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Toba MN, Malkinson TS, Howells H, Mackie MA, Spagna A. Same, Same but Different? A Multi-Method Review of the Processes Underlying Executive Control. Neuropsychol Rev 2024; 34:418-454. [PMID: 36967445 DOI: 10.1007/s11065-023-09577-4] [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: 02/17/2022] [Accepted: 09/26/2022] [Indexed: 03/29/2023]
Abstract
Attention, working memory, and executive control are commonly considered distinct cognitive functions with important reciprocal interactions. Yet, longstanding evidence from lesion studies has demonstrated both overlap and dissociation in their behavioural expression and anatomical underpinnings, suggesting that a lower dimensional framework could be employed to further identify processes supporting goal-directed behaviour. Here, we describe the anatomical and functional correspondence between attention, working memory, and executive control by providing an overview of cognitive models, as well as recent data from lesion studies, invasive and non-invasive multimodal neuroimaging and brain stimulation. We emphasize the benefits of considering converging evidence from multiple methodologies centred on the identification of brain mechanisms supporting goal-driven behaviour. We propose that expanding on this approach should enable the construction of a comprehensive anatomo-functional framework with testable new hypotheses, and aid clinical neuroscience to intervene on impairments of executive functions.
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Affiliation(s)
- Monica N Toba
- Laboratory of Functional Neurosciences (UR UPJV 4559), University Hospital of Amiens and University of Picardie Jules Verne, Amiens, France.
- CHU Amiens Picardie - Site Sud, Centre Universitaire de Recherche en Santé, Avenue René Laënnec, 80054, Amiens Cedex 1, France.
| | - Tal Seidel Malkinson
- Paris Brain Institute, ICM, Hôpital de La Pitié-Salpêtrière, Sorbonne Université, Inserm U 1127, CNRS UMR 7225, 75013, Paris, France
- Université de Lorraine, CRAN, F-54000, Nancy, France
| | - Henrietta Howells
- Laboratory of Motor Control, Department of Medical Biotechnologies and Translational Medicine, Humanitas Research Hospital, IRCCS, Università Degli Studi Di Milano, Milan, Italy
| | - Melissa-Ann Mackie
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alfredo Spagna
- Department of Psychology, Columbia University, New York, NY, 10025, USA.
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2
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Moore MJ, Byrne J, Gibson EC, Ford L, Robinson GA. Hayling and stroop tests tap dissociable deficits and network-level neural correlates. Brain Struct Funct 2024; 229:879-896. [PMID: 38478051 PMCID: PMC11004053 DOI: 10.1007/s00429-024-02767-7] [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: 03/06/2023] [Accepted: 01/24/2024] [Indexed: 04/10/2024]
Abstract
Although many executive function screens have been developed, it is not yet clear whether these assessments are equally effective in detecting post-stroke deficits of initiation and inhibition. This study presents a comparative analysis of the Stroop and Hayling tests aiming to evaluate whether these tests measure the same underlying cognitive functions and to identify the neural correlates of the deficits detected by both tasks. Sixty six stroke survivors and 70 healthy ageing controls completed the Hayling and Stroop tests. Stroke patients were found to exhibit qualitative performance differences across analogous Stroop and Hayling Test metrics intended to tap initiation and inhibition. The Stroop test was found to have high specificity to abnormal performance, but low sensitivity relative to the Hayling Test. Minimal overlap was present between the network-level correlates of analogous Stroop and Hayling Test metrics. Hayling Task strategy use metrics were significantly associated with distinct patterns of disconnection in stroke survivors, providing novel insight into the neural correlates of fine-grained behavioural patterns. Overall, these findings strongly suggest that the functions tapped by the Stroop and Hayling Test are both behaviourally and anatomically dissociable. The Hayling Test was found to offer improved sensitivity and detail relative to the Stroop test. This novel demonstration of the Hayling Test within the stroke population suggests that this task represents an effective measure for quantifying post-stroke initiation and inhibition deficits.
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Affiliation(s)
- Margaret Jane Moore
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, Australia
| | - Jessica Byrne
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - Emily C Gibson
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - Lucy Ford
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, Australia
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - Gail A Robinson
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, Australia.
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia.
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3
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Elmalem MS, Nachev P, Jha A. Graphs and the idiographic brain. Brain 2024; 147:752-754. [PMID: 38345412 PMCID: PMC10907078 DOI: 10.1093/brain/awae044] [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: 02/08/2024] [Accepted: 02/08/2024] [Indexed: 03/03/2024] Open
Abstract
This scientific commentary refers to ‘Integrating direct electrical brain stimulation with the human connectome’ by Coletta et al. (https://doi.org/10.1093/brain/awad402).
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Affiliation(s)
- Michael S Elmalem
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, WC1B 5EH, UK
| | - Parashkev Nachev
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, WC1B 5EH, UK
| | - Ashwani Jha
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, WC1B 5EH, UK
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4
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Sperber C, Wiesen D, Karnath H, de Haan B. The neuroanatomy of visual extinction following right hemisphere brain damage: Insights from multivariate and Bayesian lesion analyses in acute stroke. Hum Brain Mapp 2024; 45:e26639. [PMID: 38433712 PMCID: PMC10910281 DOI: 10.1002/hbm.26639] [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: 07/14/2023] [Revised: 01/08/2024] [Accepted: 02/06/2024] [Indexed: 03/05/2024] Open
Abstract
Multi-target attention, that is, the ability to attend and respond to multiple visual targets presented simultaneously on the horizontal meridian across both visual fields, is essential for everyday real-world behaviour. Given the close link between the neuropsychological deficit of extinction and attentional limits in healthy subjects, investigating the anatomy that underlies extinction is uniquely capable of providing important insights concerning the anatomy critical for normal multi-target attention. Previous studies into the brain areas critical for multi-target attention and its failure in extinction patients have, however, produced heterogeneous results. In the current study, we used multivariate and Bayesian lesion analysis approaches to investigate the anatomical substrate of visual extinction in a large sample of 108 acute right hemisphere stroke patients. The use of acute stroke patient data and multivariate/Bayesian lesion analysis approaches allowed us to address limitations associated with previous studies and so obtain a more complete picture of the functional network associated with visual extinction. Our results demonstrate that the right temporo-parietal junction (TPJ) is critically associated with visual extinction. The Bayesian lesion analysis additionally implicated the right intraparietal sulcus (IPS), in line with the results of studies in neurologically healthy participants that highlighted the IPS as the area critical for multi-target attention. Our findings resolve the seemingly conflicting previous findings, and emphasise the urgent need for further research to clarify the precise cognitive role of the right TPJ in multi-target attention and its failure in extinction patients.
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Affiliation(s)
- Christoph Sperber
- Center of Neurology, Division of NeuropsychologyHertie‐Institute for Clinical Brain Research, University of TübingenTübingenGermany
- Department of NeurologyInselspital, University Hospital BernBernSwitzerland
| | - Daniel Wiesen
- Center of Neurology, Division of NeuropsychologyHertie‐Institute for Clinical Brain Research, University of TübingenTübingenGermany
| | - Hans‐Otto Karnath
- Center of Neurology, Division of NeuropsychologyHertie‐Institute for Clinical Brain Research, University of TübingenTübingenGermany
- Department of PsychologyUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Bianca de Haan
- Centre for Cognitive Neuroscience, College of Health and Life Sciences, Brunel University LondonUxbridgeUK
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5
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Ribeiro M, Yordanova YN, Noblet V, Herbet G, Ricard D. White matter tracts and executive functions: a review of causal and correlation evidence. Brain 2024; 147:352-371. [PMID: 37703295 DOI: 10.1093/brain/awad308] [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: 10/08/2022] [Revised: 08/17/2023] [Accepted: 08/25/2023] [Indexed: 09/15/2023] Open
Abstract
Executive functions are high-level cognitive processes involving abilities such as working memory/updating, set-shifting and inhibition. These complex cognitive functions are enabled by interactions among widely distributed cognitive networks, supported by white matter tracts. Executive impairment is frequent in neurological conditions affecting white matter; however, whether specific tracts are crucial for normal executive functions is unclear. We review causal and correlation evidence from studies that used direct electrical stimulation during awake surgery for gliomas, voxel-based and tract-based lesion-symptom mapping, and diffusion tensor imaging to explore associations between the integrity of white matter tracts and executive functions in healthy and impaired adults. The corpus callosum was consistently associated with all executive processes, notably its anterior segments. Both causal and correlation evidence showed prominent support of the superior longitudinal fasciculus to executive functions, notably to working memory. More specifically, strong evidence suggested that the second branch of the superior longitudinal fasciculus is crucial for all executive functions, especially for flexibility. Global results showed left lateralization for verbal tasks and right lateralization for executive tasks with visual demands. The frontal aslant tract potentially supports executive functions, however, additional evidence is needed to clarify whether its involvement in executive tasks goes beyond the control of language. Converging evidence indicates that a right-lateralized network of tracts connecting cortical and subcortical grey matter regions supports the performance of tasks assessing response inhibition, some suggesting a role for the right anterior thalamic radiation. Finally, correlation evidence suggests a role for the cingulum bundle in executive functions, especially in tasks assessing inhibition. We discuss these findings in light of current knowledge about the functional role of these tracts, descriptions of the brain networks supporting executive functions and clinical implications for individuals with brain tumours.
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Affiliation(s)
- Monica Ribeiro
- Service de neuro-oncologie, Hôpital La Pitié-Salpêtrière, Groupe Hospitalier Universitaire Pitié Salpêtrière-Charles Foix, Sorbonne Université, 75013 Paris, France
- Université Paris Saclay, ENS Paris Saclay, Service de Santé des Armées, CNRS, Université Paris Cité, INSERM, Centre Borelli UMR 9010, 75006 Paris, France
| | - Yordanka Nikolova Yordanova
- Service de neurochirurgie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, 92140 Clamart, France
| | - Vincent Noblet
- ICube, IMAGeS team, Université de Strasbourg, CNRS, UMR 7357, 67412 Illkirch, France
| | - Guillaume Herbet
- Praxiling, UMR 5267, CNRS, Université Paul Valéry Montpellier 3, 34090 Montpellier, France
- Département de Neurochirurgie, Hôpital Gui de Chauliac, Centre Hospitalier Universitaire de Montpellier, 34295 Montpellier, France
- Institut Universitaire de France
| | - Damien Ricard
- Université Paris Saclay, ENS Paris Saclay, Service de Santé des Armées, CNRS, Université Paris Cité, INSERM, Centre Borelli UMR 9010, 75006 Paris, France
- Département de neurologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, 92140 Clamart, France
- Ecole du Val-de-Grâce, 75005 Paris, France
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6
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Doganci N, Yahia Coll S, Marti E, Ptak R. Anatomical predictors of mental rotation with bodily and non-bodily stimuli: A lesion-symptom study. Neuropsychologia 2024; 193:108775. [PMID: 38135209 DOI: 10.1016/j.neuropsychologia.2023.108775] [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: 11/02/2023] [Revised: 12/19/2023] [Accepted: 12/19/2023] [Indexed: 12/24/2023]
Abstract
Mental rotation (MR) is widely regarded as a quintessential example of an embodied cognitive process. This viewpoint stems from the functional parallels between MR and the physical rotation of tangible objects, as well as participants' inclination to employ motor-based strategies when tackling MR tasks involving bodily stimuli. These commonalities imply that MR may depend on brain regions crucial for the planning and execution of motor programs. However, there is disagreement regarding the anatomy of MR between findings from functional imaging and lesion studies involving brain-injured patients. The former indicate the involvement of the right-hemispheric parietal cortex, while the latter underscore the significance of posterior areas in the left hemisphere. In this study, we aimed to discern the neural underpinnings of MR using lesion-symptom mapping (LSM) for both bodily (hands) and non-bodily (letters) stimuli. Behavioral results from the two MR tasks revealed impaired MR of bodily stimuli in patients with left hemisphere damage. LSM results pinpointed the left primary motor and somatosensory cortices, along with the superior parietal lobule, as the anatomical substrates of MR for both bodily and non-bodily stimuli. Furthermore, damage to the left angular gyrus, supramarginal gyrus, supplementary motor area, and retrosplenial cortex was associated with MR of non-bodily stimuli. These findings support the causal involvement of the left hemisphere in MR and underscore the existence of a common anatomical substrate in brain regions pertinent to motor planning and execution.
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Affiliation(s)
- Naz Doganci
- Laboratory of Cognitive Neurorehabilitation, Faculty of medicine, University of Geneva, 1206, Geneva, Switzerland.
| | - Sélim Yahia Coll
- Laboratory of Cognitive Neurorehabilitation, Faculty of medicine, University of Geneva, 1206, Geneva, Switzerland
| | - Emilie Marti
- Laboratory of Cognitive Neurorehabilitation, Faculty of medicine, University of Geneva, 1206, Geneva, Switzerland
| | - Radek Ptak
- Laboratory of Cognitive Neurorehabilitation, Faculty of medicine, University of Geneva, 1206, Geneva, Switzerland; Division of Neurorehabilitation, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
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7
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Jühling D, Rajashekar D, Cheng B, Hilgetag CC, Forkert ND, Werner R. Spatial normalization for voxel-based lesion symptom mapping: impact of registration approaches. Front Neurosci 2024; 18:1296357. [PMID: 38298911 PMCID: PMC10828036 DOI: 10.3389/fnins.2024.1296357] [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: 09/18/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024] Open
Abstract
Background Voxel-based lesion symptom mapping (VLSM) assesses the relation of lesion location at a voxel level with a specific clinical or functional outcome measure at a population level. Spatial normalization, that is, mapping the patient images into an atlas coordinate system, is an essential pre-processing step of VLSM. However, no consensus exists on the optimal registration approach to compute the transformation nor are downstream effects on VLSM statistics explored. In this work, we evaluate four registration approaches commonly used in VLSM pipelines: affine (AR), nonlinear (NLR), nonlinear with cost function masking (CFM), and enantiomorphic registration (ENR). The evaluation is based on a standard VLSM scenario: the analysis of statistical relations of brain voxels and regions in imaging data acquired early after stroke onset with follow-up modified Rankin Scale (mRS) values. Materials and methods Fluid-attenuated inversion recovery (FLAIR) MRI data from 122 acute ischemic stroke patients acquired between 2 and 3 days after stroke onset and corresponding lesion segmentations, and 30 days mRS values from a European multicenter stroke imaging study (I-KNOW) were available and used in this study. The relation of the voxel location with follow-up mRS was assessed by uni- as well as multi-variate statistical testing based on the lesion segmentations registered using the four different methods (AR, NLR, CFM, ENR; implementation based on the ANTs toolkit). Results The brain areas evaluated as important for follow-up mRS were largely consistent across the registration approaches. However, NLR, CFM, and ENR led to distortions in the patient images after the corresponding nonlinear transformations were applied. In addition, local structures (for instance the lateral ventricles) and adjacent brain areas remained insufficiently aligned with corresponding atlas structures even after nonlinear registration. Conclusions For VLSM study designs and imaging data similar to the present work, an additional benefit of nonlinear registration variants for spatial normalization seems questionable. Related distortions in the normalized images lead to uncertainties in the VLSM analyses and may offset the theoretical benefits of nonlinear registration.
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Affiliation(s)
- Daniel Jühling
- Institute of Applied Medical Informatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Bastian Cheng
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claus Christian Hilgetag
- Institute of Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Center for Biomedical Artificial Intelligence (bAIome), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Rene Werner
- Institute of Applied Medical Informatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Center for Biomedical Artificial Intelligence (bAIome), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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8
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Bourached A, Bonkhoff AK, Schirmer MD, Regenhardt RW, Bretzner M, Hong S, Dalca AV, Giese AK, Winzeck S, Jern C, Lindgren AG, Maguire J, Wu O, Rhee J, Kimchi EY, Rost NS. Scaling behaviours of deep learning and linear algorithms for the prediction of stroke severity. Brain Commun 2024; 6:fcae007. [PMID: 38274570 PMCID: PMC10808016 DOI: 10.1093/braincomms/fcae007] [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: 02/14/2023] [Revised: 09/01/2023] [Accepted: 01/09/2024] [Indexed: 01/27/2024] Open
Abstract
Deep learning has allowed for remarkable progress in many medical scenarios. Deep learning prediction models often require 105-107 examples. It is currently unknown whether deep learning can also enhance predictions of symptoms post-stroke in real-world samples of stroke patients that are often several magnitudes smaller. Such stroke outcome predictions however could be particularly instrumental in guiding acute clinical and rehabilitation care decisions. We here compared the capacities of classically used linear and novel deep learning algorithms in their prediction of stroke severity. Our analyses relied on a total of 1430 patients assembled from the MRI-Genetics Interface Exploration collaboration and a Massachusetts General Hospital-based study. The outcome of interest was National Institutes of Health Stroke Scale-based stroke severity in the acute phase after ischaemic stroke onset, which we predict by means of MRI-derived lesion location. We automatically derived lesion segmentations from diffusion-weighted clinical MRI scans, performed spatial normalization and included a principal component analysis step, retaining 95% of the variance of the original data. We then repeatedly separated a train, validation and test set to investigate the effects of sample size; we subsampled the train set to 100, 300 and 900 and trained the algorithms to predict the stroke severity score for each sample size with regularized linear regression and an eight-layered neural network. We selected hyperparameters on the validation set. We evaluated model performance based on the explained variance (R2) in the test set. While linear regression performed significantly better for a sample size of 100 patients, deep learning started to significantly outperform linear regression when trained on 900 patients. Average prediction performance improved by ∼20% when increasing the sample size 9× [maximum for 100 patients: 0.279 ± 0.005 (R2, 95% confidence interval), 900 patients: 0.337 ± 0.006]. In summary, for sample sizes of 900 patients, deep learning showed a higher prediction performance than typically employed linear methods. These findings suggest the existence of non-linear relationships between lesion location and stroke severity that can be utilized for an improved prediction performance for larger sample sizes.
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Affiliation(s)
- Anthony Bourached
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Anna K Bonkhoff
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Markus D Schirmer
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Robert W Regenhardt
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Martin Bretzner
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- University of Lille, Inserm, CHU Lille, U1171—LilNCog (JPARC)—Lille Neurosciences & Cognition, Lille F-59000, France
| | - Sungmin Hong
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Adrian V Dalca
- Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Anne-Katrin Giese
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg 20251, Germany
| | - Stefan Winzeck
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, USA
- Department of Computing, Imperial College London, London SW7 2RH, UK
| | - Christina Jern
- Institute of Biomedicine, Department of Laboratory Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg 41390, Sweden
- Department of Clinical Genetics and Genomics Gothenburg, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg 41345, Sweden
| | - Arne G Lindgren
- Department of Neurology, Skåne University Hospital, Lund 22185, Sweden
| | - Jane Maguire
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund 22185, Sweden
- University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Ona Wu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - John Rhee
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02139, USA
| | - Eyal Y Kimchi
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Evaston, IL 60201, USA
| | - Natalia S Rost
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
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9
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Moore MJ, Demeyere N, Rorden C, Mattingley JB. Lesion mapping in neuropsychological research: A practical and conceptual guide. Cortex 2024; 170:38-52. [PMID: 37940465 DOI: 10.1016/j.cortex.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 11/10/2023]
Affiliation(s)
- Margaret J Moore
- Queensland Brain Institute, The University of Queensland, St. Lucia, Australia.
| | - Nele Demeyere
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Chris Rorden
- Department of Psychology, University of South Carolina, Colombia, SC, USA
| | - Jason B Mattingley
- Queensland Brain Institute, The University of Queensland, St. Lucia, Australia; School of Psychology, The University of Queensland, St. Lucia, Australia
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10
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Riccardi N, Zhao X, den Ouden DB, Fridriksson J, Desai RH, Wang Y. Network-based statistics distinguish anomic and Broca's aphasia. Brain Struct Funct 2023:10.1007/s00429-023-02738-4. [PMID: 38160205 DOI: 10.1007/s00429-023-02738-4] [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: 03/03/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Aphasia is a speech-language impairment commonly caused by damage to the left hemisphere. The neural mechanisms that underpin different types of aphasia and their symptoms are still not fully understood. This study aims to identify differences in resting-state functional connectivity between anomic and Broca's aphasia measured through resting-state functional magnetic resonance imaging (rs-fMRI). METHODS We used the network-based statistic (NBS) method, as well as voxel- and connectome-based lesion symptom mapping (V-, CLSM), to identify distinct neural correlates of the anomic and Broca's groups. To control for lesion effect, we included lesion volume as a covariate in both the NBS method and LSM. RESULTS NBS identified a subnetwork located in the dorsal language stream bilaterally, including supramarginal gyrus, primary sensory, motor, and auditory cortices, and insula. The connections in the subnetwork were weaker in the Broca's group than the anomic group. The properties of the subnetwork were examined through complex network measures, which indicated that regions in right inferior frontal sulcus, right paracentral lobule, and bilateral superior temporal gyrus exhibit intensive interaction. Left superior temporal gyrus, right postcentral gyrus, and left supramarginal gyrus play an important role in information flow and overall communication efficiency. Disruption of this network underlies the constellation of symptoms associated with Broca's aphasia. Whole-brain CLSM did not detect any significant connections, suggesting an advantage of NBS when thousands of connections are considered. However, CLSM identified connections that differentiated Broca's from anomic aphasia when analysis was restricted to a hypothesized network of interest. DISCUSSION We identified novel signatures of resting-state brain network differences between groups of individuals with anomic and Broca's aphasia. We identified a subnetwork of connections that statistically differentiated the resting-state brain networks of the two groups, in comparison with standard CLSM results that yielded isolated connections. Network-level analyses are useful tools for the investigation of the neural correlates of language deficits post-stroke.
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Affiliation(s)
- Nicholas Riccardi
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Xingpei Zhao
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Dirk-Bart den Ouden
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Rutvik H Desai
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Yuan Wang
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA.
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11
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Moore MJ, Hearne L, Demeyere N, Mattingley JB. Comprehensive voxel-wise, tract-based, and network lesion mapping reveals unique architectures of right and left visuospatial neglect. Brain Struct Funct 2023; 228:2067-2087. [PMID: 37697138 PMCID: PMC10587018 DOI: 10.1007/s00429-023-02702-2] [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: 04/28/2023] [Accepted: 08/27/2023] [Indexed: 09/13/2023]
Abstract
Visuospatial neglect is a common, post-stroke cognitive impairment which is widely considered to be a disconnection syndrome. However, the patterns of disconnectivity associated with visuospatial neglect remain unclear. Here, we had 480 acute stroke survivors [age = 72.8 (SD = 13.3), 44.3% female, 7.5 days post-stroke (SD = 11.3)] undertake routine clinical imaging and standardised visuospatial neglect testing. The data were used to conduct voxel-wise, tract-level, and network-level lesion-mapping analyses aimed at localising the neural correlates of left and right egocentric (body-centred) and allocentric (object-centred) visuospatial neglect. Only minimal anatomical homogeneity was present between the correlates of right and left egocentric neglect across all analysis types. This finding challenges previous work suggesting that right and left visuospatial neglect are anatomically homologous, and instead suggests that egocentric neglect may involve damage to a shared, but hemispherically asymmetric attention network. By contrast, egocentric and allocentric neglect was associated with disconnectivity in a distinct but overlapping set of network edges, with both deficits related to damage across the dorsal and ventral attention networks. Critically, this finding suggests that the distinction between egocentric and allocentric neglect is unlikely to reflect a simple dichotomy between dorsal versus ventral networks dysfunction, as is commonly asserted. Taken together, the current findings provide a fresh perspective on the neural circuitry involved in regulating visuospatial attention, and provide important clues to understanding the cognitive and perceptual processes involved in this common and debilitating neuropsychological syndrome.
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Affiliation(s)
- Margaret Jane Moore
- Queensland Brain Institute, University of Queensland, St. Lucia, QLD, 4072, Australia.
| | - Luke Hearne
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Nele Demeyere
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Jason B Mattingley
- Queensland Brain Institute, University of Queensland, St. Lucia, QLD, 4072, Australia
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12
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Krick S, Koob JL, Latarnik S, Volz LJ, Fink GR, Grefkes C, Rehme AK. Neuroanatomy of post-stroke depression: the association between symptom clusters and lesion location. Brain Commun 2023; 5:fcad275. [PMID: 37908237 PMCID: PMC10613857 DOI: 10.1093/braincomms/fcad275] [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: 01/28/2023] [Revised: 08/07/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023] Open
Abstract
Post-stroke depression affects about 30% of stroke patients and often hampers functional recovery. The diagnosis of depression encompasses heterogeneous symptoms at emotional, motivational, cognitive, behavioural or somatic levels. Evidence indicates that depression is caused by disruption of bio-aminergic fibre tracts between prefrontal and limbic or striatal brain regions comprising different functional networks. Voxel-based lesion-symptom mapping studies reported discrepant findings regarding the association between infarct locations and depression. Inconsistencies may be due to the usage of sum scores, thereby mixing different symptoms of depression. In this cross-sectional study, we used multivariate support vector regression for lesion-symptom mapping to identify regions significantly involved in distinct depressive symptom domains and global depression. MRI lesion data were included from 200 patients with acute first-ever ischaemic stroke (mean 0.9 ± 1.5 days of post-stroke). The Montgomery-Åsberg Depression Rating interview assessed depression severity in five symptom domains encompassing motivational, emotional and cognitive symptoms deficits, anxiety and somatic symptoms and was examined 8.4 days of post-stroke (±4.3). We found that global depression severity, irrespective of individual symptom domains, was primarily linked to right hemispheric lesions in the dorsolateral prefrontal cortex and inferior frontal gyrus. In contrast, when considering distinct symptom domains individually, the analyses yielded much more sensitive results in regions where the correlations with the global depression score yielded no effects. Accordingly, motivational deficits were associated with lesions in orbitofrontal cortex, dorsolateral prefrontal cortex, pre- and post-central gyri and basal ganglia, including putamen and pallidum. Lesions affecting the dorsal thalamus, anterior insula and somatosensory cortex were significantly associated with emotional symptoms such as sadness. Damage to the dorsolateral prefrontal cortex was associated with concentration deficits, cognitive symptoms of guilt and self-reproach. Furthermore, somatic symptoms, including loss of appetite and sleep disturbances, were linked to the insula, parietal operculum and amygdala lesions. Likewise, anxiety was associated with lesions impacting the central operculum, insula and inferior frontal gyrus. Interestingly, symptoms of anxiety were exclusively left hemispheric, whereas the lesion-symptom associations of the other domains were lateralized to the right hemisphere. In conclusion, this large-scale study shows that in acute stroke patients, differential post-stroke depression symptom domains are associated with specific structural correlates. Our findings extend existing concepts on the neural underpinnings of depressive symptoms, indicating that differential lesion patterns lead to distinct depressive symptoms in the first weeks of post-stroke. These findings may facilitate the development of personalized treatments to improve post-stroke rehabilitation.
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Affiliation(s)
- Sebastian Krick
- Department of Neurology, University Hospital Cologne, Cologne 50937, Germany
| | - Janusz L Koob
- Department of Neurology, University Hospital Cologne, Cologne 50937, Germany
| | - Sylvia Latarnik
- Department of Neurology, University Hospital Cologne, Cologne 50937, Germany
| | - Lukas J Volz
- Department of Neurology, University Hospital Cologne, Cologne 50937, Germany
| | - Gereon R Fink
- Department of Neurology, University Hospital Cologne, Cologne 50937, Germany
- Institute of Neuroscience and Medicine, Cognitive Neuroscience (INM-3), Forschungszentrum Jülich, Jülich 52425, Germany
| | - Christian Grefkes
- Department of Neurology, University Hospital Cologne, Cologne 50937, Germany
- Institute of Neuroscience and Medicine, Cognitive Neuroscience (INM-3), Forschungszentrum Jülich, Jülich 52425, Germany
- Department of Neurology, Goethe University Hospital Frankfurt, Frankfurt am Main 60528, Germany
| | - Anne K Rehme
- Department of Neurology, University Hospital Cologne, Cologne 50937, Germany
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13
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Sperber C, Gallucci L, Umarova R. Reply: The correlation of behavioural deficits post-stroke: a trivial issue? Brain 2023; 146:e86-e88. [PMID: 37224518 DOI: 10.1093/brain/awad174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/06/2023] [Indexed: 05/26/2023] Open
Affiliation(s)
- Christoph Sperber
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
| | - Laura Gallucci
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
| | - Roza Umarova
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
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14
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Garcea FE, Buxbaum LJ. Mechanisms and neuroanatomy of response selection in tool and non-tool action tasks: Evidence from left-hemisphere stroke. Cortex 2023; 167:335-350. [PMID: 37598647 PMCID: PMC10543550 DOI: 10.1016/j.cortex.2023.06.012] [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: 11/30/2022] [Revised: 04/19/2023] [Accepted: 06/18/2023] [Indexed: 08/22/2023]
Abstract
The ability to select between potential actions is central to the complex process of tool use. After left hemisphere stroke, individuals with limb apraxia make more hand action errors when gesturing the use of tools with conflicting hand actions for grasping-to-move and use (e.g., screwdriver) relative to tools that are grasped-to-move and used with the same hand action (e.g., hammer). Prior research indicates that this grasp-use interference effect is driven by abnormalities in the competitive action selection process. The goal of this project was to determine whether common mechanisms and neural substrates support the competitive selection of task-appropriate responses in both tool and non-tool domains. If so, the grasp-use interference effect in a tool use gesturing task should be correlated with response interference effects in the classic Eriksen flanker and Simon tasks, and at least partly overlapping neural regions should subserve the 3 tasks. Sixty-four left hemisphere stroke survivors (33 with apraxia) participated in the tool- and non-tool interference tasks and underwent T1 anatomical MRI. There were robust grasp-use interference effects (grasp-use conflict test) and response interference effects (Eriksen flanker and Simon tasks), but these effects were not correlated. Lesion-symptom mapping analyses showed that lesions to the left inferior parietal lobule, ventral premotor cortex, and insula were associated with grasp-use interference. Lesions to the left inferior parietal lobule, postcentral gyrus, insula, caudate, and putamen were associated with response interference in the Eriksen flanker task. Lesions to the left caudate and putamen were also associated with response interference in the Simon task. Our results suggest that the selection of hand posture for tool use is mediated by distinct cognitive mechanisms and partly distinct neuroanatomic substrates from those mapping a stimulus to an appropriate motor response in non-tool domains.
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Affiliation(s)
- Frank E Garcea
- Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY, USA; Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, USA; Del Monte Institute for Neuroscience, University of Rochester Medical Center, Rochester, NY, USA.
| | - Laurel J Buxbaum
- Moss Rehabilitation Research Institute, Elkins Park, PA, USA; Department of Rehabilitation Medicine, Jefferson University, Philadelphia, PA, USA
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15
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Olafson ER, Sperber C, Jamison KW, Bowren MD, Boes AD, Andrushko JW, Borich MR, Boyd LA, Cassidy JM, Conforto AB, Cramer SC, Dula AN, Geranmayeh F, Hordacre B, Jahanshad N, Kautz SA, Lo B, MacIntosh BJ, Piras F, Robertson AD, Seo NJ, Soekadar SR, Thomopoulos SI, Vecchio D, Weng TB, Westlye LT, Winstein CJ, Wittenberg GF, Wong KA, Thompson PM, Liew SL, Kuceyeski AF. Data-driven biomarkers outperform theory-based biomarkers in predicting stroke motor outcomes. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.19.545638. [PMID: 37693419 PMCID: PMC10491132 DOI: 10.1101/2023.06.19.545638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Chronic motor impairments are a leading cause of disability after stroke. Previous studies have predicted motor outcomes based on the degree of damage to predefined structures in the motor system, such as the corticospinal tract. However, such theory-based approaches may not take full advantage of the information contained in clinical imaging data. The present study uses data-driven approaches to predict chronic motor outcomes after stroke and compares the accuracy of these predictions to previously-identified theory-based biomarkers. Using a cross-validation framework, regression models were trained using lesion masks and motor outcomes data from 789 stroke patients (293 female/496 male) from the ENIGMA Stroke Recovery Working Group (age 64.9±18.0 years; time since stroke 12.2±0.2 months; normalised motor score 0.7±0.5 (range [0,1]). The out-of-sample prediction accuracy of two theory-based biomarkers was assessed: lesion load of the corticospinal tract, and lesion load of multiple descending motor tracts. These theory-based prediction accuracies were compared to the prediction accuracy from three data-driven biomarkers: lesion load of lesion-behaviour maps, lesion load of structural networks associated with lesion-behaviour maps, and measures of regional structural disconnection. In general, data-driven biomarkers had better prediction accuracy - as measured by higher explained variance in chronic motor outcomes - than theory-based biomarkers. Data-driven models of regional structural disconnection performed the best of all models tested (R2 = 0.210, p < 0.001), performing significantly better than predictions using the theory-based biomarkers of lesion load of the corticospinal tract (R2 = 0.132, p< 0.001) and of multiple descending motor tracts (R2 = 0.180, p < 0.001). They also performed slightly, but significantly, better than other data-driven biomarkers including lesion load of lesion-behaviour maps (R2 =0.200, p < 0.001) and lesion load of structural networks associated with lesion-behaviour maps (R2 =0.167, p < 0.001). Ensemble models - combining basic demographic variables like age, sex, and time since stroke - improved prediction accuracy for theory-based and data-driven biomarkers. Finally, combining both theory-based and data-driven biomarkers with demographic variables improved predictions, and the best ensemble model achieved R2 = 0.241, p < 0.001. Overall, these results demonstrate that models that predict chronic motor outcomes using data-driven features, particularly when lesion data is represented in terms of structural disconnection, perform better than models that predict chronic motor outcomes using theory-based features from the motor system. However, combining both theory-based and data-driven models provides the best predictions.
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Affiliation(s)
- Emily R Olafson
- Department of Radiology, Weill Cornell Medicine, New York City, New York, USA
| | - Christoph Sperber
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Keith W Jamison
- Department of Radiology, Weill Cornell Medicine, New York City, New York, USA
| | - Mark D Bowren
- Department of Neurology, Carver College of Medicine, Iowa City, IA, USA
| | - Aaron D Boes
- Departments of Neurology, Psychiatry, and Pediatrics, Carver College of Medicine, Iowa City, IA, USA
| | - Justin W Andrushko
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Michael R Borich
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Lara A Boyd
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Jessica M Cassidy
- Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Adriana B Conforto
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paolo, Brazil
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Steven C Cramer
- Dept. Neurology, UCLA; California Rehabilitation Institute, Los Angeles, CA, USA
| | - Adrienne N Dula
- Department of Neurology, Dell Medical School at The University of Texas Austin, Austin, TX, USA
| | - Fatemeh Geranmayeh
- Clinical Language and Cognition Group. Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Brenton Hordacre
- Innovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Charleston, SC, USA
| | - Steven A Kautz
- Department of Health Sciences & Research, Medical University of South Carolina, Charleston, SC, USA
- Ralph H Johnson VA Health Care System, Charleston, SC, USA
| | - Bethany Lo
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Bradley J MacIntosh
- Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Computational Radiology and Artificial Intelligence (CRAI), Department of Physics and Computational Radiology, Clinic for Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Andrew D Robertson
- Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada
| | - Na Jin Seo
- Department of Health Sciences & Research, Medical University of South Carolina, Charleston, SC, USA
- Ralph H Johnson VA Health Care System, Charleston, SC, USA
- Department of Rehabilitation Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Surjo R Soekadar
- Dept. of Psychiatry and Neurosciences, Charité Campus Mitte (CCM), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Charleston, SC, USA
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Timothy B Weng
- Department of Neurology, Dell Medical School at The University of Texas Austin, Austin, TX, USA
- Department of Diagnostic Medicine, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Carolee J Winstein
- Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - George F Wittenberg
- Departments of Neurology, Bioengineering, Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- GRECC, HERL, Department of Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Kristin A Wong
- Department of Physical Medicine & Rehabilitation, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Charleston, SC, USA
| | - Sook-Lei Liew
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Amy F Kuceyeski
- Department of Radiology, Weill Cornell Medicine, New York City, New York, USA
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16
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Liu CF, Leigh R, Johnson B, Urrutia V, Hsu J, Xu X, Li X, Mori S, Hillis AE, Faria AV. A large public dataset of annotated clinical MRIs and metadata of patients with acute stroke. Sci Data 2023; 10:548. [PMID: 37607929 PMCID: PMC10444746 DOI: 10.1038/s41597-023-02457-9] [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: 01/31/2023] [Accepted: 08/09/2023] [Indexed: 08/24/2023] Open
Abstract
To extract meaningful and reproducible models of brain function from stroke images, for both clinical and research proposes, is a daunting task severely hindered by the great variability of lesion frequency and patterns. Large datasets are therefore imperative, as well as fully automated image post-processing tools to analyze them. The development of such tools, particularly with artificial intelligence, is highly dependent on the availability of large datasets to model training and testing. We present a public dataset of 2,888 multimodal clinical MRIs of patients with acute and early subacute stroke, with manual lesion segmentation, and metadata. The dataset provides high quality, large scale, human-supervised knowledge to feed artificial intelligence models and enable further development of tools to automate several tasks that currently rely on human labor, such as lesion segmentation, labeling, calculation of disease-relevant scores, and lesion-based studies relating function to frequency lesion maps.
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Affiliation(s)
- Chin-Fu Liu
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, USA
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Richard Leigh
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Brenda Johnson
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Victor Urrutia
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Johnny Hsu
- Department of Radiology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Xin Xu
- Department of Radiology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Xin Li
- Department of Radiology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Susumu Mori
- Department of Radiology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Argye E Hillis
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Department of Physical Medicine & Rehabilitation, and Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, USA
| | - Andreia V Faria
- Department of Radiology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
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17
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Adam-Darque A, Ptak R, Schneider S, Schnider A. Anatomical and functional predictors of disorientation after first-ever brain damage. Neuropsychologia 2023; 187:108601. [PMID: 37263576 DOI: 10.1016/j.neuropsychologia.2023.108601] [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: 02/23/2023] [Revised: 05/20/2023] [Accepted: 05/29/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND AND OBJECTIVES Disorientation is a frequent consequence of acute brain injury or diffuse disorders, such as confusional states or dementia. Its anatomical correlates are debated. Impaired memory as its commonly assumed mechanism predicts that disorientation is associated with medial temporal damage. The alternative is that disorientation reflects defective orbitofrontal reality filtering (ORFi) - a specific failure to identify whether thoughts or memories refer to present reality or not. The latter is a function of the posterior orbitofrontal cortex and connected structures. This study examined the mechanisms and anatomical basis of disorientation in an unselected group of patients with first-ever subacute brain injury. METHODS Participants hospitalized for neurorehabilitation were asked to participate in this observational cohort study if they had first-ever organic hemispheric brain dysfunction as evident in a localizable brain lesion or verbal amnesia (often without localizable brain damage). Orientation to time, place, situation and person was tested with a 20-items questionnaire. To identify the mechanisms of disorientation, we determined its correlations with executive tasks, verbal episodic memory, and ORFi in all patients. ORFi was examined with a continuous recognition task, which measures learning and item recognition in the first run, and ORFi as reflected in the increase of false positive responses in the second run (temporal context confusion). Lesions of patients having localizable brain damage were manually delineated and normalized before entering multivariate lesion-symptom-mapping (LSM) to determine anatomical predictors of orientation. RESULTS Eighty-four patients (61.1 ± 14.4 years, 29 women) were included. Among measures of memory and executive functioning, a step-wise regression retained temporal context confusion (R = -0.71, p < 0.0001), item recognition (R = 0.67, p < 0.0001) and delayed free recall (R = 0.63, p < 0.0001) as significant predictors of orientation. LSM was possible in 67 participants; it revealed an association of disorientation with damage of the right OFC and the bilateral head of the caudate nucleus. CONCLUSION Disorientation in non-confused, non-demented patients with first-ever brain damage is associated with impaired orbitofrontal reality filtering and memory dysfunction, but not with executive dysfunction. Its main anatomical determinant is damage to the orbitofrontal cortex and its subcortical relay, the head of the caudate.
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Affiliation(s)
- Alexandra Adam-Darque
- Laboratory of Cognitive Neurorehabilitation, Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospital and University of Geneva, 1211, Geneva 14, Switzerland
| | - Radek Ptak
- Laboratory of Cognitive Neurorehabilitation, Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospital and University of Geneva, 1211, Geneva 14, Switzerland
| | - Stephan Schneider
- Laboratory of Cognitive Neurorehabilitation, Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospital and University of Geneva, 1211, Geneva 14, Switzerland
| | - Armin Schnider
- Laboratory of Cognitive Neurorehabilitation, Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospital and University of Geneva, 1211, Geneva 14, Switzerland.
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18
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Krason A, Vigliocco G, Mailend ML, Stoll H, Varley R, Buxbaum LJ. Benefit of visual speech information for word comprehension in post-stroke aphasia. Cortex 2023; 165:86-100. [PMID: 37271014 PMCID: PMC10850036 DOI: 10.1016/j.cortex.2023.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 03/13/2023] [Accepted: 04/22/2023] [Indexed: 06/06/2023]
Abstract
Aphasia is a language disorder that often involves speech comprehension impairments affecting communication. In face-to-face settings, speech is accompanied by mouth and facial movements, but little is known about the extent to which they benefit aphasic comprehension. This study investigated the benefit of visual information accompanying speech for word comprehension in people with aphasia (PWA) and the neuroanatomic substrates of any benefit. Thirty-six PWA and 13 neurotypical matched control participants performed a picture-word verification task in which they indicated whether a picture of an animate/inanimate object matched a subsequent word produced by an actress in a video. Stimuli were either audiovisual (with visible mouth and facial movements) or auditory-only (still picture of a silhouette) with audio being clear (unedited) or degraded (6-band noise-vocoding). We found that visual speech information was more beneficial for neurotypical participants than PWA, and more beneficial for both groups when speech was degraded. A multivariate lesion-symptom mapping analysis for the degraded speech condition showed that lesions to superior temporal gyrus, underlying insula, primary and secondary somatosensory cortices, and inferior frontal gyrus were associated with reduced benefit of audiovisual compared to auditory-only speech, suggesting that the integrity of these fronto-temporo-parietal regions may facilitate cross-modal mapping. These findings provide initial insights into our understanding of the impact of audiovisual information on comprehension in aphasia and the brain regions mediating any benefit.
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Affiliation(s)
- Anna Krason
- Experimental Psychology, University College London, UK; Moss Rehabilitation Research Institute, Elkins Park, PA, USA.
| | - Gabriella Vigliocco
- Experimental Psychology, University College London, UK; Moss Rehabilitation Research Institute, Elkins Park, PA, USA
| | - Marja-Liisa Mailend
- Moss Rehabilitation Research Institute, Elkins Park, PA, USA; Department of Special Education, University of Tartu, Tartu Linn, Estonia
| | - Harrison Stoll
- Moss Rehabilitation Research Institute, Elkins Park, PA, USA; Applied Cognitive and Brain Science, Drexel University, Philadelphia, PA, USA
| | | | - Laurel J Buxbaum
- Moss Rehabilitation Research Institute, Elkins Park, PA, USA; Department of Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, PA, USA
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19
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Akkad H, Hope TMH, Howland C, Ondobaka S, Pappa K, Nardo D, Duncan J, Leff AP, Crinion J. Mapping spoken language and cognitive deficits in post-stroke aphasia. Neuroimage Clin 2023; 39:103452. [PMID: 37321143 PMCID: PMC10275719 DOI: 10.1016/j.nicl.2023.103452] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 06/17/2023]
Abstract
Aphasia is an acquired disorder caused by damage, most commonly due to stroke, to brain regions involved in speech and language. While language impairment is the defining symptom of aphasia, the co-occurrence of non-language cognitive deficits and their importance in predicting rehabilitation and recovery outcomes is well documented. However, people with aphasia (PWA) are rarely tested on higher-order cognitive functions, making it difficult for studies to associate these functions with a consistent lesion correlate. Broca's area is a particular brain region of interest that has long been implicated in speech and language production. Contrary to classic models of speech and language, cumulative evidence shows that Broca's area and surrounding regions in the left inferior frontal cortex (LIFC) are involved in, but not specific to, speech production. In this study we aimed to explore the brain-behaviour relationships between tests of cognitive skill and language abilities in thirty-six adults with long-term speech production deficits caused by post-stroke aphasia. Our findings suggest that non-linguistic cognitive functions, namely executive functions and verbal working memory, explain more of the behavioural variance in PWA than classical language models imply. Additionally, lesions to the LIFC, including Broca's area, were associated with non-linguistic executive (dys)function, suggesting that lesions to this area are associated with non-language-specific higher-order cognitive deficits in aphasia. Whether executive (dys)function - and its neural correlate in Broca's area - contributes directly to PWA's language production deficits or simply co-occurs with it, adding to communication difficulties, remains unclear. These findings support contemporary models of speech production that place language processing within the context of domain-general perception, action and conceptual knowledge. An understanding of the covariance between language and non-language deficits and their underlying neural correlates will inform better targeted aphasia treatment and outcomes.
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Affiliation(s)
- Haya Akkad
- Institute of Cognitive Neuroscience, University College London, UK.
| | - Thomas M H Hope
- Institute of Cognitive Neuroscience, University College London, UK; Wellcome Centre for Human Neuroimaging, University College London, UK
| | | | - Sasha Ondobaka
- Institute of Cognitive Neuroscience, University College London, UK
| | | | - Davide Nardo
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK; Department of Education, University of Roma Tre, Italy
| | - John Duncan
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK; Department of Experimental Psychology, University of Oxford, UK
| | - Alexander P Leff
- Institute of Cognitive Neuroscience, University College London, UK; Wellcome Centre for Human Neuroimaging, University College London, UK; Institute of Neurology, University College London, UK
| | - Jenny Crinion
- Institute of Cognitive Neuroscience, University College London, UK; Wellcome Centre for Human Neuroimaging, University College London, UK
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20
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Moore MJ, Jenkinson M, Griffanti L, Huygelier H, Gillebert CR, Demeyere N. A comparison of lesion mapping analyses based on CT versus MR imaging in stroke. Neuropsychologia 2023; 184:108564. [PMID: 37068585 PMCID: PMC10933788 DOI: 10.1016/j.neuropsychologia.2023.108564] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/19/2023]
Abstract
It is commonly asserted that MRI-derived lesion masks outperform CT-derived lesion masks in lesion-mapping analysis. However, no quantitative analysis has been conducted to support or refute this claim. This study reports an objective comparison of lesion-mapping analyses based on CT- and MRI-derived lesion masks to clarify how input imaging type may ultimately impact analysis results. Routine CT and MRI data were collected from 85 acute stroke survivors. These data were employed to create binarized lesion masks and conduct lesion-mapping analyses on simulated behavioral data. Following standard lesion-mapping analysis methodology, each voxel or region of interest (ROI) were considered as the underlying "target" within CT and MRI data independently. The resulting thresholded z-maps were compared between matched CT- and MRI-based analyses. Paired MRI- and CT-derived lesion masks were found to exhibit significant variance in location, overlap, and size. In ROI-level simulations, both CT and MRI-derived analyses yielded low Dice similarity coefficients, but CT analyses yielded a significantly higher proportion of results which overlapped with target ROIs. In single-voxel simulations, MRI-based lesion mapping was able to include more voxels than CT-based analyses, but CT-based analysis results were closer to the underlying target voxel. Simulated lesion-symptom mapping results yielded by paired CT and MRI lesion-symptom mapping analyses demonstrated moderate agreement in terms of Dice coefficient when systematic differences in cluster size and lesion overlay are considered. Overall, these results suggest that CT and MR-derived lesion-symptom mapping results do not reliably differ in accuracy. This finding is critically important as it suggests that future studies can employ CT-derived lesion masks if these scans are available within the appropriate time-window.
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Affiliation(s)
- Margaret J Moore
- Queensland Brain Institute, University of Queensland, Brisbane, Australia; Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Mark Jenkinson
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Australian Institute for Machine Learning, University of Adelaide, Adelaide, Australia
| | - Ludovica Griffanti
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | | | | | - Nele Demeyere
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom.
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21
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Seghier ML, Price CJ. Interpreting and validating complexity and causality in lesion-symptom prognoses. Brain Commun 2023; 5:fcad178. [PMID: 37346231 PMCID: PMC10279811 DOI: 10.1093/braincomms/fcad178] [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: 04/13/2023] [Revised: 05/08/2023] [Accepted: 06/04/2023] [Indexed: 06/23/2023] Open
Abstract
This paper considers the steps needed to generate pragmatic and interpretable lesion-symptom mappings that can be used for clinically reliable prognoses. The novel contributions are 3-fold. We first define and inter-relate five neurobiological and five methodological constraints that need to be accounted for when interpreting lesion-symptom associations and generating synthetic lesion data. The first implication is that, because of these constraints, lesion-symptom mapping needs to focus on probabilistic relationships between Lesion and Symptom, with Lesion as a multivariate spatial pattern, Symptom as a time-dependent behavioural profile and evidence that Lesion raises the probability of Symptom. The second implication is that in order to assess the strength of probabilistic causality, we need to distinguish between causal lesion sites, incidental lesion sites, spared but dysfunctional sites and intact sites, all of which might affect the accuracy of the predictions and prognoses generated. We then formulate lesion-symptom mappings in logical notations, including combinatorial rules, that are then used to evaluate and better understand complex brain-behaviour relationships. The logical and theoretical framework presented applies to any type of neurological disorder but is primarily discussed in relationship to stroke damage. Accommodating the identified constraints, we discuss how the 1965 Bradford Hill criteria for inferring probabilistic causality, post hoc, from observed correlations in epidemiology-can be applied to lesion-symptom mapping in stroke survivors. Finally, we propose that rather than rely on post hoc evaluation of how well the causality criteria have been met, the neurobiological and methodological constraints should be addressed, a priori, by changing the experimental design of lesion-symptom mappings and setting up an open platform to share and validate the discovery of reliable and accurate lesion rules that are clinically useful.
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Affiliation(s)
- Mohamed L Seghier
- Correspondence to: Mohamed Seghier Department of Biomedical Engineering Khalifa University of Science and Technology PO BOX: 127788, Abu Dhabi, UAE E-mail:
| | - Cathy J Price
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
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22
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Sperber C, Gallucci L, Umarova R. The low dimensionality of post-stroke cognitive deficits: it's the lesion anatomy! Brain 2023; 146:2443-2452. [PMID: 36408903 DOI: 10.1093/brain/awac443] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/01/2022] [Accepted: 11/10/2022] [Indexed: 10/06/2023] Open
Abstract
For years, dissociation studies on neurological single-case patients with brain lesions were the dominant method to infer fundamental cognitive functions in neuropsychology. In contrast, the association between deficits was considered to be of less epistemological value. Still, associational computational methods for dimensionality reduction-such as principal component analysis or factor analysis-became popular for the identification of fundamental cognitive functions and to understand human cognitive brain architecture from post-stroke neuropsychological profiles. In the present in silico study with lesion imaging of 300 stroke patients, we investigated the dimensionality of artificial simulated neuropsychological profiles that exclusively contained independent fundamental cognitive functions without any underlying low-dimensional cognitive architecture. Still, the anatomy of stroke lesions alone was sufficient to create a dependence between variables that allowed a low-dimensional description of the data with principal component analysis. All criteria that we used to estimate the dimensionality of data, including the Kaiser criterion, were strongly affected by lesion anatomy, while the Joliffe criterion provided the least affected estimates. The dimensionality of profiles was reduced by 62-70% for the Kaiser criterion, up to the degree that is commonly found in neuropsychological studies on actual cognitive measures. The interpretability of such low-dimensional factors as deficits of fundamental cognitive functions and their provided insights into human cognitive architecture thus seem to be severely limited, and the heavy focus of current cognitive neuroscience on group studies and associations calls for improvements. We suggest that qualitative criteria and dissociation patterns could be used to refine estimates for the dimensionality of the cognitive architecture behind post-stroke deficits. Further, given the strong impact of lesion anatomy on the associational structure of data, we see the need for further optimization of interpretation strategies of computational factors in post-stroke lesion studies of cognitive deficits.
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Affiliation(s)
- Christoph Sperber
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Laura Gallucci
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Roza Umarova
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
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23
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Klingbeil J, Brandt ML, Stockert A, Baum P, Hoffmann KT, Saur D, Wawrzyniak M. Associations of lesion location, structural disconnection, and functional diaschisis with depressive symptoms post stroke. Front Neurol 2023; 14:1144228. [PMID: 37265471 PMCID: PMC10231644 DOI: 10.3389/fneur.2023.1144228] [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: 01/14/2023] [Accepted: 04/20/2023] [Indexed: 06/03/2023] Open
Abstract
Introduction Post-stroke depressive symptoms (PSDS) are common and relevant for patient outcome, but their complex pathophysiology is ill understood. It likely involves social, psychological and biological factors. Lesion location is a readily available information in stroke patients, but it is unclear if the neurobiological substrates of PSDS are spatially localized. Building on previous analyses, we sought to determine if PSDS are associated with specific lesion locations, structural disconnection and/or localized functional diaschisis. Methods In a prospective observational study, we examined 270 patients with first-ever stroke with the Hospital Anxiety and Depression Scale (HADS) around 6 months post-stroke. Based on individual lesion locations and the depression subscale of the HADS we performed support vector regression lesion-symptom mapping, structural-disconnection-symptom mapping and functional lesion network-symptom-mapping, in a reanalysis of this previously published cohort to infer structure-function relationships. Results We found that depressive symptoms were associated with (i) lesions in the right insula, right putamen, inferior frontal gyrus and right amygdala and (ii) structural disconnection in the right temporal lobe. In contrast, we found no association with localized functional diaschisis. In addition, we were unable to confirm a previously described association between depressive symptom load and a network damage score derived from functional disconnection maps. Discussion Based on our results, and other recent lesion studies, we see growing evidence for a prominent role of right frontostriatal brain circuits in PSDS.
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Affiliation(s)
- Julian Klingbeil
- Neuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Max-Lennart Brandt
- Neuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Anika Stockert
- Neuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Petra Baum
- Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Karl-Titus Hoffmann
- Department of Neuroradiology, University of Leipzig Medical Center, Leipzig, Germany
| | - Dorothee Saur
- Neuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Max Wawrzyniak
- Neuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
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24
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da Silva PHR, de Leeuw FE, Zotin MCZ, Neto OMP, Leoni RF, Tuladhar AM. Neural Substrates of Psychomotor Speed Deficits in Cerebral Small Vessel Disease: A Brain Disconnectome Mapping Study. Brain Topogr 2023:10.1007/s10548-023-00961-0. [PMID: 37156893 DOI: 10.1007/s10548-023-00961-0] [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: 12/22/2022] [Accepted: 04/11/2023] [Indexed: 05/10/2023]
Abstract
It remains unknown which factors influence how brain disconnectivity derived from White Matter Hyperintensity (WMH) lesions leads to psychomotor speed dysfunction, one of the earliest and most common cognitive manifestations in the cerebral Small Vessel Disease (cSVD) population. While the burden of WMH has been strongly linked to psychomotor speed performance, the effect that different locations and volumes of WMH may have on cSVD-related cognitive impairment remains unclear. Therefore, we aimed to explore (1) whether global WMH, deep WMH (DWMH), and periventricular (PVWMH) volumes display different psychomotor speed associations; (2) whether tract-specific WMH volume shows stronger cognitive associations compared with global measures of WMH volume; (3) whether specific patterns of WMH location lead to different degrees of disconnectivity. Using the BCBToolkit, we investigated which pattern of distribution and which locations of WMH lesion result in impaired psychomotor speed in a well-characterized sample (n = 195) of cSVD patients without dementia. Two key findings emerge from our study. First, global (and not tract-specific) measures of WMH volume were associated with psychomotor speed performance. Second, disconnection maps revealed the involvement of callosal tracts, association and projection fibers, and frontal and parietal cortical brain areas related to psychomotor speed, while the lesion location influenced such associations. In conclusion, psychomotor deficits are affected differently by WMH burden and topographic distribution through brain disconnection in non-demented cSVD patients.
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Affiliation(s)
| | - Frank-Erik de Leeuw
- Department of Physics, FFCLRP, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Maria Clara Zanon Zotin
- Department of Neurology, J. Philip Kistler Stroke Research Center, MGH, Boston, MA, USA
- Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, Ribeirão Preto, Brazil
| | - Octavio Marques Pontes Neto
- Department of Neurosciences and Behavioural Sciences, Hospital das Clínicas - Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Anil M Tuladhar
- Department of Neurology (A.M.T, Donders Center for Medical Neuroscience, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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25
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Dresang HC, Wong AL, Buxbaum LJ. Shared and distinct routes in speech and gesture imitation: Evidence from stroke. Cortex 2023; 162:81-95. [PMID: 37018891 PMCID: PMC10106441 DOI: 10.1016/j.cortex.2023.01.010] [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: 07/15/2022] [Revised: 10/25/2022] [Accepted: 01/09/2023] [Indexed: 03/08/2023]
Abstract
Dual-route models of high-level (praxis) actions distinguish between an "indirect" semantic route mediating meaningful gesture imitation, and a "direct" sensory-motor route mediates meaningless gesture imitation. Similarly, dual-route language models distinguish between an indirect route mediating production and repetition of words, and a direct route mediating non-word repetition. Although aphasia and limb apraxia frequently co-occur following left-hemisphere cerebrovascular accident (LCVA), it is unclear which aspects of these functional-neuroanatomic dual-route architectures are shared across praxis and language domains. This study focused on gesture imitation to test the hypothesis that semantic information (and portions of the indirect route) are shared across domains, whereas two distinct dorsal routes mediate sensory-motor mapping. Forty chronic LCVA and 17 neurotypical controls completed semantic memory and language tasks and imitated 3 types of gesture stimuli: (1) labeled/"named" meaningful, (2) unnamed meaningful, and (3) meaningless gestures. The comparison of accuracy between meaningless versus unnamed meaningful gestures examined the benefits of semantic information, while the comparison of unnamed meaningful versus named meaningful imitation examined additional benefits of linguistic cueing. Mixed-effects models examined group by task interaction effects on gesture ability. We found that for patients with LCVA, unnamed meaningful gestures were imitated more accurately than meaningless gestures, suggesting that semantic information was beneficial, but there was no benefit of labeling. Reduced benefit of semantic information on gesture accuracy was associated with lesions to inferior frontal and posterior temporal regions as well as semantic memory performance on a pictorial (non-gesture) task. In contrast, there was no relationship between meaningless gesture imitation and nonword repetition, indicating that measures of direct route performance are not associated across language and action. These results provide preliminary evidence that portions of the indirect semantic route are shared across the language and action domains, while two direct sensory-motor mapping routes mediate word repetition and gesture imitation.
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Affiliation(s)
- Haley C Dresang
- Moss Rehabilitation Research Institute, Elkins Park, PA, USA; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
| | - Aaron L Wong
- Moss Rehabilitation Research Institute, Elkins Park, PA, USA
| | - Laurel J Buxbaum
- Moss Rehabilitation Research Institute, Elkins Park, PA, USA; Department of Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, PA, USA
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26
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Trapp NT, Bruss JE, Manzel K, Grafman J, Tranel D, Boes AD. Large-scale lesion symptom mapping of depression identifies brain regions for risk and resilience. Brain 2023; 146:1672-1685. [PMID: 36181425 PMCID: PMC10319784 DOI: 10.1093/brain/awac361] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 08/15/2022] [Accepted: 09/02/2022] [Indexed: 11/14/2022] Open
Abstract
Understanding neural circuits that support mood is a central goal of affective neuroscience, and improved understanding of the anatomy could inform more targeted interventions in mood disorders. Lesion studies provide a method of inferring the anatomical sites causally related to specific functions, including mood. Here, we performed a large-scale study evaluating the location of acquired, focal brain lesions in relation to symptoms of depression. Five hundred and twenty-six individuals participated in the study across two sites (356 male, average age 52.4 ± 14.5 years). Each subject had a focal brain lesion identified on structural imaging and an assessment of depression using the Beck Depression Inventory-II, both obtained in the chronic period post-lesion (>3 months). Multivariate lesion-symptom mapping was performed to identify lesion sites associated with higher or lower depression symptom burden, which we refer to as 'risk' versus 'resilience' regions. The brain networks and white matter tracts associated with peak regional findings were identified using functional and structural lesion network mapping, respectively. Lesion-symptom mapping identified brain regions significantly associated with both higher and lower depression severity (r = 0.11; P = 0.01). Peak 'risk' regions include the bilateral anterior insula, bilateral dorsolateral prefrontal cortex and left dorsomedial prefrontal cortex. Functional lesion network mapping demonstrated that these 'risk' regions localized to nodes of the salience network. Peak 'resilience' regions include the right orbitofrontal cortex, right medial prefrontal cortex and right inferolateral temporal cortex, nodes of the default mode network. Structural lesion network mapping implicated dorsal prefrontal white matter tracts as 'risk' tracts and ventral prefrontal white matter tracts as 'resilience' tracts, although the structural lesion network mapping findings did not survive correction for multiple comparisons. Taken together, these results demonstrate that lesions to specific nodes of the salience network and default mode network are associated with greater risk versus resiliency for depression symptoms in the setting of focal brain lesions.
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Affiliation(s)
- Nicholas T Trapp
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, USA
| | - Joel E Bruss
- Department of Neurology, University of Iowa, Iowa City, IA, USA
| | - Kenneth Manzel
- Department of Neurology, University of Iowa, Iowa City, IA, USA
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Jordan Grafman
- Shirley Ryan AbilityLab, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Daniel Tranel
- Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, USA
- Department of Neurology, University of Iowa, Iowa City, IA, USA
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Aaron D Boes
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, USA
- Department of Neurology, University of Iowa, Iowa City, IA, USA
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
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27
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Elmalem MS, Moody H, Ruffle JK, de Schotten MT, Haggard P, Diehl B, Nachev P, Jha A. A framework for focal and connectomic mapping of transiently disrupted brain function. Commun Biol 2023; 6:430. [PMID: 37076578 PMCID: PMC10115870 DOI: 10.1038/s42003-023-04787-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 03/30/2023] [Indexed: 04/21/2023] Open
Abstract
The distributed nature of the neural substrate, and the difficulty of establishing necessity from correlative data, combine to render the mapping of brain function a far harder task than it seems. Methods capable of combining connective anatomical information with focal disruption of function are needed to disambiguate local from global neural dependence, and critical from merely coincidental activity. Here we present a comprehensive framework for focal and connective spatial inference based on sparse disruptive data, and demonstrate its application in the context of transient direct electrical stimulation of the human medial frontal wall during the pre-surgical evaluation of patients with focal epilepsy. Our framework formalizes voxel-wise mass-univariate inference on sparsely sampled data within the statistical parametric mapping framework, encompassing the analysis of distributed maps defined by any criterion of connectivity. Applied to the medial frontal wall, this transient dysconnectome approach reveals marked discrepancies between local and distributed associations of major categories of motor and sensory behaviour, revealing differentiation by remote connectivity to which purely local analysis is blind. Our framework enables disruptive mapping of the human brain based on sparsely sampled data with minimal spatial assumptions, good statistical efficiency, flexible model formulation, and explicit comparison of local and distributed effects.
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Affiliation(s)
- Michael S Elmalem
- UCL Queen Square Institute of Neurology, London, UK.
- National Hospital for Neurology and Neurosurgery, London, UK.
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - Hanna Moody
- UCL Queen Square Institute of Neurology, London, UK
| | - James K Ruffle
- UCL Queen Square Institute of Neurology, London, UK
- National Hospital for Neurology and Neurosurgery, London, UK
| | - Michel Thiebaut de Schotten
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénérative, University of Bordeaux, Bordeaux, France
- Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France
| | | | - Beate Diehl
- UCL Queen Square Institute of Neurology, London, UK
- National Hospital for Neurology and Neurosurgery, London, UK
| | - Parashkev Nachev
- UCL Queen Square Institute of Neurology, London, UK.
- National Hospital for Neurology and Neurosurgery, London, UK.
| | - Ashwani Jha
- UCL Queen Square Institute of Neurology, London, UK.
- National Hospital for Neurology and Neurosurgery, London, UK.
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28
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Weaver NA, Mamdani MH, Lim JS, Biesbroek JM, Biessels GJ, Huenges Wajer IMC, Kang Y, Kim BJ, Lee BC, Lee KJ, Yu KH, Bae HJ, Bzdok D, Kuijf HJ. Disentangling poststroke cognitive deficits and their neuroanatomical correlates through combined multivariable and multioutcome lesion-symptom mapping. Hum Brain Mapp 2023; 44:2266-2278. [PMID: 36661231 PMCID: PMC10028652 DOI: 10.1002/hbm.26208] [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: 04/13/2022] [Revised: 12/21/2022] [Accepted: 01/04/2023] [Indexed: 01/21/2023] Open
Abstract
Studies in patients with brain lesions play a fundamental role in unraveling the brain's functional anatomy. Lesion-symptom mapping (LSM) techniques can relate lesion location to cognitive performance. However, a limitation of current LSM approaches is that they can only evaluate one cognitive outcome at a time, without considering interdependencies between different cognitive tests. To overcome this challenge, we implemented canonical correlation analysis (CCA) as combined multivariable and multioutcome LSM approach. We performed a proof-of-concept study on 1075 patients with acute ischemic stroke to explore whether addition of CCA to a multivariable single-outcome LSM approach (support vector regression) could identify infarct locations associated with deficits in three well-defined verbal memory functions (encoding, consolidation, retrieval) based on four verbal memory subscores derived from the Seoul Verbal Learning Test (immediate recall, delayed recall, recognition, learning ability). We evaluated whether CCA could extract cognitive score patterns that matched prior knowledge of these verbal memory functions, and if these patterns could be linked to more specific infarct locations than through single-outcome LSM alone. Two of the canonical modes identified with CCA showed distinct cognitive patterns that matched prior knowledge on encoding and consolidation. In addition, CCA revealed that each canonical mode was linked to a distinct infarct pattern, while with multivariable single-outcome LSM individual verbal memory subscores were associated with largely overlapping patterns. In conclusion, our findings demonstrate that CCA can complement single-outcome LSM techniques to help disentangle cognitive functions and their neuroanatomical correlates.
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Affiliation(s)
- Nick A Weaver
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - Muhammad Hasnain Mamdani
- Department of Biomedical Engineering, Faculty of Medicine, McConnell Brain Imaging Centre, School of Computer Science, Montreal Neurological Institute (MNI), McGill University, Montreal, Canada
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - Irene M C Huenges Wajer
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, The Netherlands
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Yeonwook Kang
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
- Department of Psychology, Hallym University, Chuncheon, Republic of Korea
| | - Beom Joon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Keon-Joo Lee
- Department of Neurology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Danilo Bzdok
- Department of Biomedical Engineering, Faculty of Medicine, McConnell Brain Imaging Centre, School of Computer Science, Montreal Neurological Institute (MNI), McGill University, Montreal, Canada
- Mila-Quebec Artificial Intelligence Institute, Montreal, Canada
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
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29
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Seghier ML. The elusive metric of lesion load. Brain Struct Funct 2023; 228:703-716. [PMID: 36947181 DOI: 10.1007/s00429-023-02630-1] [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: 12/19/2022] [Accepted: 03/15/2023] [Indexed: 03/23/2023]
Abstract
One of the widely used metrics in lesion-symptom mapping is lesion load that codes the amount of damage to a given brain region of interest. Lesion load aims to reduce the complex 3D lesion information into a feature that can reflect both site of damage, defined by the location of the region of interest, and size of damage within that region of interest. Basically, the process of estimation of lesion load converts a voxel-based lesion map into a region-based lesion map, with regions defined as atlas-based or data-driven spatial patterns. Here, after examining current definitions of lesion load, four methodological issues are discussed: (1) lesion load is agnostic to the location of damage within the region of interest, and it disregards damage outside the region of interest, (2) lesion load estimates are prone to errors introduced by the uncertainty in lesion delineation, spatial warping of the lesion/region, and binarization of the lesion/region, (3) lesion load calculation depends on brain parcellation selection, and (4) lesion load does not necessarily reflect a white matter disconnection. Overall, lesion load, when calculated in a robust way, can serve as a clinically-useful feature for explaining and predicting post-stroke outcome and recovery.
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Affiliation(s)
- Mohamed L Seghier
- Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, UAE.
- Healthcare Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, UAE.
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30
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Sperber C, Gallucci L, Smaczny S, Umarova R. Bayesian lesion-deficit inference with Bayes factor mapping: Key advantages, limitations, and a toolbox. Neuroimage 2023; 271:120008. [PMID: 36914109 DOI: 10.1016/j.neuroimage.2023.120008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/15/2023] Open
Abstract
Statistical lesion-symptom mapping is largely dominated by frequentist approaches with null hypothesis significance testing. They are popular for mapping functional brain anatomy but are accompanied by some challenges and limitations. The typical analysis design and the structure of clinical lesion data are linked to the multiple comparison problem, an association problem, limitations to statistical power, and a lack of insights into evidence for the null hypothesis. Bayesian lesion deficit inference (BLDI) could be an improvement as it collects evidence for the null hypothesis, i.e. the absence of effects, and does not accumulate α-errors with repeated testing. We implemented BLDI by Bayes factor mapping with Bayesian t-tests and general linear models and evaluated its performance in comparison to frequentist lesion-symptom mapping with a permutation-based family-wise error correction. We mapped the voxel-wise neural correlates of simulated deficits in an in-silico-study with 300 stroke patients, and the voxel-wise and disconnection-wise neural correlates of phonemic verbal fluency and constructive ability in 137 stroke patients. Both the performance of frequentist and Bayesian lesion-deficit inference varied largely across analyses. In general, BLDI could find areas with evidence for the null hypothesis and was statistically more liberal in providing evidence for the alternative hypothesis, i.e. the identification of lesion-deficit associations. BLDI performed better in situations in which the frequentist method is typically strongly limited, for example with on average small lesions and in situations with low power, where BLDI also provided unprecedented transparency in terms of the informative value of the data. On the other hand, BLDI suffered more from the association problem, which led to a pronounced overshoot of lesion-deficit associations in analyses with high statistical power. We further implemented a new approach to lesion size control, adaptive lesion size control, that, in many situations, was able to counter the limitations imposed by the association problem, and increased true evidence both for the null and the alternative hypothesis. In summary, our results suggest that BLDI is a valuable addition to the method portfolio of lesion-deficit inference with some specific and exclusive advantages: it deals better with smaller lesions and low statistical power (i.e. small samples and effect sizes) and identifies regions with absent lesion-deficit associations. However, it is not superior to established frequentist approaches in all respects and therefore not to be seen as a general replacement. To make Bayesian lesion-deficit inference widely accessible, we published an R toolkit for the analysis of voxel-wise and disconnection-wise data.
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Affiliation(s)
- Christoph Sperber
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
| | - Laura Gallucci
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Stefan Smaczny
- Centre of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Roza Umarova
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
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31
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Smaczny S, Sperber C, Jung S, Moeller K, Karnath HO, Klein E. Disconnection in a left-hemispheric temporo-parietal network impairs multiplication fact retrieval. Neuroimage 2023; 268:119840. [PMID: 36621582 DOI: 10.1016/j.neuroimage.2022.119840] [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: 11/10/2022] [Revised: 12/16/2022] [Accepted: 12/25/2022] [Indexed: 01/07/2023] Open
Abstract
Arithmetic fact retrieval has been suggested to recruit a left-lateralized network comprising perisylvian language areas, parietal areas such as the angular gyrus (AG), and non-neocortical structures such as the hippocampus. However, the underlying white matter connectivity of these areas has not been evaluated systematically so far. Using simple multiplication problems, we evaluated how disconnections in parietal brain areas affected arithmetic fact retrieval following stroke. We derived disconnectivity measures by jointly considering data from n = 73 patients with acute unilateral lesions in either hemisphere and a white-matter tractography atlas (HCP-842) using the Lesion Quantification Toolbox (LQT). Whole-brain voxel-based analysis indicated a left-hemispheric cluster of white matter fibers connecting the AG and superior temporal areas to be associated with a fact retrieval deficit. Subsequent analyses of direct gray-to-gray matter disconnections revealed that disconnections of additional left-hemispheric areas (e.g., between the superior temporal gyrus and parietal areas) were significantly associated with the observed fact retrieval deficit. Results imply that disconnections of parietal areas (i.e., the AG) with language-related areas (i.e., superior and middle temporal gyri) seem specifically detrimental to arithmetic fact retrieval. This suggests that arithmetic fact retrieval recruits a widespread left-hemispheric network and emphasizes the relevance of white matter connectivity for number processing.
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Affiliation(s)
- S Smaczny
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | - C Sperber
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - S Jung
- Department of Computer Science/Therapy Science, Trier University of Applied Science, Trier, Germany; Leibniz Institut fuer Wissensmedien, Tuebingen, Germany
| | - K Moeller
- Leibniz Institut fuer Wissensmedien, Tuebingen, Germany; Centre for Individual Development and Adaptive Education of Children at Risk (IDeA), Frankfurt, Germany; Centre for Mathematical Cognition, School of Science, Loughborough University, United Kingdom
| | - H O Karnath
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany; Department of Psychology, University of South Carolina, Columbia, SC, USA.
| | - E Klein
- Leibniz Institut fuer Wissensmedien, Tuebingen, Germany; University of Paris, LaPsyDÉ, CNRS, Sorbonne Paris Cité, Paris, France.
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32
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Ofir‐Geva S, Meilijson I, Frenkel‐Toledo S, Soroker N. Use of multi-perturbation Shapley analysis in lesion studies of functional networks: The case of upper limb paresis. Hum Brain Mapp 2023; 44:1320-1343. [PMID: 36206326 PMCID: PMC9921264 DOI: 10.1002/hbm.26105] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/07/2022] [Accepted: 09/19/2022] [Indexed: 11/07/2022] Open
Abstract
Understanding the impact of variation in lesion topography on the expression of functional impairments following stroke is important, as it may pave the way to modeling structure-function relations in statistical terms while pointing to constraints for adaptive remapping and functional recovery. Multi-perturbation Shapley-value analysis (MSA) is a relatively novel game-theoretical approach for multivariate lesion-symptom mapping. In this methodological paper, we provide a comprehensive explanation of MSA. We use synthetic data to assess the method's accuracy and perform parameter optimization. We then demonstrate its application using a cohort of 107 first-event subacute stroke patients, assessed for upper limb (UL) motor impairment (Fugl-Meyer Assessment scale). Under the conditions tested, MSA could correctly detect simulated ground-truth lesion-symptom relationships with a sensitivity of 75% and specificity of ~90%. For real behavioral data, MSA disclosed a strong hemispheric effect in the relative contribution of specific regions-of-interest (ROIs): poststroke UL motor function was mostly contributed by damage to ROIs associated with movement planning (supplementary motor cortex and superior frontal gyrus) following left-hemispheric damage (LHD) and by ROIs associated with movement execution (primary motor and somatosensory cortices and the ventral brainstem) following right-hemispheric damage (RHD). Residual UL motor ability following LHD was found to depend on a wider array of brain structures compared to the residual motor ability of RHD patients. The results demonstrate that MSA can provide a unique insight into the relative importance of different hubs in neural networks, which is difficult to obtain using standard univariate methods.
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Affiliation(s)
- Shay Ofir‐Geva
- Department of Neurological RehabilitationLoewenstein Rehabilitation Medical CenterRaananaIsrael
- Department of Rehabilitation Medicine, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Isaac Meilijson
- School of Mathematical SciencesTel Aviv UniversityTel AvivIsrael
| | | | - Nachum Soroker
- Department of Neurological RehabilitationLoewenstein Rehabilitation Medical CenterRaananaIsrael
- Department of Rehabilitation Medicine, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
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33
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Zhang J, Yao Y, Wu JS, Rolls ET, Sun CC, Bu LH, Lu JF, Lin CP, Feng JF, Mao Y, Zhou LF. The cortical regions and white matter tracts underlying auditory comprehension in patients with primary brain tumor. Hum Brain Mapp 2023; 44:1603-1616. [PMID: 36515634 PMCID: PMC9921237 DOI: 10.1002/hbm.26161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 11/07/2022] [Accepted: 11/11/2022] [Indexed: 12/15/2022] Open
Abstract
The comprehension of spoken language is one of the most essential language functions in humans. However, the neurological underpinnings of auditory comprehension remain under debate. Here we used multi-modal neuroimaging analyses on a group of patients with low-grade gliomas to localize cortical regions and white matter tracts responsible for auditory language comprehension. Region-of-interests and voxel-level whole-brain analyses showed that cortical areas in the posterior temporal lobe are crucial for language comprehension. The fiber integrity assessed with diffusion tensor imaging of the arcuate fasciculus and the inferior longitudinal fasciculus was strongly correlated with both auditory comprehension and the grey matter volume of the inferior temporal and middle temporal gyri. Together, our findings provide direct evidence for an integrated network of auditory comprehension whereby the superior temporal gyrus and sulcus, the posterior parts of the middle and inferior temporal gyri serve as auditory comprehension cortex, and the arcuate fasciculus and the inferior longitudinal fasciculus subserve as crucial structural connectivity. These findings provide critical evidence on the neural underpinnings of language comprehension.
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Affiliation(s)
- Jie Zhang
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Shanghai, China.,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China.,Neurosurgical Institute of Fudan University, Shanghai, China.,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
| | - Ye Yao
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.,National Clinical Research Centre for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Jin-Song Wu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Shanghai, China.,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China.,Neurosurgical Institute of Fudan University, Shanghai, China.,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
| | - Edmund T Rolls
- Department of Computer Science, University of Warwick, Coventry, UK.,Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China.,Oxford Centre for Computational Neuroscience, Oxford, UK
| | - Ce-Chen Sun
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Ling-Hao Bu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Shanghai, China.,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China.,Neurosurgical Institute of Fudan University, Shanghai, China.,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
| | - Jun-Feng Lu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Shanghai, China.,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China.,Neurosurgical Institute of Fudan University, Shanghai, China.,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
| | - Ching-Po Lin
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
| | - Jian-Feng Feng
- Department of Computer Science, University of Warwick, Coventry, UK.,Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
| | - Ying Mao
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Shanghai, China.,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China.,Neurosurgical Institute of Fudan University, Shanghai, China.,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
| | - Liang-Fu Zhou
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Shanghai, China.,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China.,Neurosurgical Institute of Fudan University, Shanghai, China.,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
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34
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Moore MJ, Milosevich E, Mattingley JB, Demeyere N. The neuroanatomy of visuospatial neglect: A systematic review and analysis of lesion-mapping methodology. Neuropsychologia 2023; 180:108470. [PMID: 36621594 DOI: 10.1016/j.neuropsychologia.2023.108470] [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: 09/28/2022] [Revised: 12/20/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023]
Abstract
While visuospatial neglect is commonly associated with damage to the right posterior parietal cortex, neglect is an anatomically heterogenous syndrome. This project presents a systematic review of 34 lesion-mapping studies reporting on the anatomical correlates of neglect. Specifically, the reported correlates of egocentric versus allocentric, acute versus chronic, personal versus extra-personal, and left versus right hemisphere neglect are summarised. The quality of each included lesion-mapping analysis was then evaluated to identify methodological factors which may help account for the reported variance in correlates of neglect. Overall, the existing literature strongly suggests that egocentric and allocentric neglect represent anatomically dissociable conditions and that the anatomy of these conditions may not be entirely homologous across hemispheres. Studies which have compared the anatomy of acute versus chronic neglect have found that these conditions are associated with distinct lesion loci, while studies comparing the correlates of peripersonal/extrapersonal neglect are split as to whether these neglect subtypes are anatomically dissociable. The included studies employed a wide range of lesion-mapping analysis techniques, each producing results of varying quality and generalisability. This review concludes that the reported underlying anatomical correlates of heterogeneous visuospatial neglect vary considerably. Future, high quality studies are needed to investigate patterns of disconnection associated with clearly defined forms of visuospatial neglect in large and representative samples.
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Affiliation(s)
- Margaret Jane Moore
- Queensland Brain Institute, The University of Queensland, St Lucia, Australia.
| | - Elise Milosevich
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Jason B Mattingley
- Queensland Brain Institute, The University of Queensland, St Lucia, Australia; School of Psychology, The University of Queensland, St Lucia, Australia
| | - Nele Demeyere
- Department of Experimental Psychology, University of Oxford, Oxford, UK
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35
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Fukutomi H, Yamamoto T, Sibon I, Christensen S, Raposo N, Marnat G, Albucher JF, Olindo S, Calvière L, Sagnier S, Viguier A, Renou P, Guenego A, Poli M, Darcourt J, Debruxelles S, Drif A, Thalamas C, Sommet A, Rousseau V, Mazighi M, Bonneville F, Albers GW, Cognard C, Dousset V, Olivot JM, Tourdias T. Location-weighted versus Volume-weighted Mismatch at MRI for Response to Mechanical Thrombectomy in Acute Stroke. Radiology 2023; 306:e220080. [PMID: 36194114 PMCID: PMC9885343 DOI: 10.1148/radiol.220080] [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: 01/10/2022] [Revised: 07/06/2022] [Accepted: 08/16/2022] [Indexed: 01/28/2023]
Abstract
Background A target mismatch profile can identify good clinical response to recanalization after acute ischemic stroke, but does not consider region specificities. Purpose To test whether location-weighted infarction core and mismatch, determined from diffusion and perfusion MRI performed in patients with acute stroke, could improve prediction of good clinical response to mechanical thrombectomy compared with a target mismatch profile. Materials and Methods In this secondary analysis, two prospectively collected independent stroke data sets (2012-2015 and 2017-2019) were analyzed. From the brain before stroke (BBS) study data (data set 1), an eloquent map was computed through voxel-wise associations between the infarction core (based on diffusion MRI on days 1-3 following stroke) and National Institutes of Health Stroke Scale (NIHSS) score. The French acute multimodal imaging to select patients for mechanical thrombectomy (FRAME) data (data set 2) consisted of large vessel occlusion-related acute ischemic stroke successfully recanalized. From acute MRI studies (performed on arrival, prior to thrombectomy) in data set 2, target mismatch and eloquent (vs noneloquent) infarction core and mismatch were computed from the intersection of diffusion- and perfusion-detected lesions with the coregistered eloquent map. Associations of these imaging metrics with early neurologic improvement were tested in multivariable regression models, and areas under the receiver operating characteristic curve (AUCs) were compared. Results Data sets 1 and 2 included 321 (median age, 69 years [IQR, 58-80 years]; 207 men) and 173 (median age, 74 years [IQR, 65-82 years]; 90 women) patients, respectively. Eloquent mismatch was positively and independently associated with good clinical response (odds ratio [OR], 1.14; 95% CI: 1.02, 1.27; P = .02) and eloquent infarction core was negatively associated with good response (OR, 0.85; 95% CI: 0.77, 0.95; P = .004), while noneloquent mismatch was not associated with good response (OR, 1.03; 95% CI: 0.98, 1.07; P = .20). Moreover, adding eloquent metrics improved the prediction accuracy (AUC, 0.73; 95% CI: 0.65, 0.81) compared with clinical variables alone (AUC, 0.65; 95% CI: 0.56, 0.73; P = .01) or a target mismatch profile (AUC, 0.67; 95% CI: 0.59, 0.76; P = .03). Conclusion Location-weighted infarction core and mismatch on diffusion and perfusion MRI scans improved the identification of patients with acute stroke who would benefit from mechanical thrombectomy compared with the volume-based target mismatch profile. Clinical trial registration no. NCT03045146 © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Nael in this issue.
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Affiliation(s)
- Hikaru Fukutomi
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Takayuki Yamamoto
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Igor Sibon
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Soren Christensen
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Nicolas Raposo
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Gaultier Marnat
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Jean-François Albucher
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Stéphane Olindo
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Lionel Calvière
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Sharmila Sagnier
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Alain Viguier
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Pauline Renou
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Adrien Guenego
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Mathilde Poli
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Jean Darcourt
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Sabrina Debruxelles
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Amel Drif
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Claire Thalamas
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Agnès Sommet
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Vanessa Rousseau
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Mikael Mazighi
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Fabrice Bonneville
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Gregory W. Albers
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Christophe Cognard
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Vincent Dousset
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Jean Marc Olivot
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Thomas Tourdias
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
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Presurgical Executive Functioning in Low-Grade Glioma Patients Cannot Be Topographically Mapped. Cancers (Basel) 2023; 15:cancers15030807. [PMID: 36765764 PMCID: PMC9913560 DOI: 10.3390/cancers15030807] [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: 11/18/2022] [Revised: 01/18/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
Executive dysfunctions have a high prevalence in low-grade glioma patients and may be the result of structural disconnections of particular subcortical tracts and/or networks. However, little research has focused on preoperative low-grade glioma patients. The frontotemporoparietal network has been closely linked to executive functions and is substantiated by the superior longitudinal fasciculus. The aim of this study was to investigate their role in executive functions in low-grade glioma patients. Patients from two neurological centers were included with IDH-mutated low-grade gliomas. The sets of preoperative predictors were (i) distance between the tumor and superior longitudinal fasciculus, (ii) structural integrity of the superior longitudinal fasciculus, (iii) overlap between tumor and cortical networks, and (iv) white matter disconnection of the same networks. Linear regression and random forest analyses were performed. The group of 156 patients demonstrated significantly lower performance than normative samples and had a higher prevalence of executive impairments. However, both regression and random forest analyses did not demonstrate significant results, meaning that neither structural, cortical network overlap, nor network disconnection predictors explained executive performance. Overall, our null results indicate that there is no straightforward topographical explanation of executive performance in low-grade glioma patients. We extensively discuss possible explanations, including plasticity-induced network-level equipotentiality. Finally, we stress the need for the development of novel methods to unveil the complex and interacting mechanisms that cause executive deficits in low-grade glioma patients.
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Cipolotti L, Ruffle JK, Mole J, Xu T, Hyare H, Shallice T, Chan E, Nachev P. Graph lesion-deficit mapping of fluid intelligence. Brain 2022; 146:167-181. [PMID: 36574957 PMCID: PMC9825598 DOI: 10.1093/brain/awac304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/27/2022] [Accepted: 08/11/2022] [Indexed: 12/29/2022] Open
Abstract
Fluid intelligence is arguably the defining feature of human cognition. Yet the nature of its relationship with the brain remains a contentious topic. Influential proposals drawing primarily on functional imaging data have implicated 'multiple demand' frontoparietal and more widely distributed cortical networks, but extant lesion-deficit studies with greater causal power are almost all small, methodologically constrained, and inconclusive. The task demands large samples of patients, comprehensive investigation of performance, fine-grained anatomical mapping, and robust lesion-deficit inference, yet to be brought to bear on it. We assessed 165 healthy controls and 227 frontal or non-frontal patients with unilateral brain lesions on the best-established test of fluid intelligence, Raven's Advanced Progressive Matrices, employing an array of lesion-deficit inferential models responsive to the potentially distributed nature of fluid intelligence. Non-parametric Bayesian stochastic block models were used to reveal the community structure of lesion deficit networks, disentangling functional from confounding pathological distributed effects. Impaired performance was confined to patients with frontal lesions [F(2,387) = 18.491; P < 0.001; frontal worse than non-frontal and healthy participants P < 0.01, P <0.001], more marked on the right than left [F(4,385) = 12.237; P < 0.001; right worse than left and healthy participants P < 0.01, P < 0.001]. Patients with non-frontal lesions were indistinguishable from controls and showed no modulation by laterality. Neither the presence nor the extent of multiple demand network involvement affected performance. Both conventional network-based statistics and non-parametric Bayesian stochastic block modelling heavily implicated the right frontal lobe. Crucially, this localization was confirmed on explicitly disentangling functional from pathology-driven effects within a layered stochastic block model, prominently highlighting a right frontal network involving middle and inferior frontal gyrus, pre- and post-central gyri, with a weak contribution from right superior parietal lobule. Similar results were obtained with standard lesion-deficit analyses. Our study represents the first large-scale investigation of the distributed neural substrates of fluid intelligence in the focally injured brain. Combining novel graph-based lesion-deficit mapping with detailed investigation of cognitive performance in a large sample of patients provides crucial information about the neural basis of intelligence. Our findings indicate that a set of predominantly right frontal regions, rather than a more widely distributed network, is critical to the high-level functions involved in fluid intelligence. Further they suggest that Raven's Advanced Progressive Matrices is a useful clinical index of fluid intelligence and a sensitive marker of right frontal lobe dysfunction.
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Affiliation(s)
- Lisa Cipolotti
- Correspondence to: Prof. Lisa Cipolotti Department of NeuropsychologyNational Hospital for Neurology and NeurosurgeryQueen Square, London WC1N 3BG, UKE-mail:
| | - James K Ruffle
- Institute of Neurology, University College London, London WC1N 3BG, UK,Department of Radiology, University College London Hospitals NHS Foundation Trust, London NW1 2PG, UK
| | - Joe Mole
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK,Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Tianbo Xu
- Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Harpreet Hyare
- Institute of Neurology, University College London, London WC1N 3BG, UK,Department of Radiology, University College London Hospitals NHS Foundation Trust, London NW1 2PG, UK
| | - Tim Shallice
- Institute of Cognitive Neuroscience, University College London, London WC1N 3AZ, UK,Cognitive Neuropsychology and Neuroimaging Lab, International School for Advanced Studies (SISSA-ISAS), 34136 Trieste, Italy
| | - Edgar Chan
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK,Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Parashkev Nachev
- Institute of Neurology, University College London, London WC1N 3BG, UK
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38
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van Grinsven EE, Smits AR, van Kessel E, Raemaekers MAH, de Haan EHF, Huenges Wajer IMC, Ruijters VJ, Philippens MEP, Verhoeff JJC, Ramsey NF, Robe PAJT, Snijders TJ, van Zandvoort MJE. The impact of etiology in lesion-symptom mapping - A direct comparison between tumor and stroke. Neuroimage Clin 2022; 37:103305. [PMID: 36610310 PMCID: PMC9850191 DOI: 10.1016/j.nicl.2022.103305] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/19/2022] [Accepted: 12/22/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Lesion-symptom mapping is a key tool in understanding the relationship between brain structures and behavior. However, the behavioral consequences of lesions from different etiologies may vary because of how they affect brain tissue and how they are distributed. The inclusion of different etiologies would increase the statistical power but has been critically debated. Meanwhile, findings from lesion studies are a valuable resource for clinicians and used across different etiologies. Therefore, the main objective of the present study was to directly compare lesion-symptom maps for memory and language functions from two populations, a tumor versus a stroke population. METHODS Data from two different studies were combined. Both the brain tumor (N = 196) and stroke (N = 147) patient populations underwent neuropsychological testing and an MRI, pre-operatively for the tumor population and within three months after stroke. For this study, we selected two internationally widely used standardized cognitive tasks, the Rey Auditory Verbal Learning Test and the Verbal Fluency Test. We used a state-of-the-art machine learning-based, multivariate voxel-wise approach to produce lesion-symptom maps for these cognitive tasks for both populations separately and combined. RESULTS Our lesion-symptom mapping results for the separate patient populations largely followed the expected neuroanatomical pattern based on previous literature. Substantial differences in lesion distribution hindered direct comparison. Still, in brain areas with adequate coverage in both groups, considerable LSM differences between the two populations were present for both memory and fluency tasks. Post-hoc analyses of these locations confirmed that the cognitive consequences of focal brain damage varied between etiologies. CONCLUSION The differences in the lesion-symptom maps between the stroke and tumor population could partly be explained by differences in lesion volume and topography. Despite these methodological limitations, both the lesion-symptom mapping results and the post-hoc analyses confirmed that etiology matters when investigating the cognitive consequences of lesions with lesion-symptom mapping. Therefore, caution is advised with generalizing lesion-symptom results across etiologies.
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Affiliation(s)
- E E van Grinsven
- Department of Neurology & Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands.
| | - A R Smits
- Department of Neurology & Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands; Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - E van Kessel
- Department of Neurology & Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - M A H Raemaekers
- Department of Neurology & Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - E H F de Haan
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; St. Hugh's College, Oxford University, UK
| | - I M C Huenges Wajer
- Department of Neurology & Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands; Department of Experimental Psychology and Helmholtz Institute, Utrecht University, the Netherlands
| | - V J Ruijters
- Department of Neurology & Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - M E P Philippens
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the Netherlands
| | - J J C Verhoeff
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the Netherlands
| | - N F Ramsey
- Department of Neurology & Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - P A J T Robe
- Department of Neurology & Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - T J Snijders
- Department of Neurology & Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - M J E van Zandvoort
- Department of Neurology & Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands; Department of Experimental Psychology and Helmholtz Institute, Utrecht University, the Netherlands
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Wiesen D, Bonilha L, Rorden C, Karnath HO. Disconnectomics to unravel the network underlying deficits of spatial exploration and attention. Sci Rep 2022; 12:22315. [PMID: 36566307 PMCID: PMC9789971 DOI: 10.1038/s41598-022-26491-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 12/15/2022] [Indexed: 12/25/2022] Open
Abstract
Spatial attention and exploration are related to a predominantly right hemispheric network structure. However, the areas of the brain involved and their exact role is still debated. Spatial neglect following right hemispheric stroke lesions has been frequently viewed as a model to study these processes in humans. Previous investigations on the anatomical basis on spatial neglect predominantly focused on focal brain damage and lesion-behaviour mapping analyses. This approach might not be suited to detect remote areas structurally spared but which might contribute to the behavioural deficit. In the present study of a sample of 203 right hemispheric stroke patients, we combined connectome lesion-symptom mapping with multivariate support vector regression to unravel the complex and disconnected network structure in spatial neglect. We delineated three central nodes that were extensively disconnected from other intrahemispheric areas, namely the right superior parietal lobule, the insula, and the temporal pole. Additionally, the analysis allocated central roles within this network to the inferior frontal gyrus (pars triangularis and opercularis), right middle temporal gyrus, right temporal pole and left and right orbitofrontal cortices, including interhemispheric disconnection. Our results suggest that these structures-although not necessarily directly damaged-might play a role within the network underlying spatial neglect in humans.
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Affiliation(s)
- Daniel Wiesen
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, 72076, Tübingen, Germany.
| | | | | | - Hans-Otto Karnath
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, 72076, Tübingen, Germany
- Department of Psychology, University of South Carolina, Columbia, USA
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Engleitner H, Jha A, Pinilla MS, Nelson A, Herron D, Rees G, Friston K, Rossor M, Nachev P. GeoSPM: Geostatistical parametric mapping for medicine. PATTERNS (NEW YORK, N.Y.) 2022; 3:100656. [PMID: 36569555 PMCID: PMC9768692 DOI: 10.1016/j.patter.2022.100656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/01/2022] [Accepted: 11/11/2022] [Indexed: 12/13/2022]
Abstract
The characteristics and determinants of health and disease are often organized in space, reflecting our spatially extended nature. Understanding the influence of such factors requires models capable of capturing spatial relations. Drawing on statistical parametric mapping, a framework for topological inference well established in the realm of neuroimaging, we propose and validate an approach to the spatial analysis of diverse clinical data-GeoSPM-based on differential geometry and random field theory. We evaluate GeoSPM across an extensive array of synthetic simulations encompassing diverse spatial relationships, sampling, and corruption by noise, and demonstrate its application on large-scale data from UK Biobank. GeoSPM is readily interpretable, can be implemented with ease by non-specialists, enables flexible modeling of complex spatial relations, exhibits robustness to noise and under-sampling, offers principled criteria of statistical significance, and is through computational efficiency readily scalable to large datasets. We provide a complete, open-source software implementation.
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Affiliation(s)
- Holger Engleitner
- UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
- Corresponding author
| | - Ashwani Jha
- UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Marta Suarez Pinilla
- UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Amy Nelson
- UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Daniel Herron
- Research & Development, NIHR University College London Hospitals Biomedical Research Centre, London W1T 7DN, UK
| | - Geraint Rees
- UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Karl Friston
- UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Martin Rossor
- UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Parashkev Nachev
- UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
- Corresponding author
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Structural disconnection-based prediction of poststroke depression. Transl Psychiatry 2022; 12:461. [PMID: 36329029 PMCID: PMC9633711 DOI: 10.1038/s41398-022-02223-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
Poststroke depression (PSD) is a common complication of stroke. Brain network disruptions caused by stroke are potential biological determinants of PSD but their conclusive roles are unavailable. Our study aimed to identify the strategic structural disconnection (SDC) pattern for PSD at three months poststroke and assess the predictive value of SDC information. Our prospective cohort of 697 first-ever acute ischemic stroke patients were recruited from three hospitals in central China. Sociodemographic, clinical, psychological and neuroimaging data were collected at baseline and depression status was assessed at three months poststroke. Voxel-based disconnection-symptom mapping found that SDCs involving bilateral temporal white matter and posterior corpus callosum, as well as white matter next to bilateral prefrontal cortex and posterior parietal cortex, were associated with PSD. This PSD-specific SDC pattern was used to derive SDC scores for all participants. SDC score was an independent predictor of PSD after adjusting for all imaging and clinical-sociodemographic-psychological covariates (odds ratio, 1.25; 95% confidence interval, 1.07, 1.48; P = 0.006). Split-half replication showed the stability and generalizability of above results. When added to the clinical-sociodemographic-psychological prediction model, SDC score significantly improved the model performance and ranked the highest in terms of predictor importance. In conclusion, a strategic SDC pattern involving multiple lobes bilaterally is identified for PSD at 3 months poststroke. The SDC score is an independent predictor of PSD and may improve the predictive performance of the clinical-sociodemographic-psychological prediction model, providing new evidence for the brain-behavior mechanism and biopsychosocial theory of PSD.
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Mrah S, Descoteaux M, Wager M, Boré A, Rheault F, Thirion B, Mandonnet E. Network-level prediction of set-shifting deterioration after lower-grade glioma resection. J Neurosurg 2022; 137:1329-1337. [PMID: 35245898 DOI: 10.3171/2022.1.jns212257] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/13/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to predict set-shifting deterioration after resection of low-grade glioma. METHODS The authors retrospectively analyzed a bicentric series of 102 patients who underwent surgery for low-grade glioma. The difference between the completion times of the Trail Making Test parts B and A (TMT B-A) was evaluated preoperatively and 3-4 months after surgery. High dimensionality of the information related to the surgical cavity topography was reduced to a small set of predictors in four different ways: 1) overlap between surgical cavity and each of the 122 cortical parcels composing Yeo's 17-network parcellation of the brain; 2) Tractotron: disconnection by the cavity of the major white matter bundles; 3) overlap between the surgical cavity and each of Yeo's networks; and 4) disconets: signature of structural disconnection by the cavity of each of Yeo's networks. A random forest algorithm was implemented to predict the postoperative change in the TMT B-A z-score. RESULTS The last two network-based approaches yielded significant accuracies in left-out subjects (area under the receiver operating characteristic curve [AUC] approximately equal to 0.8, p approximately equal to 0.001) and outperformed the two alternatives. In single tree hierarchical models, the degree of damage to Yeo corticocortical network 12 (CC 12) was a critical node: patients with damage to CC 12 higher than 7.5% (cortical overlap) or 7.2% (disconets) had much higher risk to deteriorate, establishing for the first time a causal link between damage to this network and impaired set-shifting. CONCLUSIONS The authors' results give strong support to the idea that network-level approaches are a powerful way to address the lesion-symptom mapping problem, enabling machine learning-powered individual outcome predictions.
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Affiliation(s)
- Sofiane Mrah
- 1Department of Neurosurgery, Hôpital Lariboisière, AP-HP, Paris, France
| | - Maxime Descoteaux
- 2Sherbrooke Connectivity Imaging Lab, Department of Computer Science, Faculty of Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- 3Imeka Solutions, Sherbrooke, Quebec, Canada
| | - Michel Wager
- 4Department of Neurosurgery, CHU Poitiers, DACTIM-LMA, CNRS 7348, Poitiers, France
| | - Arnaud Boré
- 3Imeka Solutions, Sherbrooke, Quebec, Canada
| | | | | | - Emmanuel Mandonnet
- 1Department of Neurosurgery, Hôpital Lariboisière, AP-HP, Paris, France
- 6Frontlab, Paris Brain Institute (ICM), CNRS UMR 7225, INSERM U1127, Paris, France
- 7Université de Paris, Paris, France
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Billot A, Thiebaut de Schotten M, Parrish TB, Thompson CK, Rapp B, Caplan D, Kiran S. Structural disconnections associated with language impairments in chronic post-stroke aphasia using disconnectome maps. Cortex 2022; 155:90-106. [PMID: 35985126 PMCID: PMC9623824 DOI: 10.1016/j.cortex.2022.06.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 09/14/2021] [Accepted: 06/10/2022] [Indexed: 11/16/2022]
Abstract
Inconsistent findings have been reported about the impact of structural disconnections on language function in post-stroke aphasia. This study investigated patterns of structural disconnections associated with chronic language impairments using disconnectome maps. Seventy-six individuals with post-stroke aphasia underwent a battery of language assessments and a structural MRI scan. Support-vector regression disconnectome-symptom mapping analyses were performed to examine the correlations between disconnectome maps, representing the probability of disconnection at each white matter voxel and different language scores. To further understand whether significant disconnections were primarily representing focal damage or a more extended network of seemingly preserved but disconnected areas beyond the lesion site, results were qualitatively compared to support-vector regression lesion-symptom mapping analyses. Part of the left white matter perisylvian network was similarly disconnected in 90% of the individuals with aphasia. Surrounding this common left perisylvian disconnectome, specific structural disconnections in the left fronto-temporo-parietal network were significantly associated with aphasia severity and with lower performance in auditory comprehension, syntactic comprehension, syntactic production, repetition and naming tasks. Auditory comprehension, repetition and syntactic processing deficits were related to disconnections in areas that overlapped with and extended beyond lesion sites significant in SVR-LSM analyses. In contrast, overall language abilities as measured by aphasia severity and naming seemed to be mostly explained by focal damage at the level of the insular and central opercular cortices, given the high overlap between SVR-DSM and SVR-LSM results for these scores. While focal damage seems to be sufficient to explain broad measures of language performance, the structural disconnections between language areas provide additional information on the neural basis of specific and persistent language impairments at the chronic stage beyond lesion volume. Leveraging routinely available clinical data, disconnectome mapping furthers our understanding of anatomical connectivity constraints that may limit the recovery of some language abilities in chronic post-stroke aphasia.
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Affiliation(s)
- Anne Billot
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA, USA; School of Medicine, Boston University, Boston, MA, USA.
| | - Michel Thiebaut de Schotten
- Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France; Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of Bordeaux, Bordeaux, France
| | - Todd B Parrish
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Cynthia K Thompson
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
| | - Brenda Rapp
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, USA
| | - David Caplan
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Swathi Kiran
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA, USA
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Halai AD, De Dios Perez B, Stefaniak JD, Lambon Ralph MA. Efficient and effective assessment of deficits and their neural bases in stroke aphasia. Cortex 2022; 155:333-346. [PMID: 36087431 PMCID: PMC9548407 DOI: 10.1016/j.cortex.2022.07.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 08/17/2021] [Accepted: 07/20/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Multi-assessment batteries are necessary for diagnosing and quantifying the multifaceted deficits observed post-stroke. Extensive batteries are thorough but impractically long for clinical settings or large-scale research studies. Clinically-targeted "shallow" batteries superficially cover a wide range of language skills relatively quickly but can struggle to identify mild deficits or quantify the impairment level. Our aim was to compare these batteries across a large group of chronic stroke aphasia and to test a novel data-driven reduced version of an extensive battery that maintained sensitivity to mild impairment, ability to grade deficits and the underlying component structure. METHODS We tested 75 chronic left-sided stroke participants, spanning global to mild aphasia. The underlying structure of these three batteries was analysed using cross-validation and principal component analysis, in addition to univariate and multivariate lesion-symptom mapping. RESULTS This revealed a four-factor solution for the extensive and data-reduced batteries, identifying phonology, semantic skills, fluency and executive function in contrast to a two-factor solution using the shallow battery (language severity and cognitive severity). Lesion symptom mapping using participants' factor scores identified convergent neural structures for phonology (superior temporal gyrus), semantics (inferior temporal gyrus), speech fluency (precentral gyrus) and executive function (lateral occipitotemporal cortex). The two shallow battery components converged with the phonology and executive function clusters. In addition, we show that multivariate models could predict the component scores using neural data, however not for every component. CONCLUSIONS Overall, the data-driven battery appears to be an effective way to save time yet retain maintained sensitivity to mild impairment, ability to grade deficits and the underlying component structure observed in post-stroke aphasia.
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Affiliation(s)
- Ajay D Halai
- MRC Cognition & Brain Sciences Unit, University of Cambridge, Cambridge, CB2 7EF, United Kingdom.
| | - Blanca De Dios Perez
- Neuroscience and Aphasia Research Unit (NARU), School of Biological Sciences, The University of Manchester, Manchester, United Kingdom; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - James D Stefaniak
- Neuroscience and Aphasia Research Unit (NARU), School of Biological Sciences, The University of Manchester, Manchester, United Kingdom
| | - Matthew A Lambon Ralph
- MRC Cognition & Brain Sciences Unit, University of Cambridge, Cambridge, CB2 7EF, United Kingdom.
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Sperber C, Griffis J, Kasties V. Indirect structural disconnection-symptom mapping. Brain Struct Funct 2022; 227:3129-3144. [PMID: 36048282 DOI: 10.1007/s00429-022-02559-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 08/24/2022] [Indexed: 01/01/2023]
Abstract
In vivo tracking of white matter fibres catalysed a modern perspective on the pivotal role of brain connectome disruption in neuropsychological deficits. However, the examination of white matter integrity in neurological patients by diffusion-weighted magnetic resonance imaging bears conceptual limitations and is not widely applicable, as it requires imaging-compatible patients and resources beyond the capabilities of many researchers. The indirect estimation of structural disconnection offers an elegant and economical alternative. For this approach, a patient's structural lesion information and normative connectome data are combined to estimate different measures of lesion-induced structural disconnection. Using one of several toolboxes, this method is relatively easy to implement and is even available to scientists without expertise in fibre tracking analyses. Nevertheless, the anatomo-behavioural statistical mapping of structural brain disconnection requires analysis steps that are not covered by these toolboxes. In this paper, we first review the current state of indirect lesion disconnection estimation, the different existing measures, and the available software. Second, we aim to fill the remaining methodological gap in statistical disconnection-symptom mapping by providing an overview and guide to disconnection data and the statistical mapping of their relationship to behavioural measurements using either univariate or multivariate statistical modelling. To assist in the practical implementation of statistical analyses, we have included software tutorials and analysis scripts.
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Affiliation(s)
- Christoph Sperber
- University of Tubingen: Eberhard Karls Universitat Tubingen, Tubingen, Germany.
| | - Joseph Griffis
- University of Tubingen: Eberhard Karls Universitat Tubingen, Tubingen, Germany
| | - Vanessa Kasties
- Centre of Neurology, Hertie-Institute for Clinical Brain Research, University of Tubingen, Tubingen, Germany
- Child Development Center, University Childrens Hospital Zurich, University of Zurich, Zurich, Switzerland
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Schneider HR, Wawrzyniak M, Stockert A, Klingbeil J, Saur D. fMRI informed voxel-based lesion analysis to identify lesions associated with right-hemispheric activation in aphasia recovery. Neuroimage Clin 2022; 36:103169. [PMID: 36037659 PMCID: PMC9440420 DOI: 10.1016/j.nicl.2022.103169] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/01/2022] [Accepted: 08/22/2022] [Indexed: 12/14/2022]
Abstract
Several mechanisms have been attributed to post-stroke loss and recovery of language functions. However, the significance and timing of domain-general and homotopic right-hemispheric activation is controversial. We aimed to examine the effect of left-hemispheric lesion location and time post-stroke on right-hemispheric activation. Voxel-based lesion analyses were informed by auditory language-related fMRI activation of 71 patients with left middle cerebral artery stroke examined longitudinally in the acute, subacute and early chronic phase. Language activation was determined in several right-hemispheric regions of interest and served as regressor of interest for voxel-based lesion analyses. We found that an acute to chronic increase of language activation in the right supplementary motor area was associated with lesions to the left extreme capsule as part of the ventral language pathway. Importantly, this activation increase correlated significantly with improvement of out-of-scanner comprehension abilities. We interpret our findings in terms of successful domain-general compensation in patients with critical left frontotemporal disconnection due to damage to the ventral language pathway but relatively spared cortical language areas.
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Affiliation(s)
| | - Max Wawrzyniak
- Corresponding author at: Klinik und Poliklinik für Neurologie, Universitätsklinikum Leipzig AöR, Liebigstraße 20, 04103 Leipzig, Germany.
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Mapping correlated neurological deficits after stroke to distributed brain networks. Brain Struct Funct 2022; 227:3173-3187. [PMID: 35881254 DOI: 10.1007/s00429-022-02525-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 06/12/2022] [Indexed: 11/02/2022]
Abstract
Understanding the relationships between brain organization and behavior is a central goal of neuroscience. Traditional teaching emphasizes that the human cerebrum includes many distinct areas for which damage or dysfunction would lead to a unique and specific behavioral syndrome. This teaching implies that brain areas correspond to encapsulated modules that are specialized for specific cognitive operations. However, empirically, local damage from stroke more often produces one of a small number of clusters of deficits and disrupts brain-wide connectivity in a small number of predictable ways (relative to the vast complexity of behavior and brain connectivity). Behaviors that involve shared operations show correlated deficits following a stroke, consistent with a low-dimensional behavioral space. Because of the networked organization of the brain, local damage from a stroke can result in widespread functional abnormalities, matching the low dimensionality of behavioral deficit. In alignment with this, neurological disease, psychiatric disease, and altered brain states produce behavioral changes that are highly correlated across a range of behaviors. We discuss how known structural and functional network priors in addition to graph theoretical concepts such as modularity and entropy have provided inroads to understanding this more complex relationship between brain and behavior. This model for brain disease has important implications for normal brain-behavior relationships and the treatment of neurological and psychiatric diseases.
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Sullivan AW, Bowren MD, Bruss J, Tranel D, Demir-Lira ÖE. Academic skills after brain injury: A lifespan perspective. Neuropsychology 2022; 36:419-432. [PMID: 35420857 PMCID: PMC9631230 DOI: 10.1037/neu0000806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES This study investigated academic skills outcomes after brain injury and identified the influence of age and injury factors across the lifespan. METHOD Our sample included 651 participants with focal brain lesions. Math, reading, and spelling data from the Wide Range Achievement Test (WRAT) were used as the academic skills outcomes. Age of lesion onset ranged from 0 to 85 years old. Linear regressions were conducted to identify the relation between age and injury factors and academic skills outcomes. Lesion-symptom mapping was conducted to identify the brain areas that, when lesioned, were associated with deficits in academic skills. RESULTS A quadratic model of age of lesion onset significantly predicted math (R² = .28, p < .001), reading (R² = .29, p < .001), and spelling outcomes (R² = .32, p < .001), while accounting for various covariates. Education, sex, lesion size and laterality, etiology, and seizure history were additional reliable predictors of academic skills outcomes across the lifespan. Academic skill deficits were associated with damage to various brain areas across the left-hemisphere frontal, temporal, and parietal lobes, the insular area, and left- and right-hemisphere white matter. CONCLUSIONS This study supports age of lesion onset as a relevant predictor of academic skills after brain injury in a lifespan sample. Several other variables (e.g., education, sex, lesion characteristics, and seizure history) are notable in the prediction of outcomes across the lifespan. Future work could investigate more diverse samples and emphasize recruitment of early onset injuries to examine generalizability and potential critical periods for academic skills. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Fakhar K, Hilgetag CC. Systematic perturbation of an artificial neural network: A step towards quantifying causal contributions in the brain. PLoS Comput Biol 2022; 18:e1010250. [PMID: 35714139 PMCID: PMC9246164 DOI: 10.1371/journal.pcbi.1010250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 06/30/2022] [Accepted: 05/25/2022] [Indexed: 11/24/2022] Open
Abstract
Lesion inference analysis is a fundamental approach for characterizing the causal contributions of neural elements to brain function. This approach has gained new prominence through the arrival of modern perturbation techniques with unprecedented levels of spatiotemporal precision. While inferences drawn from brain perturbations are conceptually powerful, they face methodological difficulties. Particularly, they are challenged to disentangle the true causal contributions of the involved elements, since often functions arise from coalitions of distributed, interacting elements, and localized perturbations have unknown global consequences. To elucidate these limitations, we systematically and exhaustively lesioned a small artificial neural network (ANN) playing a classic arcade game. We determined the functional contributions of all nodes and links, contrasting results from sequential single-element perturbations with simultaneous perturbations of multiple elements. We found that lesioning individual elements, one at a time, produced biased results. By contrast, multi-site lesion analysis captured crucial details that were missed by single-site lesions. We conclude that even small and seemingly simple ANNs show surprising complexity that needs to be addressed by multi-lesioning for a coherent causal characterization. The motto “No causation without manipulation” is canonical to scientific endeavors. In particular, neuroscience seeks to identify which brain elements are causally involved in cognition and behavior, by perturbing them. However, due to multi-dimensional interactions among the elements, this goal has remained challenging. Here, we used an Artificial Neural Network as a ground-truth model to compare the inferential capacities of two principal approaches, lesioning a system one element at a time versus sampling from the set of all possible combinations of lesions. We show that lesioning one element at a time provides misleading results. Hence, we argue for employing exhaustive perturbation regimes. We further advocate using simulation experiments and ground-truth models to verify the assumptions and limitations of current approaches for brain mapping by perturbation.
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Affiliation(s)
- Kayson Fakhar
- Institute of Computational Neuroscience, University Medical Center Eppendorf, Hamburg University, Hamburg, Germany
- * E-mail:
| | - Claus C. Hilgetag
- Institute of Computational Neuroscience, University Medical Center Eppendorf, Hamburg University, Hamburg, Germany
- Department of Health Sciences, Boston University, Boston, Massachusetts, United States of America
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Bowren M, Bruss J, Manzel K, Edwards D, Liu C, Corbetta M, Tranel D, Boes AD. Post-stroke outcomes predicted from multivariate lesion-behaviour and lesion network mapping. Brain 2022; 145:1338-1353. [PMID: 35025994 PMCID: PMC9630711 DOI: 10.1093/brain/awac010] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/10/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
Clinicians and scientists alike have long sought to predict the course and severity of chronic post-stroke cognitive and motor outcomes, as the ability to do so would inform treatment and rehabilitation strategies. However, it remains difficult to make accurate predictions about chronic post-stroke outcomes due, in large part, to high inter-individual variability in recovery and a reliance on clinical heuristics rather than empirical methods. The neuroanatomical location of a stroke is a key variable associated with long-term outcomes, and because lesion location can be derived from routinely collected clinical neuroimaging data there is an opportunity to use this information to make empirically based predictions about post-stroke deficits. For example, lesion location can be compared to statistically weighted multivariate lesion-behaviour maps of neuroanatomical regions that, when damaged, are associated with specific deficits based on aggregated outcome data from large cohorts. Here, our goal was to evaluate whether we can leverage lesion-behaviour maps based on data from two large cohorts of individuals with focal brain lesions to make predictions of 12-month cognitive and motor outcomes in an independent sample of stroke patients. Further, we evaluated whether we could augment these predictions by estimating the structural and functional networks disrupted in association with each lesion-behaviour map through the use of structural and functional lesion network mapping, which use normative structural and functional connectivity data from neurologically healthy individuals to elucidate lesion-associated networks. We derived these brain network maps using the anatomical regions with the strongest association with impairment for each cognitive and motor outcome based on lesion-behaviour map results. These peak regional findings became the 'seeds' to generate networks, an approach that offers potentially greater precision compared to previously used single-lesion approaches. Next, in an independent sample, we quantified the overlap of each lesion location with the lesion-behaviour maps and structural and functional lesion network mapping and evaluated how much variance each could explain in 12-month behavioural outcomes using a latent growth curve statistical model. We found that each lesion-deficit mapping modality was able to predict a statistically significant amount of variance in cognitive and motor outcomes. Both structural and functional lesion network maps were able to predict variance in 12-month outcomes beyond lesion-behaviour mapping. Functional lesion network mapping performed best for the prediction of language deficits, and structural lesion network mapping performed best for the prediction of motor deficits. Altogether, these results support the notion that lesion location and lesion network mapping can be combined to improve the prediction of post-stroke deficits at 12-months.
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Affiliation(s)
- Mark Bowren
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52242, USA
| | - Joel Bruss
- Department of Neurology, Carver College of Medicine, Iowa City, IA 52242, USA
| | - Kenneth Manzel
- Department of Neurology, Carver College of Medicine, Iowa City, IA 52242, USA
| | - Dylan Edwards
- Moss Rehabilitation Research Institute, Elkins Park, PA 19027, USA
- Edith Cowan University, Joondalup, WA 6027, Australia
| | - Charles Liu
- Neurorestoration Center and Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Rancho Los Amigos National Rehabilitation Center, Downey, CA, USA
| | - Maurizio Corbetta
- Department of Neuroscience, Venetian Institute of Molecular Medicine and Padova Neuroscience Center, University of Padua, Padova, PD 32122, Italy
| | - Daniel Tranel
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52242, USA
- Department of Neurology, Carver College of Medicine, Iowa City, IA 52242, USA
| | - Aaron D Boes
- Departments of Neurology, Psychiatry, and Pediatrics, Carver College of Medicine, Iowa City, IA 52242, USA
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