. However, its underlying mechanism for improving language function and its effect on other cognitive functions remains unclear. In the present study, we investigated whether intensive speech therapy using a newly developed speech support app could improve aphasia and other cognitive functions in patients with chronic stroke. Furthermore, we examined whether it can alter the brain network related to language and other cortical areas. Thus, we conducted a prospective, single-comparison study to examine the effects of a new speech support app on language and cognitive functions and used resting state functional MRI (rs-fMRI) regions of interest (ROI) to ROI analysis to determine changes in the related brain network. Two patients with chronic stroke participated in this study. They used the independent speech therapy system to perform eight sets of 20 randomly presented words/time (taking approximately 20 min), for 8 consecutive weeks. Their language, higher cognitive functions including attention function, and rs-fMRI, were evaluated before and after the rehabilitation intervention using the speech support app. Both patients had improved pronunciation, daily conversational situations, and attention. The rs-fMRI analysis showed increased functional connectivity of brain regions associated with language and attention related areas. Our results show that intensive speech therapy using this speech support app can improve language and attention functions even in the chronic stage of stroke, and may be a useful tool for patients with aphasia. In the future, we will conduct longitudinal studies with larger numbers of patients, which we hope will continue the trends seen in the current study, and provide even stronger evidence for the usefulness of this new speech support app.
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Affiliation(s)
- Yuta Katsuno
- Department of Rehabilitation Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | - Yoshino Ueki
- Department of Rehabilitation Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- *Correspondence: Yoshino Ueki
| | - Keiichi Ito
- Department of Rehabilitation Medicine, Kamiida Rehabilitation Hospital, Nagoya, Japan
| | - Satona Murakami
- Department of Rehabilitation Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Satona Murakami
| | - Kiminori Aoyama
- Department of Rehabilitation Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Naoya Oishi
- Medical Innovation Centre, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hirohito Kan
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Noriyuki Matsukawa
- Department of Neurology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Katashi Nagao
- Department of Intelligent Systems, Graduate School of Informatics, Nagoya University, Nagoya, Japan
| | - Hiroshi Tatsumi
- Department of Health Science, Aichi Gakuin University, Nagoya, Japan
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48
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Zhang J, Chang Y. Alterations of static and dynamic functional network connectivity in acute ischemic brainstem stroke. Acta Radiol 2022; 64:1623-1630. [PMID: 36113019 DOI: 10.1177/02841851221127271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Prior studies have shown abnormal brain functional network changes in patients with acute ischemic stroke. However, the alterations of dynamic functional network connectivity (FNC) in brainstem strokes have not been elucidated. Purpose To assess alterations of static and dynamic FNCs and determine the relationships between these and upper limb movement performance in patients with acute brainstem ischemic stroke. Material and Methods In total, 50 patients with acute brainstem ischemic stroke and 50 age- and sex-matched healthy controls were enrolled in the present study and underwent resting-state functional magnetic resonance imaging (rs-fMRI). Independent component analysis was conducted to assess static and dynamic FNC patterns based on seven resting-state networks, namely, the default mode network (DMN), executive control network (ECN), attention network (AN), somatomotor network (SMN), visual network (VN), auditory network (AUN), and cerebellum network (CN). Results Compared with controls, patients with acute brainstem ischemic stroke exhibited wide aberrations of static FNC, including increased FNC in DMN–ECN, DMN–VN, ECN–VN, ECN–AN and AN–AUN pairs. Patients with acute brainstem ischemic stroke showed aberrant dynamic FNC in State 1, involving increased FNC aberrance in the DMN with AN, DMN with ECN, and reduced FNC in SMN–VN pairs. In State 5, patients with acute brainstem ischemic stroke showed increased FNC in DMN–VN and AN–AUN, and decreased FNC in AN–SMN pairs. Conclusion This study suggests that static and dynamic FNC impairment and aberrant connections exist in acute brainstem ischemic stroke, which expands what is known regarding the relationship between stroke and FNC from static and dynamic perspectives.
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Affiliation(s)
- Jian Zhang
- Department of Radiology, Taizhou People’s Hospital, Fifth Affiliated Hospital of Nantong University, Taizhou, Jiangsu, PR China
| | - Yi Chang
- Department of Radiology, Taizhou People’s Hospital, Fifth Affiliated Hospital of Nantong University, Taizhou, Jiangsu, PR China
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49
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Li Y, Yu Z, Wu P, Chen J. Ability of an altered functional coupling between resting-state networks to predict behavioral outcomes in subcortical ischemic stroke: A longitudinal study. Front Aging Neurosci 2022; 14:933567. [PMID: 36185473 PMCID: PMC9520312 DOI: 10.3389/fnagi.2022.933567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/16/2022] [Indexed: 11/22/2022] Open
Abstract
Stroke can be viewed as an acute disruption of an individual's connectome caused by a focal or widespread loss of blood flow. Although individuals exhibit connectivity changes in multiple functional networks after stroke, the neural mechanisms that underlie the longitudinal reorganization of the connectivity patterns are still unclear. The study aimed to determine whether brain network connectivity patterns after stroke can predict longitudinal behavioral outcomes. Nineteen patients with stroke with subcortical lesions underwent two sessions of resting-state functional magnetic resonance imaging scanning at a 1-month interval. By independent component analysis, the functional connectivity within and between multiple brain networks (including the default mode network, the dorsal attention network, the limbic network, the visual network, and the frontoparietal network) was disrupted after stroke and partial recovery at the second time point. Additionally, regression analyses revealed that the connectivity between the limbic and dorsal attention networks at the first time point showed sufficient reliability in predicting the clinical scores (Fugl-Meyer Assessment and Neurological Deficit Scores) at the second time point. The overall findings suggest that functional coupling between the dorsal attention and limbic networks after stroke can be regarded as a biomarker to predict longitudinal clinical outcomes in motor function and the degree of neurological functional deficit. Overall, the present study provided a novel opportunity to improve prognostic ability after subcortical strokes.
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Affiliation(s)
- Yongxin Li
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Zeyun Yu
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ping Wu
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiaxu Chen
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
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50
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Almeida SRM, Stefano Filho CA, Vicentini J, Novi SL, Mesquita RC, Castellano G, Li LM. Modeling functional network topology following stroke through graph theory: functional reorganization and motor recovery prediction. Braz J Med Biol Res 2022; 55:e12036. [PMID: 35976269 PMCID: PMC9377533 DOI: 10.1590/1414-431x2022e12036] [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: 12/18/2021] [Accepted: 06/10/2022] [Indexed: 11/21/2022] Open
Abstract
The study of functional reorganization following stroke has been steadily growing
supported by advances in neuroimaging techniques, such as functional magnetic
resonance imaging (fMRI). Concomitantly, graph theory has been increasingly
employed in neuroscience to model the brain's functional connectivity (FC) and
to investigate it in a variety of contexts. The aims of this study were: 1) to
investigate the reorganization of network topology in the ipsilesional (IL) and
contralesional (CL) hemispheres of stroke patients with (motor stroke group) and
without (control stroke group) motor impairment, and 2) to predict motor
recovery through the relationship between local topological variations of the
functional network and increased motor function. We modeled the brain's FC as a
graph using fMRI data, and we characterized its interactions with the following
graph metrics: degree, clustering coefficient, characteristic path length, and
betweenness centrality (BC). For both patient groups, BC yielded the largest
variations between the two analyzed time points, especially in the motor stroke
group. This group presented significant correlations (P<0.05) between average
BC changes and the improvements in upper-extremity Fugl-Meyer (UE-FM) scores at
the primary sensorimotor cortex and the supplementary motor area for the CL
hemisphere. These regions participate in processes related to the selection,
planning, and execution of movement. Generally, higher increases in average BC
over these areas were related to larger improvements in UE-FM assessment.
Although the sample was small, these results suggest the possibility of using BC
as an indication of brain plasticity mechanisms following stroke.
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Affiliation(s)
- S R M Almeida
- Departamento de Neurologia, Faculdade de Ciências Médicas, Universidade de Campinas, Campinas, SP, Brasil.,BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil
| | - C A Stefano Filho
- BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil.,Grupo de Neurofísica, Instituto de Física "Gleb Wataghin", Universidade de Campinas, Campinas, SP, Brasil
| | - J Vicentini
- Departamento de Neurologia, Faculdade de Ciências Médicas, Universidade de Campinas, Campinas, SP, Brasil.,BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil
| | - S L Novi
- BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil.,Grupo de Neurofísica, Instituto de Física "Gleb Wataghin", Universidade de Campinas, Campinas, SP, Brasil
| | - R C Mesquita
- BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil.,Grupo de Neurofísica, Instituto de Física "Gleb Wataghin", Universidade de Campinas, Campinas, SP, Brasil
| | - G Castellano
- BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil.,Grupo de Neurofísica, Instituto de Física "Gleb Wataghin", Universidade de Campinas, Campinas, SP, Brasil
| | - L M Li
- Departamento de Neurologia, Faculdade de Ciências Médicas, Universidade de Campinas, Campinas, SP, Brasil.,BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil
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