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Namgung E, Kim YH, Lee EJ, Sasaki Y, Watanabe T, Kang DW. Functional connectivity interacts with visual perceptual learning for visual field recovery in chronic stroke. Sci Rep 2024; 14:3247. [PMID: 38332042 PMCID: PMC10853510 DOI: 10.1038/s41598-024-52778-x] [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: 09/27/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024] Open
Abstract
A reciprocal relationship between perceptual learning and functional brain changes towards perceptual learning effectiveness has been demonstrated previously; however, the underlying neural correlates remain unclear. Further, visual perceptual learning (VPL) is implicated in visual field defect (VFD) recovery following chronic stroke. We investigated resting-state functional connectivity (RSFC) in the visual cortices associated with mean total deviation (MTD) scores for VPL-induced VFD recovery in chronic stroke. Patients with VFD due to chronic ischemic stroke in the visual cortex received 24 VPL training sessions over 2 months, which is a dual discrimination task of orientation and letters. At baseline and two months later, the RSFC in the ipsilesional, interhemispheric, and contralesional visual cortices and MTD scores in the affected hemi-field were assessed. Interhemispheric visual RSFC at baseline showed the strongest correlation with MTD scores post-2-month VPL training. Notably, only the subgroup with high baseline interhemispheric visual RSFC showed significant VFD improvement following the VPL training. The interactions between the interhemispheric visual RSFC at baseline and VPL led to improvement in MTD scores and largely influenced the degree of VFD recovery. The interhemispheric visual RSFC at baseline could be a promising brain biomarker for the effectiveness of VPL-induced VFD recovery.
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Affiliation(s)
- Eun Namgung
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, South Korea
| | | | - Eun-Jae Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yuka Sasaki
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, Providence, USA
| | - Takeo Watanabe
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, Providence, USA
| | - Dong-Wha Kang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
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Chao X, Wang J, Dong Y, Fang Y, Yin D, Wen J, Wang P, Sun W. Neuroimaging of neuropsychological disturbances following ischaemic stroke (CONNECT): a prospective cohort study protocol. BMJ Open 2024; 14:e077799. [PMID: 38286706 PMCID: PMC10826587 DOI: 10.1136/bmjopen-2023-077799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 01/09/2024] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION Neuropsychiatric distubance is a common clinical manifestation in acute ischemic stroke. However, it is frequently overlooked by clinicians. This study aimed to explore the possible aetiology and pathogenesis of neuropsychiatric disturbances following ischaemic stroke (NDIS) from an anatomical and functional perspective with the help of neuroimaging methods. METHOD AND ANALYSIS CONNECT is a prospective cohort study of neuroimaging and its functional outcome in NDIS. We aim to enrol a minimum of 300 individuals with first-ever stroke. The neuropsychological disturbances involved in this study include depression, anxiety disorder, headache, apathy, insomnia, fatigue and cognitive impairment. Using scales that have been shown to be effective in assessing the above symptoms, the NDIS evaluation battery requires at least 2 hours at baseline. Moreover, all patients will be required to complete 2 years of follow-up, during which the NDIS will be re-evaluated at 3 months, 12 months and 24 months by telephone and 6 months by outpatient interview after the index stroke. The primary outcome of our study is the incidence of NDIS at the 6-month mark. Secondary outcomes are related to the severity of NDIS as well as functional rehabilitation of patients. Functional imaging evaluation will be performed at baseline and 6-month follow-up using specific sequences including resting-state functional MRI, diffusion tensor imaging, T1-weighted imaging, T2-weighted imaging, diffusion-weighted imaging, arterial spin labelling, quantitative susceptibility mapping and fluid-attenuated inversion recovery imaging. In addition, we collect haematological information from patients to explore potential biological and genetic markers of NDIS through histological analysis. ETHICS AND DISSEMINATION The CONNECT Study was approved by the Ethics Review Committee of the First Hospital of the University of Science and Technology of China (2021-ky012) and written informed consent will be obtained from all participants. Results will be disseminated via a peer-reviewed journal. TRIAL REGISTRATION NUMBER ChiCTR2100043886.
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Affiliation(s)
- Xian Chao
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jinjing Wang
- Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yiran Dong
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yirong Fang
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Dawei Yin
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jie Wen
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Peng Wang
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Wen Sun
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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Jiang S, Yang C, Wang R, Bao X. Resting-state functional connectivity in a non-human primate model of cortical ischemic stroke in area F1. Magn Reson Imaging 2023; 104:121-128. [PMID: 37844784 DOI: 10.1016/j.mri.2023.10.005] [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: 07/19/2023] [Revised: 09/07/2023] [Accepted: 10/12/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND The application of functional MRI to non-human primates after stroke has not yet been undertaken. This is the first study to explore the functional connectivity changes in non-human primate models during acute stages after stroke onset. METHODS Nineteen healthy male cynomolgus monkeys (4-5 years) were used in this study. The photothrombosis model was employed to induce focal ischemic stroke in F1 area in the monkey's left hemisphere. T1-weighted structural images and resting-state functional magnetic resonance imaging (rs-fMRI) of all subjects were obtained using a 3.0 Tesla MRI system on the third day following stroke. Based on the D99 atlas, the structural and functional changes of bilateral F1 areas in monkeys were analyzed using region of interest (ROI)-based functional connectivity (FC). The bilateral F1 areas were selected as the seed regions due to their crucial role in motor control and their potential to unveil the comprehensive functional reorganization of the motor system at a whole-brain level following stroke. RESULTS Ischemic lesions were observed after the stroke, with larger lesion volumes associated with poorer neurological dysfunction. Compared with baseline condition, left area F1 demonstrated decreased FC with the left cerebellum, left ventral pons and left 5_(PEa). When the ROI was located in the right area F1, ischemic monkeys showed decreased FC in left ventral pons, left cerebellum, left primary visual cortex and left 5_(PEa), accompanied by increased FC in the right orbitofrontal cortex. Importantly, the degree of altered FC between left area F1 and left cerebellum was associated with upper limb tone. CONCLUSIONS These results provide valuable insights into the early-stage functional connectivity changes in the F1 areas of monkeys under ischemic conditions, highlighting the potential involvement of specific brain regions in the pathophysiology of ischemic injury.
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Affiliation(s)
- Shenzhong Jiang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chengxian Yang
- Department of Orthopaedics, Peking University First Hospital, Beijing, China
| | - Renzhi Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Xinjie Bao
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Akaike S, Okamoto T, Kurosawa R, Onodera N, Lin Y, Sato W, Yamamura T, Takahashi Y. Exploring the Potential of the Corpus Callosum Area as a Predictive Marker for Impaired Information Processing in Multiple Sclerosis. J Clin Med 2023; 12:6948. [PMID: 37959412 PMCID: PMC10647459 DOI: 10.3390/jcm12216948] [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: 08/28/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
Early cognitive impairment (CI) detection is crucial in multiple sclerosis (MS). However, it can progress silently regardless of relapse activity and reach an advanced stage. We aimed to determine whether the corpus callosum area (CCA) is a sensitive and feasible marker for CI in MS compared to other neuroimaging markers. We assessed cognitive function in 77 MS patients using the Symbol Digit Modalities Test, Paced Auditory Serial Additions Task, Wechsler Adult Intelligence Scale-IV, and Wechsler Memory Scale-Revised. The neuroimaging markers included manually measured CCA, two diffusion tensor imaging markers, and nine volumetric measurements. Apart from volumes of the hippocampus and cerebellum, ten markers showed a significant correlation with all neuropsychological tests and significant differences between the groups. The normalized CCA demonstrated a moderate-to-strong correlation with all neuropsychological tests and successfully differentiated between the CI and cognitively normal groups with 80% sensitivity and 83% specificity. The marker had a large area under the curve and a high Youden index (0.82 and 0.63, respectively) and comparability with established cognitive markers. Therefore, the normalized CCA may serve as a reliable marker for CI in MS and can be easily implemented in clinical practice, providing a supportive diagnostic tool for CI in MS.
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Affiliation(s)
- Shun Akaike
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan; (S.A.); (Y.T.)
| | - Tomoko Okamoto
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan; (S.A.); (Y.T.)
| | - Ryoji Kurosawa
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan; (S.A.); (Y.T.)
| | - Nozomi Onodera
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan; (S.A.); (Y.T.)
| | - Youwei Lin
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan; (S.A.); (Y.T.)
| | - Wakiro Sato
- Department of Immunology, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Takashi Yamamura
- Department of Immunology, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Yuji Takahashi
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan; (S.A.); (Y.T.)
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Tosoni A, Capotosto P, Baldassarre A, Spadone S, Sestieri C. Neuroimaging evidence supporting a dual-network architecture for the control of visuospatial attention in the human brain: a mini review. Front Hum Neurosci 2023; 17:1250096. [PMID: 37841074 PMCID: PMC10571720 DOI: 10.3389/fnhum.2023.1250096] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/14/2023] [Indexed: 10/17/2023] Open
Abstract
Neuroimaging studies conducted in the last three decades have distinguished two frontoparietal networks responsible for the control of visuospatial attention. The present review summarizes recent findings on the neurophysiological mechanisms implemented in both networks and describes the evolution from a model centered on the distinction between top-down and bottom-up attention to a model that emphasizes the dynamic interplay between the two networks based on attentional demands. The role of the dorsal attention network (DAN) in attentional orienting, by boosting behavioral performance, has been investigated with multiple experimental approaches. This research effort allowed us to trace a distinction between DAN regions involved in shifting vs. maintenance of attention, gather evidence for the modulatory influence exerted by the DAN over sensory cortices, and identify the electrophysiological correlates of the orienting function. Simultaneously, other studies have contributed to reframing our understanding of the functions of the ventral attention network (VAN) and its relevance for behavior. The VAN is not simply involved in bottom-up attentional capture but interacts with the DAN during reorienting to behaviorally relevant targets, exhibiting a general resetting function. Further studies have confirmed the selective rightward asymmetry of the VAN, proposed a functional dissociation along the anteroposterior axis, and suggested hypotheses about its emergence during the evolution of the primate brain. Finally, novel models of network interactions explain the expression of complex attentional functions and the emergence and restorations of symptoms characterizing unilateral spatial neglect. These latter studies emphasize the importance of considering patterns of network interactions for understanding the consequences of brain lesions.
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Affiliation(s)
- Annalisa Tosoni
- Department of Neuroscience, Imaging and Clinical Sciences (DNISC) and ITAB, Institute for Advanced Biomedical Technologies, G. d’Annunzio University of Chieti-Pescara, Chieti, Italy
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Cao X, Wang Z, Chen X, Liu Y, Abdoulaye IA, Ju S, Zhang S, Wu S, Wang Y, Guo Y. Changes in Resting-State Neural Activity and Nerve Fibres in Ischaemic Stroke Patients with Hemiplegia. Brain Topogr 2023; 36:255-268. [PMID: 36604349 DOI: 10.1007/s10548-022-00937-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 12/30/2022] [Indexed: 01/07/2023]
Abstract
Many neuroimaging studies have reported that stroke induces abnormal brain activity. However, little is known about resting-state networks (RSNs) and the corresponding white matter changes in stroke patients with hemiplegia. Here, we utilized functional magnetic resonance imaging (fMRI) to measure neural activity and related fibre tracts in 14 ischaemic stroke patients with hemiplegia and 12 healthy controls. Fractional amplitude of low-frequency fluctuations (fALFF) calculation and correlation analyses were used to assess the relationship between regional neural activity and movement scores. Tractography was performed using diffusion tensor imaging (DTI) data to analyse the fibres passing through the regions of interest. Compared with controls, stroke patients showed abnormal functional connectivity (FC) between some brain regions in the RSNs. The fALFF was increased in the contralesional parietal lobe, with the regional fALFF being correlated with behavioural scores in stroke patients. Additionally, the passage of fibres across regions with reduced FC in the RSNs was increased in stroke patients. This study suggests that structural remodelling of functionally relevant white matter tracts is probably an adaptive response that compensates for injury to the brain.
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Affiliation(s)
- Xuejin Cao
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China
| | - Zan Wang
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China
| | - Xiaohui Chen
- Department of Radiology, Affiliated ZhongDa Hospital of Southeast University, Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, China
| | - Yanli Liu
- Department of Rehabilitation, Affiliated ZhongDa Hospital of Southeast University, Nanjing, China
| | - Idriss Ali Abdoulaye
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China
| | - Shenghong Ju
- Department of Radiology, Affiliated ZhongDa Hospital of Southeast University, Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, China
| | - Shiyao Zhang
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China
| | - Shanshan Wu
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China
| | - Yuancheng Wang
- Department of Radiology, Affiliated ZhongDa Hospital of Southeast University, Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing, China
| | - Yijing Guo
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China. .,Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, 210009, Jiangsu Province, China.
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Khalil AA, Tanritanir AC, Grittner U, Kirilina E, Villringer A, Fiebach JB, Mekle R. Reproducibility of cerebral perfusion measurements using BOLD delay. Hum Brain Mapp 2023; 44:2778-2789. [PMID: 36840928 PMCID: PMC10089099 DOI: 10.1002/hbm.26244] [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: 12/03/2022] [Revised: 02/06/2023] [Accepted: 02/11/2023] [Indexed: 02/26/2023] Open
Abstract
BOLD delay is an emerging, noninvasive method for assessing cerebral perfusion that does not require the use of intravenous contrast agents and is thus particularly suited for longitudinal monitoring. In this study, we assess the reproducibility of BOLD delay using data from 136 subjects with normal cerebral perfusion scanned on two separate occasions with scanners, sequence parameters, and intervals between scans varying between subjects. The effects of various factors on the reproducibility of BOLD delay, defined here as the differences in BOLD delay values between the scanning sessions, were investigated using a linear mixed model. Reproducibility was additionally assessed using the intraclass correlation coefficient of BOLD delay between sessions. Reproducibility was highest in the posterior cerebral artery territory. The mean BOLD delay test-retest difference after accounting for the aforementioned factors was 1.2 s (95% CI = 1.0 to 1.4 s). Overall, BOLD delay shows good reproducibility, but care should be taken when interpreting longitudinal BOLD delay changes that are either very small or are located in certain brain regions.
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Affiliation(s)
- Ahmed A Khalil
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Ayse C Tanritanir
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrike Grittner
- Berlin Institute of Health (BIH), Berlin, Germany.,Charité - Universitätsmedizin Berlin, Institute of Biometry and Clinical Epidemiology, Berlin, Germany
| | - Evgeniya Kirilina
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Center for Cognitive Neuroscience Berlin, Free University, Berlin, Germany
| | - Arno Villringer
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Jochen B Fiebach
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ralf Mekle
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Imms P, Clemente A, Deutscher E, Radwan AM, Akhlaghi H, Beech P, Wilson PH, Irimia A, Poudel G, Domínguez Duque JF, Caeyenberghs K. Exploring personalized structural connectomics for moderate to severe traumatic brain injury. Netw Neurosci 2023; 7:160-183. [PMID: 37334004 PMCID: PMC10270710 DOI: 10.1162/netn_a_00277] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 09/06/2022] [Indexed: 10/03/2023] Open
Abstract
Graph theoretical analysis of the structural connectome has been employed successfully to characterize brain network alterations in patients with traumatic brain injury (TBI). However, heterogeneity in neuropathology is a well-known issue in the TBI population, such that group comparisons of patients against controls are confounded by within-group variability. Recently, novel single-subject profiling approaches have been developed to capture inter-patient heterogeneity. We present a personalized connectomics approach that examines structural brain alterations in five chronic patients with moderate to severe TBI who underwent anatomical and diffusion magnetic resonance imaging. We generated individualized profiles of lesion characteristics and network measures (including personalized graph metric GraphMe plots, and nodal and edge-based brain network alterations) and compared them against healthy reference cases (N = 12) to assess brain damage qualitatively and quantitatively at the individual level. Our findings revealed alterations of brain networks with high variability between patients. With validation and comparison to stratified, normative healthy control comparison cohorts, this approach could be used by clinicians to formulate a neuroscience-guided integrative rehabilitation program for TBI patients, and for designing personalized rehabilitation protocols based on their unique lesion load and connectome.
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Affiliation(s)
- Phoebe Imms
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Adam Clemente
- Healthy Brain and Mind Research Centre, School of Behavioural, Health, and Human Sciences, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Evelyn Deutscher
- Cognitive Neuroscience Unit, School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Ahmed M. Radwan
- KU Leuven, Department of Imaging and Pathology, Translational MRI, Leuven, Belgium
| | - Hamed Akhlaghi
- Emergency Department, St. Vincent’s Hospital (Melbourne), Faculty of Health, Deakin University, Melbourne, Victoria, Australia
| | - Paul Beech
- Department of Radiology and Nuclear Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Peter H. Wilson
- Healthy Brain and Mind Research Centre, School of Behavioural, Health, and Human Sciences, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Andrei Irimia
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
- Corwin D. Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
- Department of Quantitative and Computational Biology, Dana and David Dornsife College of Arts and Sciences, University of Southern California, Los Angeles, CA, USA
| | - Govinda Poudel
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Juan F. Domínguez Duque
- Cognitive Neuroscience Unit, School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
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Bistriceanu CE, Danciu FA, Cuciureanu DI. Cortical connectivity in stroke using signals from resting-state EEG: a review of current literature. Acta Neurol Belg 2022; 123:351-357. [PMID: 36190646 DOI: 10.1007/s13760-022-02102-z] [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: 04/30/2022] [Accepted: 09/20/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Stroke is considered a substantial cause of disability worldwide and many researches are focused on rehabilitative interventions. Functional magnetic resonance imaging studies centered on brain networks after stroke describe affected functional connectivity between areas within the default mode, sensorimotor, visual, fronto-parietal and executive networks. Recent studies renewed the perspective of utilizing electroencephalography to describe markers of cortical activity in stroke and recovery neurophysiological processes. METHODS We included in our research studies realized on patients that had an ischemic or hemorrhagic stroke that performed electroencephalography and had an analysis of connectivity indices. Resting-state electroencephalography has the advantage of including patients with any neurological deficit and it is easier to perform than the task-based variant. The changes in resting-state EEG networks after stroke are important to determine a relationship between frequency cortical activity and spatial conformation of a network. From conventional to quantitative EEG analysis in stroke, these techniques are improved with additional brain connectivity tools that lead to a better characterization between injured areas and other intra- and inter-hemispheric areas. RESULTS There are studies that underline the disruptions in local networks in a frequency-dependent modality after stroke, while other results are focused on bilateral changes in resting-state cortical networks, independent of the side of the lesions. CONCLUSIONS Many studies found alterations in various connectivity measures after stroke with the help of EEG, but the clinical significance of these findings is a field of increasing interest in research area.
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Affiliation(s)
- Cătălina Elena Bistriceanu
- Elytis Hospital Hope, Iasi, Romania.
- Neurology Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
| | | | - Dan Iulian Cuciureanu
- Prof. Dr. N. Oblu" Neurosurgery Clinical Emergency Hospital, Iasi, Romania
- Neurology Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
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Joubran K, Bar-Haim S, Shmuelof L. The functional and structural neural correlates of dynamic balance impairment and recovery in persons with acquired brain injury. Sci Rep 2022; 12:7990. [PMID: 35568728 PMCID: PMC9107482 DOI: 10.1038/s41598-022-12123-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 05/03/2022] [Indexed: 12/29/2022] Open
Abstract
Dynamic balance control is associated with the function of multiple brain networks and is impaired following Acquired Brain Injury (ABI). This study aims to characterize the functional and structural correlates of ABI-induced dynamic balance impairments and recovery following a rehabilitation treatment. Thirty-one chronic participants with ABI participated in a novel rehabilitation treatment composed of 22 sessions of a perturbation-based rehabilitation training. Dynamic balance was assessed using the Community Balance and Mobility scale (CB&M) and the 10-Meter Walking Test (10MWT). Brain function was estimated using resting-state fMRI imaging that was analysed using independent component analysis (ICA), and regions-of-interest analyses. Brain morphology was also assessed using structural MRI. ICA revealed a reduction in component-related activation within the sensorimotor and cerebellar networks post-intervention. Improvement in CB&M scale was associated with a reduction in FC within the cerebellar network and with baseline FC within the cerebellar-putamen and cerebellar-thalamic networks. Improvement in 10MWT was associated with baseline FC within the cerebellar-putamen and cerebellar-cortical networks. Brain volume analysis did not reveal structural correlates of dynamic balance, but dynamic balance was correlated with time since injury. Our results show that dynamic balance recovery is associated with FC reduction within and between the cerebellar and sensorimotor networks. The lack of global structural correlates of dynamic balance may point to the involvement of specific networks in balance control.
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Affiliation(s)
- Katherin Joubran
- Department of Cognitive and Brain Sciences, Ben-Gurion University of the Negev, P.O. Box 653, 84105, Beer-Sheva, Israel. .,Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, 84105, Beer-Sheva, Israel. .,Department of Physical Therapy, Zefat College, Zefat, Israel.
| | - Simona Bar-Haim
- Department of Physical Therapy, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Lior Shmuelof
- Department of Cognitive and Brain Sciences, Ben-Gurion University of the Negev, P.O. Box 653, 84105, Beer-Sheva, Israel. .,Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, 84105, Beer-Sheva, Israel.
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Wu J, Nahab F, Allen JW, Hu R, Dehkharghani S, Qiu D. Alterations in Functional Network Topology Within Normal Hemispheres Contralateral to Anterior Circulation Steno-Occlusive Disease: A Resting-State BOLD Study. Front Neurol 2022; 13:780896. [PMID: 35392638 PMCID: PMC8980268 DOI: 10.3389/fneur.2022.780896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/21/2022] [Indexed: 11/20/2022] Open
Abstract
The purpose of this study was to assess spatially remote effects of hemodynamic impairment on functional network topology contralateral to unilateral anterior circulation steno-occlusive disease (SOD) using resting-state blood oxygen level-dependent (BOLD) imaging, and to investigate the relationships between network connectivity and cerebrovascular reactivity (CVR), a measure of hemodynamic stress. Twenty patients with unilateral, chronic anterior circulation SOD and 20 age-matched healthy controls underwent resting-state BOLD imaging. Five-minute standardized baseline BOLD acquisition was followed by acetazolamide infusion to measure CVR. The BOLD baseline was used to analyze network connectivity contralateral to the diseased hemispheres of SOD patients. Compared to healthy controls, reduced network degree (z-score = −1.158 ± 1.217, P < 0.001, false discovery rate (FDR) corrected), local efficiency (z-score = −1.213 ± 1.120, P < 0.001, FDR corrected), global efficiency (z-score = −1.346 ± 1.119, P < 0.001, FDR corrected), and enhanced modularity (z-score = 1.000 ± 1.205, P = 0.002, FDR corrected) were observed in the contralateral, normal hemispheres of SOD patients. Network degree (P = 0.089, FDR corrected; P = 0.027, uncorrected) and nodal efficiency (P = 0.089, FDR corrected; P = 0.045, uncorrected) showed a trend toward a positive association with CVR. The results indicate remote abnormalities in functional connectivity contralateral to the diseased hemispheres in patients with unilateral SOD, despite the absence of macrovascular disease or demonstrable hemodynamic impairment. The clinical impact of remote functional disruptions requires dedicated investigation but may portend far reaching consequence for even putatively unilateral cerebrovascular disease.
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Affiliation(s)
- Junjie Wu
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Fadi Nahab
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Jason W. Allen
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
- Joint Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, United States
| | - Ranliang Hu
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Seena Dehkharghani
- Department of Radiology, New York University Langone Medical Center, New York, NY, United States
- Department of Neurology, New York University Langone Medical Center, New York, NY, United States
| | - Deqiang Qiu
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States
- Joint Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, United States
- *Correspondence: Deqiang Qiu
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12
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Ren J, Hu Q, Wang W, Zhang W, Hubbard CS, Zhang P, An N, Zhou Y, Dahmani L, Wang D, Fu X, Sun Z, Wang Y, Wang R, Li L, Liu H. Fast cortical surface reconstruction from MRI using deep learning. Brain Inform 2022; 9:6. [PMID: 35262808 PMCID: PMC8907118 DOI: 10.1186/s40708-022-00155-7] [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: 01/02/2022] [Accepted: 02/25/2022] [Indexed: 11/23/2022] Open
Abstract
Reconstructing cortical surfaces from structural magnetic resonance imaging (MRI) is a prerequisite for surface-based functional and anatomical image analyses. Conventional algorithms for cortical surface reconstruction are computationally inefficient and typically take several hours for each subject, causing a bottleneck in applications when a fast turnaround time is needed. To address this challenge, we propose a fast cortical surface reconstruction (FastCSR) pipeline by leveraging deep machine learning. We trained our model to learn an implicit representation of the cortical surface in volumetric space, termed the “level set representation”. A fast volumetric topology correction method and a topology-preserving surface mesh extraction procedure were employed to reconstruct the cortical surface based on the level set representation. Using 1-mm isotropic T1-weighted images, the FastCSR pipeline was able to reconstruct a subject’s cortical surfaces within 5 min with comparable surface quality, which is approximately 47 times faster than the traditional FreeSurfer pipeline. The advantage of FastCSR becomes even more apparent when processing high-resolution images. Importantly, the model demonstrated good generalizability in previously unseen data and showed high test–retest reliability in cortical morphometrics and anatomical parcellations. Finally, FastCSR was robust to images with compromised quality or with distortions caused by lesions. This fast and robust pipeline for cortical surface reconstruction may facilitate large-scale neuroimaging studies and has potential in clinical applications wherein brain images may be compromised.
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Affiliation(s)
- Jianxun Ren
- National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, 100084, China.,Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Qingyu Hu
- School of Computer Science and Technology, University of Science and Technology of China, Hefei, 230027, China
| | | | - Wei Zhang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100080, China
| | - Catherine S Hubbard
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, 29425, USA
| | | | - Ning An
- Neural Galaxy, Beijing, 102206, China
| | - Ying Zhou
- Neural Galaxy, Beijing, 102206, China
| | - Louisa Dahmani
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Danhong Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Xiaoxuan Fu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA.,Department of Neuroscience, Medical University of South Carolina, Charleston, SC, 29425, USA.,State Key Laboratory of Reliability and Intelligence of Electrical Equipment, Hebei University of Technology, Tianjin, 300401, China
| | | | | | - Ruiqi Wang
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, 29425, USA
| | - Luming Li
- National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, 100084, China. .,Precision Medicine and Healthcare Research Center, Tsinghua-Berkeley Shenzhen Institute, Tsinghua University, Shenzhen, 518055, China. .,IDG/McGovern Institute for Brain Research at Tsinghua University, Beijing, 100084, China. .,Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
| | - Hesheng Liu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA. .,Department of Neuroscience, Medical University of South Carolina, Charleston, SC, 29425, USA.
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13
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Boyne P, Doren S, Scholl V, Staggs E, Whitesel D, Carl D, Shatz R, Sawyer R, Awosika OO, Reisman DS, Billinger SA, Kissela B, Vannest J, Dunning K. Preliminary Outcomes of Combined Treadmill and Overground High-Intensity Interval Training in Ambulatory Chronic Stroke. Front Neurol 2022; 13:812875. [PMID: 35185766 PMCID: PMC8854218 DOI: 10.3389/fneur.2022.812875] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/11/2022] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Locomotor high-intensity interval training (HIIT) is a promising intervention for stroke rehabilitation. However, overground translation of treadmill speed gains has been somewhat limited, some important outcomes have not been tested and baseline response predictors are poorly understood. This pilot study aimed to guide future research by assessing preliminary outcomes of combined overground and treadmill HIIT. MATERIALS AND METHODS Ten participants >6 months post-stroke were assessed before and after a 4-week no-intervention control phase and a 4-week treatment phase involving 12 sessions of overground and treadmill HIIT. RESULTS Overground and treadmill gait function both improved during the treatment phase relative to the control phase, with overground speed changes averaging 61% of treadmill speed changes (95% CI: 33-89%). Moderate or larger effect sizes were observed for measures of gait performance, balance, fitness, cognition, fatigue, perceived change and brain volume. Participants with baseline comfortable gait speed <0.4 m/s had less absolute improvement in walking capacity but similar proportional and perceived changes. CONCLUSIONS These findings reinforce the potential of locomotor HIIT research for stroke rehabilitation and provide guidance for more definitive studies. Based on the current results, future locomotor HIIT studies should consider including: (1) both overground and treadmill training; (2) measures of cognition, fatigue and brain volume, to complement typical motor and fitness assessment; and (3) baseline gait speed as a covariate.
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Affiliation(s)
- Pierce Boyne
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Sarah Doren
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Victoria Scholl
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Emily Staggs
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Dustyn Whitesel
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Daniel Carl
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Rhonna Shatz
- Department of Neurology and Rehabilitation Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Russell Sawyer
- Department of Neurology and Rehabilitation Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Oluwole O. Awosika
- Department of Neurology and Rehabilitation Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Darcy S. Reisman
- Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, DE, United States
| | - Sandra A. Billinger
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States
| | - Brett Kissela
- Department of Neurology and Rehabilitation Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Jennifer Vannest
- Department of Communication Sciences and Disorders, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Kari Dunning
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, United States
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14
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Wu Z, Cao M, Di X, Wu K, Gao Y, Li X. Regional Topological Aberrances of White Matter- and Gray Matter-Based Functional Networks for Attention Processing May Foster Traumatic Brain Injury-Related Attention Deficits in Adults. Brain Sci 2021; 12:brainsci12010016. [PMID: 35053760 PMCID: PMC8774280 DOI: 10.3390/brainsci12010016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 12/31/2022] Open
Abstract
Traumatic brain injury (TBI) is highly prevalent in adults. TBI-related functional brain alterations have been linked with common post-TBI neurobehavioral sequelae, with unknown neural substrates. This study examined the systems-level functional brain alterations in white matter (WM) and gray matter (GM) for visual sustained-attention processing, and their interactions and contributions to post-TBI attention deficits. Task-based functional MRI data were collected from 42 adults with TBI and 43 group-matched normal controls (NCs), and analyzed using the graph theoretic technique. Global and nodal topological properties were calculated and compared between the two groups. Correlation analyses were conducted between the neuroimaging measures that showed significant between-group differences and the behavioral symptom measures in attention domain in the groups of TBI and NCs, respectively. Significantly altered nodal efficiencies and/or degrees in several WM and GM nodes were reported in the TBI group, including the posterior corona radiata (PCR), posterior thalamic radiation (PTR), postcentral gyrus (PoG), and superior temporal sulcus (STS). Subjects with TBI also demonstrated abnormal systems-level functional synchronization between the PTR and STS in the right hemisphere, hypo-interaction between the PCR and PoG in the left hemisphere, as well as the involvement of systems-level functional aberrances in the PCR in TBI-related behavioral impairments in the attention domain. The findings of the current study suggest that TBI-related systems-level functional alterations associated with these two major-association WM tracts, and their anatomically connected GM regions may play critical role in TBI-related behavioral deficits in attention domains.
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Affiliation(s)
- Ziyan Wu
- Department of Electrical and Computer Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA;
| | - Meng Cao
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA; (M.C.); (X.D.)
| | - Xin Di
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA; (M.C.); (X.D.)
| | - Kai Wu
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou 510630, China;
| | - Yu Gao
- Department of Psychology, Brooklyn College, The City University of New York, New York, NY 11210, USA;
- The Graduate Center, The City University of New York, New York, NY 10016, USA
| | - Xiaobo Li
- Department of Electrical and Computer Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA;
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA; (M.C.); (X.D.)
- Correspondence: or ; Tel.: +1-973-596-5880
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15
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Adhikari MH, Griffis J, Siegel JS, Thiebaut de Schotten M, Deco G, Instabato A, Gilson M, Corbetta M. Effective connectivity extracts clinically relevant prognostic information from resting state activity in stroke. Brain Commun 2021; 3:fcab233. [PMID: 34729479 PMCID: PMC8557690 DOI: 10.1093/braincomms/fcab233] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/11/2021] [Accepted: 06/25/2021] [Indexed: 11/16/2022] Open
Abstract
Recent resting-state functional MRI studies in stroke patients have identified two robust biomarkers of acute brain dysfunction: a reduction of inter-hemispheric functional connectivity between homotopic regions of the same network, and an abnormal increase of ipsi-lesional functional connectivity between task-negative and task-positive resting-state networks. Whole-brain computational modelling studies, at the individual subject level, using undirected effective connectivity derived from empirically measured functional connectivity, have shown a reduction of measures of integration and segregation in stroke as compared to healthy brains. Here we employ a novel method, first, to infer whole-brain directional effective connectivity from zero-lagged and lagged covariance matrices, then, to compare it to empirically measured functional connectivity for predicting stroke versus healthy status, and patient performance (zero, one, multiple deficits) across neuropsychological tests. We also investigated the accuracy of functional connectivity versus model effective connectivity in predicting the long-term outcome from acute measures. Both functional and effective connectivity predicted healthy from stroke individuals significantly better than the chance-level; however, accuracy for the effective connectivity was significantly higher than for functional connectivity at 1- to 2-week, 3-month and 1-year post-stroke. Predictive functional connections mainly included those reported in previous studies (within-network inter-hemispheric and between task-positive and -negative networks intra-hemispherically). Predictive effective connections included additional between-network links. Effective connectivity was a better predictor than functional connectivity of the number of behavioural domains in which patients suffered deficits, both at 2-week and 1-year post-onset of stroke. Interestingly, patient deficits at 1-year time-point were better predicted by effective connectivity values at 2 weeks rather than at 1-year time-point. Our results thus demonstrate that the second-order statistics of functional MRI resting-state activity at an early stage of stroke, derived from a whole-brain effective connectivity, estimated in a model fitted to reproduce the propagation of neuronal activity, has pertinent information for clinical prognosis.
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Affiliation(s)
- Mohit H Adhikari
- Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, University of Pompeu Fabra, Barcelona 08018, Spain.,Bio-imaging Lab, Department of Biomedical Sciences, University of Antwerp, Anwerp 2610, Belgium
| | - Joseph Griffis
- Department of Neurology, Radiology and Neuroscience, Washington University School of Medicine, 660 S Euclid Ave, St. Louis, MO 63108, USA
| | - Joshua S Siegel
- Department of Neurology, Radiology and Neuroscience, Washington University School of Medicine, 660 S Euclid Ave, St. Louis, MO 63108, USA
| | - Michel Thiebaut de Schotten
- Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Quai Saint Bernard 75005, Paris, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of Bordeaux, 146 Rue Léo Saignat, 33000, Bordeaux, France
| | - Gustavo Deco
- Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, University of Pompeu Fabra, Barcelona 08018, Spain.,Institucio Catalana de la Recerca I Estudis Avancats (ICREA), University of Pompeu Fabra, Barcelona 08010, Spain
| | - Andrea Instabato
- Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, University of Pompeu Fabra, Barcelona 08018, Spain
| | - Matthieu Gilson
- Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, University of Pompeu Fabra, Barcelona 08018, Spain.,Institute of Neuroscience and Medicine (INM-6) and Institute for Advanced Simulation (IAS-6) and JARA Institute Brain Structure-Function Relationships (INM-10), Jülich Research Centre, 52425, Jülich, Germany
| | - Maurizio Corbetta
- Department of Neurology, Radiology and Neuroscience, Washington University School of Medicine, 660 S Euclid Ave, St. Louis, MO 63108, USA.,Department of Neuroscience, Padova Neuroscience Center (PNC), University of Padova, Via Giuseppe Orus, 2, 35131 Padova PD, Italy.,Venetian Institute of Molecular Medicine (VIMM), Fondazione Biomedica, Via Orus 2, 35129, Padova, Italy
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16
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Krishnamurthy LC, Krishnamurthy V, Rodriguez AD, McGregor KM, Glassman CN, Champion GS, Rocha N, Harnish SM, Belagaje SR, Kundu S, Crosson BA. Not All Lesioned Tissue Is Equal: Identifying Pericavitational Areas in Chronic Stroke With Tissue Integrity Gradation via T2w T1w Ratio. Front Neurosci 2021; 15:665707. [PMID: 34421509 PMCID: PMC8378269 DOI: 10.3389/fnins.2021.665707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/05/2021] [Indexed: 11/14/2022] Open
Abstract
Stroke-related tissue damage within lesioned brain areas is topologically non-uniform and has underlying tissue composition changes that may have important implications for rehabilitation. However, we know of no uniformly accepted, objective non-invasive methodology to identify pericavitational areas within the chronic stroke lesion. To fill this gap, we propose a novel magnetic resonance imaging (MRI) methodology to objectively quantify the lesion core and surrounding pericavitational perimeter, which we call tissue integrity gradation via T2w T1w ratio (TIGR). TIGR uses standard T1-weighted (T1w) and T2-weighted (T2w) anatomical images routinely collected in the clinical setting. TIGR maps are analyzed with relation to subject-specific gray matter and cerebrospinal fluid thresholds and binned to create a false colormap of tissue damage within the stroke lesion, and these are further categorized into low-, medium-, and high-damage areas. We validate TIGR by showing that the cerebral blood flow within the lesion reduces with greater tissue damage (p = 0.005). We further show that a significant task activity can be detected in pericavitational areas and that medium-damage areas contain a significantly lower magnitude of hemodynamic response function than the adjacent damaged areas (p < 0.0001). We also demonstrate the feasibility of using TIGR maps to extract multivariate brain-behavior relationships (p < 0.05) and show general agreement in location compared to binary lesion, T1w-only, and T2w-only maps but that the extent of brain behavior maps may depend on signal sensitivity as denoted by the sparseness coefficient (p < 0.0001). Finally, we show the feasibility of quantifying TIGR in early and late subacute stroke phases, where higher-damage areas were smaller in size (p = 0.002) and that lesioned voxels transition from lower to higher damage with increasing time post-stroke (p = 0.004). We conclude that TIGR is able to (1) identify tissue damage gradient within the stroke lesion across different post-stroke timepoints and (2) more objectively delineate lesion core from pericavitational areas wherein such areas demonstrate reasonable and expected physiological and functional impairments. Importantly, because T1w and T2w scans are routinely collected in the clinic, TIGR maps can be readily incorporated in clinical settings without additional imaging costs or patient burden to facilitate decision processes related to rehabilitation planning.
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Affiliation(s)
- Lisa C. Krishnamurthy
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, United States
- Department of Physics and Astronomy, Georgia State University, Atlanta, GA, United States
| | - Venkatagiri Krishnamurthy
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, United States
- Division of Geriatrics and Gerontology, Department of Medicine, Emory University, Atlanta, GA, United States
- Department of Neurology, Emory University, Atlanta, GA, United States
| | - Amy D. Rodriguez
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, United States
- Department of Neurology, Emory University, Atlanta, GA, United States
| | - Keith M. McGregor
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, United States
- Department of Neurology, Emory University, Atlanta, GA, United States
| | - Clara N. Glassman
- Department of Nuclear and Radiological Engineering and Medical Physics, Georgia Institute of Technology, Atlanta, GA, United States
| | - Gabriell S. Champion
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, United States
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Natalie Rocha
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, United States
| | - Stacy M. Harnish
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, United States
| | - Samir R. Belagaje
- Department of Neurology, Emory University, Atlanta, GA, United States
- Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
| | - Suprateek Kundu
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, United States
| | - Bruce A. Crosson
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, United States
- Department of Neurology, Emory University, Atlanta, GA, United States
- Department of Psychology, Georgia State University, Atlanta, GA, United States
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17
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Nicolas K, Goodin P, Visser MM, Michie PT, Bivard A, Levi C, Parsons MW, Karayanidis F. Altered Functional Connectivity and Cognition Persists 4 Years After a Transient Ischemic Attack or Minor Stroke. Front Neurol 2021; 12:612177. [PMID: 34163417 PMCID: PMC8215289 DOI: 10.3389/fneur.2021.612177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 04/30/2021] [Indexed: 11/25/2022] Open
Abstract
Background and Purpose: Altered executive functions and resting-state functional connectivity (rsFC) are common following a minor stroke or transient ischemic attack (TIA). However, the long-term persistence of these abnormalities is not well-studied. We investigated whether there were cognitive and rsFC differences between (a) controls and minor cerebrovascular event (CVE) patients and (b) between CVE patients with and without an imaging confirmed infarct (i.e., minor stroke and TIA, respectively) at an average of 3.8 years following their event. Methods: Structural and resting-state imaging and cognitive assessments including the Montreal Cognitive Assessment, the Trail Making Task and the National Institute of Health (NIH) Cognition Toolbox were conducted on 42 patients (minor stroke = 17, TIA = 25) and 20 healthy controls (total N = 62). Results: Controls performed better than patients on two measures of executive functioning (both p < 0.046) and had reduced rsFC between the frontoparietal and default mode networks (FPN and DMN, respectively; p = 0.035). No cognitive differences were found between minor stroke and TIA patients, however, rsFC differences were found within the FPN and the DMN (both p < 0.013). Specifically, increased connectivity within the FPN was associated with faster performance in the minor stroke group but not the TIA group (p = 0.047). Conclusions: These findings suggest that transient or relatively minor cerebrovascular events are associated with persistent disruption of functional connectivity of neural networks and cognitive performance. These findings suggest a need for novel interventions beyond secondary prevention to reduce the risk of persistent cognitive deficits.
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Affiliation(s)
- Korinne Nicolas
- Functional Neuroimaging Laboratory, School of Psychology, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia.,Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia
| | - Peter Goodin
- Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Milanka M Visser
- Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia.,Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Patricia T Michie
- Functional Neuroimaging Laboratory, School of Psychology, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Andrew Bivard
- Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia.,Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Christopher Levi
- Hunter Medical Research Institute, Newcastle, NSW, Australia.,Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia.,Sydney Partnership for Health, Education, Research and Enterprise, Sydney, NSW, Australia
| | - Mark W Parsons
- Hunter Medical Research Institute, Newcastle, NSW, Australia.,Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia.,Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Frini Karayanidis
- Functional Neuroimaging Laboratory, School of Psychology, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia.,Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia
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18
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Bonkhoff AK, Schirmer MD, Bretzner M, Etherton M, Donahue K, Tuozzo C, Nardin M, Giese A, Wu O, D. Calhoun V, Grefkes C, Rost NS. Abnormal dynamic functional connectivity is linked to recovery after acute ischemic stroke. Hum Brain Mapp 2021; 42:2278-2291. [PMID: 33650754 PMCID: PMC8046120 DOI: 10.1002/hbm.25366] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/26/2021] [Accepted: 01/29/2021] [Indexed: 12/30/2022] Open
Abstract
The aim of the current study was to explore the whole-brain dynamic functional connectivity patterns in acute ischemic stroke (AIS) patients and their relation to short and long-term stroke severity. We investigated resting-state functional MRI-based dynamic functional connectivity of 41 AIS patients two to five days after symptom onset. Re-occurring dynamic connectivity configurations were obtained using a sliding window approach and k-means clustering. We evaluated differences in dynamic patterns between three NIHSS-stroke severity defined groups (mildly, moderately, and severely affected patients). Furthermore, we built Bayesian hierarchical models to evaluate the predictive capacity of dynamic connectivity and examine the interrelation with clinical measures, such as white matter hyperintensity lesions. Finally, we established correlation analyses between dynamic connectivity and AIS severity as well as 90-day neurological recovery (ΔNIHSS). We identified three distinct dynamic connectivity configurations acutely post-stroke. More severely affected patients spent significantly more time in a configuration that was characterized by particularly strong connectivity and isolated processing of functional brain domains (three-level ANOVA: p < .05, post hoc t tests: p < .05, FDR-corrected). Configuration-specific time estimates possessed predictive capacity of stroke severity in addition to the one of clinical measures. Recovery, as indexed by the realized change of the NIHSS over time, was significantly linked to the dynamic connectivity between bilateral intraparietal lobule and left angular gyrus (Pearson's r = -.68, p = .003, FDR-corrected). Our findings demonstrate transiently increased isolated information processing in multiple functional domains in case of severe AIS. Dynamic connectivity involving default mode network components significantly correlated with recovery in the first 3 months poststroke.
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Affiliation(s)
- Anna K. Bonkhoff
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
- Cognitive NeuroscienceInstitute of Neuroscience and Medicine (INM‐3), Research Centre JuelichJuelichGermany
| | - Markus D. Schirmer
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
- Department of Population Health SciencesGerman Centre for Neurodegenerative Diseases (DZNE)Germany
| | - Martin Bretzner
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
- Neurosciences and CognitionUniversity of LilleLilleFrance
| | - Mark Etherton
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
| | - Kathleen Donahue
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
| | - Carissa Tuozzo
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
| | - Marco Nardin
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
| | - Anne‐Katrin Giese
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
- Department of NeurologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Ona Wu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of RadiologyMassachusetts General HospitalCharlestownMassachusettsUSA
| | - Vince D. Calhoun
- Tri‐institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of TechnologyEmory UniversityAtlantaGeorgiaUSA
| | - Christian Grefkes
- Cognitive NeuroscienceInstitute of Neuroscience and Medicine (INM‐3), Research Centre JuelichJuelichGermany
- Department of NeurologyUniversity Hospital CologneCologneGermany
| | - Natalia S. Rost
- J. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMassachusettsUSA
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19
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Cheng HJ, Ng KK, Qian X, Ji F, Lu ZK, Teo WP, Hong X, Nasrallah FA, Ang KK, Chuang KH, Guan C, Yu H, Chew E, Zhou JH. Task-related brain functional network reconfigurations relate to motor recovery in chronic subcortical stroke. Sci Rep 2021; 11:8442. [PMID: 33875691 PMCID: PMC8055891 DOI: 10.1038/s41598-021-87789-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/27/2021] [Indexed: 12/12/2022] Open
Abstract
Stroke leads to both regional brain functional disruptions and network reorganization. However, how brain functional networks reconfigure as task demand increases in stroke patients and whether such reorganization at baseline would facilitate post-stroke motor recovery are largely unknown. To address this gap, brain functional connectivity (FC) were examined at rest and motor tasks in eighteen chronic subcortical stroke patients and eleven age-matched healthy controls. Stroke patients underwent a 2-week intervention using a motor imagery-assisted brain computer interface-based (MI-BCI) training with or without transcranial direct current stimulation (tDCS). Motor recovery was determined by calculating the changes of the upper extremity component of the Fugl-Meyer Assessment (FMA) score between pre- and post-intervention divided by the pre-intervention FMA score. The results suggested that as task demand increased (i.e., from resting to passive unaffected hand gripping and to active affected hand gripping), patients showed greater FC disruptions in cognitive networks including the default and dorsal attention networks. Compared to controls, patients had lower task-related spatial similarity in the somatomotor-subcortical, default-somatomotor, salience/ventral attention-subcortical and subcortical-subcortical connections, suggesting greater inefficiency in motor execution. Importantly, higher baseline network-specific FC strength (e.g., dorsal attention and somatomotor) and more efficient brain network reconfigurations (e.g., somatomotor and subcortical) from rest to active affected hand gripping at baseline were related to better future motor recovery. Our findings underscore the importance of studying functional network reorganization during task-free and task conditions for motor recovery prediction in stroke.
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Affiliation(s)
- Hsiao-Ju Cheng
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Biomedical Engineering, Faculty of Engineering, National University of Singapore, Singapore, Singapore
| | - Kwun Kei Ng
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xing Qian
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Fang Ji
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Zhong Kang Lu
- Institute for Infocomm Research, Agency for Science Technology and Research, Singapore, Singapore
| | - Wei Peng Teo
- National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Xin Hong
- Singapore Bioimaging Consortium, Agency for Science Technology and Research, Singapore, Singapore
| | - Fatima Ali Nasrallah
- Singapore Bioimaging Consortium, Agency for Science Technology and Research, Singapore, Singapore
- Queensland Brain Institute and Centre for Advanced Imaging, The University of Queensland, Brisbane, Australia
| | - Kai Keng Ang
- Institute for Infocomm Research, Agency for Science Technology and Research, Singapore, Singapore
- School of Computer Science and Engineering, Nanyang Technology University, Singapore, Singapore
| | - Kai-Hsiang Chuang
- Singapore Bioimaging Consortium, Agency for Science Technology and Research, Singapore, Singapore
- Queensland Brain Institute and Centre for Advanced Imaging, The University of Queensland, Brisbane, Australia
| | - Cuntai Guan
- School of Computer Science and Engineering, Nanyang Technology University, Singapore, Singapore
| | - Haoyong Yu
- Department of Biomedical Engineering, Faculty of Engineering, National University of Singapore, Singapore, Singapore
| | - Effie Chew
- Division of Neurology/Rehabilitation Medicine, National University Hospital, Singapore, Singapore.
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore.
| | - Juan Helen Zhou
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Center for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Tahir Foundation Building (MD1), 12 Science Drive 2, #13-05C, Singapore, 117549, Singapore.
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore.
- Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore, Singapore.
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20
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Kraeutner SN, Rubino C, Rinat S, Lakhani B, Borich MR, Wadden KP, Boyd LA. Resting State Connectivity Is Modulated by Motor Learning in Individuals After Stroke. Neurorehabil Neural Repair 2021; 35:513-524. [PMID: 33825574 PMCID: PMC8135242 DOI: 10.1177/15459683211006713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective Activity patterns across brain regions that can be characterized at rest (ie, resting-state functional connectivity [rsFC]) are disrupted after stroke and linked to impairments in motor function. While changes in rsFC are associated with motor recovery, it is not clear how rsFC is modulated by skilled motor practice used to promote recovery. The current study examined how rsFC is modulated by skilled motor practice after stroke and how changes in rsFC are linked to motor learning. Methods Two groups of participants (individuals with stroke and age-matched controls) engaged in 4 weeks of skilled motor practice of a complex, gamified reaching task. Clinical assessments of motor function and impairment, and brain activity (via functional magnetic resonance imaging) were obtained before and after training. Results While no differences in rsFC were observed in the control group, increased connectivity was observed in the sensorimotor network, linked to learning in the stroke group. Relative to healthy controls, a decrease in network efficiency was observed in the stroke group following training. Conclusions Findings indicate that rsFC patterns related to learning observed after stroke reflect a shift toward a compensatory network configuration characterized by decreased network efficiency.
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Affiliation(s)
| | - Cristina Rubino
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Shie Rinat
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Bimal Lakhani
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Katie P Wadden
- Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Lara A Boyd
- University of British Columbia, Vancouver, British Columbia, Canada
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21
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Griffis JC, Metcalf NV, Corbetta M, Shulman GL. Lesion Quantification Toolkit: A MATLAB software tool for estimating grey matter damage and white matter disconnections in patients with focal brain lesions. Neuroimage Clin 2021; 30:102639. [PMID: 33813262 PMCID: PMC8053805 DOI: 10.1016/j.nicl.2021.102639] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 12/19/2022]
Abstract
Lesion studies are an important tool for cognitive neuroscientists and neurologists. However, while brain lesion studies have traditionally aimed to localize neurological symptoms to specific anatomical loci, a growing body of evidence indicates that neurological diseases such as stroke are best conceptualized as brain network disorders. While researchers in the fields of neuroscience and neurology are therefore increasingly interested in quantifying the effects of focal brain lesions on the white matter connections that form the brain's structural connectome, few dedicated tools exist to facilitate this endeavor. Here, we present the Lesion Quantification Toolkit, a publicly available MATLAB software package for quantifying the structural impacts of focal brain lesions. The Lesion Quantification Toolkit uses atlas-based approaches to estimate parcel-level grey matter lesion loads and multiple measures of white matter disconnection severity that include tract-level disconnection measures, voxel-wise disconnection maps, and parcel-wise disconnection matrices. The toolkit also estimates lesion-induced increases in the lengths of the shortest structural paths between parcel pairs, which provide information about changes in higher-order structural network topology. We describe in detail each of the different measures produced by the toolkit, discuss their applications and considerations relevant to their use, and perform example analyses using real behavioral data collected from sub-acute stroke patients. We show that analyses performed using the different measures produced by the toolkit produce results that are highly consistent with results that have been reported in the prior literature, and we demonstrate the consistency of results obtained from analyses conducted using the different disconnection measures produced by the toolkit. We anticipate that the Lesion Quantification Toolkit will empower researchers to address research questions that would be difficult or impossible to address using traditional lesion analyses alone, and ultimately, lead to advances in our understanding of how white matter disconnections contribute to the cognitive, behavioral, and physiological consequences of focal brain lesions.
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Affiliation(s)
- Joseph C Griffis
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Nicholas V Metcalf
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Maurizio Corbetta
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Anatomy and Neurobiology, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Bioengineering, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Neuroscience, University of Padua, Padua, Italy; Padua Neuroscience Center, Padua, Italy
| | - Gordon L Shulman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
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22
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Ozzoude M, Ramirez J, Raamana PR, Holmes MF, Walker K, Scott CJM, Gao F, Goubran M, Kwan D, Tartaglia MC, Beaton D, Saposnik G, Hassan A, Lawrence-Dewar J, Dowlatshahi D, Strother SC, Symons S, Bartha R, Swartz RH, Black SE. Cortical Thickness Estimation in Individuals With Cerebral Small Vessel Disease, Focal Atrophy, and Chronic Stroke Lesions. Front Neurosci 2020; 14:598868. [PMID: 33381009 PMCID: PMC7768006 DOI: 10.3389/fnins.2020.598868] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/24/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Regional changes to cortical thickness in individuals with neurodegenerative and cerebrovascular diseases (CVD) can be estimated using specialized neuroimaging software. However, the presence of cerebral small vessel disease, focal atrophy, and cortico-subcortical stroke lesions, pose significant challenges that increase the likelihood of misclassification errors and segmentation failures. PURPOSE The main goal of this study was to examine a correction procedure developed for enhancing FreeSurfer's (FS's) cortical thickness estimation tool, particularly when applied to the most challenging MRI obtained from participants with chronic stroke and CVD, with varying degrees of neurovascular lesions and brain atrophy. METHODS In 155 CVD participants enrolled in the Ontario Neurodegenerative Disease Research Initiative (ONDRI), FS outputs were compared between a fully automated, unmodified procedure and a corrected procedure that accounted for potential sources of error due to atrophy and neurovascular lesions. Quality control (QC) measures were obtained from both procedures. Association between cortical thickness and global cognitive status as assessed by the Montreal Cognitive Assessment (MoCA) score was also investigated from both procedures. RESULTS Corrected procedures increased "Acceptable" QC ratings from 18 to 76% for the cortical ribbon and from 38 to 92% for tissue segmentation. Corrected procedures reduced "Fail" ratings from 11 to 0% for the cortical ribbon and 62 to 8% for tissue segmentation. FS-based segmentation of T1-weighted white matter hypointensities were significantly greater in the corrected procedure (5.8 mL vs. 15.9 mL, p < 0.001). The unmodified procedure yielded no significant associations with global cognitive status, whereas the corrected procedure yielded positive associations between MoCA total score and clusters of cortical thickness in the left superior parietal (p = 0.018) and left insula (p = 0.04) regions. Further analyses with the corrected cortical thickness results and MoCA subscores showed a positive association between left superior parietal cortical thickness and Attention (p < 0.001). CONCLUSION These findings suggest that correction procedures which account for brain atrophy and neurovascular lesions can significantly improve FS's segmentation results and reduce failure rates, thus maximizing power by preventing the loss of our important study participants. Future work will examine relationships between cortical thickness, cerebral small vessel disease, and cognitive dysfunction due to neurodegenerative disease in the ONDRI study.
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Affiliation(s)
- Miracle Ozzoude
- LC Campbell Cognitive Neurology Research, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Joel Ramirez
- LC Campbell Cognitive Neurology Research, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | | | - Melissa F. Holmes
- LC Campbell Cognitive Neurology Research, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Kirstin Walker
- LC Campbell Cognitive Neurology Research, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Christopher J. M. Scott
- LC Campbell Cognitive Neurology Research, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Fuqiang Gao
- LC Campbell Cognitive Neurology Research, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Maged Goubran
- LC Campbell Cognitive Neurology Research, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Donna Kwan
- Centre for Neuroscience Studies, Queens University, Kingston, ON, Canada
| | - Maria C. Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
- Division of Neurology, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Derek Beaton
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Gustavo Saposnik
- Stroke Outcomes and Decision Neuroscience Research Unit, Division of Neurology, St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada
| | - Ayman Hassan
- Thunder Bay Regional Health Research Institute, Thunder Bay, ON, Canada
| | | | - Dariush Dowlatshahi
- Department of Medicine (Neurology), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Stephen C. Strother
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Sean Symons
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Robert Bartha
- Centre for Functional and Metabolic Mapping, Department of Medical Biophysics, Robarts Research Institute, University of Western Ontario, London, ON, Canada
| | - Richard H. Swartz
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Sandra E. Black
- LC Campbell Cognitive Neurology Research, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
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23
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Zhang Y, Hua Y, Bai Y. Applications of Functional Magnetic Resonance Imaging in Determining the Pathophysiological Mechanisms and Rehabilitation of Spatial Neglect. Front Neurol 2020; 11:548568. [PMID: 33281698 PMCID: PMC7688780 DOI: 10.3389/fneur.2020.548568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 09/25/2020] [Indexed: 12/16/2022] Open
Abstract
Functional magnetic resonance imaging (fMRI) is a neuroimaging tool which has been applied extensively to explore the pathophysiological mechanisms of neurological disorders. Spatial neglect is considered to be the failure to attend or respond to stimuli on the side of the space or body opposite a cerebral lesion. In this review, we summarize and analyze fMRI studies focused specifically on spatial neglect. Evidence from fMRI studies have highlighted the role of dorsal and ventral attention networks in the pathophysiological mechanisms of spatial neglect, and also support the concept of interhemispheric rivalry as an explanatory model. fMRI studies have shown that several rehabilitation methods can induce activity changes in brain regions implicated in the control of spatial attention. Future investigations with large study cohorts and appropriate subgroup analyses should be conducted to confirm the possibility that fMRI might offer an objective standard for predicting spatial neglect and tracking the response of brain activity to clinical treatment, as well as provide biomarkers to guide rehabilitation for patients with SN.
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Affiliation(s)
- Yuqian Zhang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yan Hua
- Department of Rehabilitation Medicine, Huashan Hospital North, Fudan University, Shanghai, China
| | - Yulong Bai
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
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24
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Boyne P, Doren S, Scholl V, Staggs E, Whitesel D, Maloney T, Awosika O, Kissela B, Dunning K, Vannest J. Functional magnetic resonance brain imaging of imagined walking to study locomotor function after stroke. Clin Neurophysiol 2020; 132:167-177. [PMID: 33291023 DOI: 10.1016/j.clinph.2020.11.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/25/2020] [Accepted: 11/08/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Imagined walking has yielded insights into normal locomotor control and could improve understanding of neurologic gait dysfunction. This study evaluated brain activation during imagined walking in chronic stroke. METHODS Ten persons with stroke and 10 matched controls completed a walking test battery and a magnetic resonance imaging session including imagined walking and knee extension tasks. Brain activations were compared between tasks and groups. Associations between activations and composite gait score were also calculated, while controlling for lesion load. RESULTS Stroke and worse gait score were each associated with lesser overall brain activation during knee extension but greater overall activation during imagined walking. During imagined walking, the stroke group significantly activated the primary motor cortex lower limb region and cerebellar locomotor region. Better walking function was associated with less activation of these regions and greater activation of medial superior frontal gyrus area 9. CONCLUSIONS Compared with knee extension, imagined walking was less sensitive to stroke-related deficits in brain activation but better at revealing compensatory changes, some of which could be maladaptive. SIGNIFICANCE The identified associations for imagined walking suggest potential neural mechanisms of locomotor adaptation after stroke, which could be useful for future intervention development and prognostication.
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Affiliation(s)
- Pierce Boyne
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, USA.
| | - Sarah Doren
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Victoria Scholl
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Emily Staggs
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Dustyn Whitesel
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Thomas Maloney
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Oluwole Awosika
- Department of Neurology and Rehabilitation Medicine, College of Medicine, University of Cincinnati, OH, USA
| | - Brett Kissela
- Department of Neurology and Rehabilitation Medicine, College of Medicine, University of Cincinnati, OH, USA
| | - Kari Dunning
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Jennifer Vannest
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Communication Sciences and Disorders, College of Allied Health Sciences, University of Cincinnati, OH, USA
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25
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Yao G, Li J, Liu S, Wang J, Cao X, Li X, Cheng L, Chen H, Xu Y. Alterations of Functional Connectivity in Stroke Patients With Basal Ganglia Damage and Cognitive Impairment. Front Neurol 2020; 11:980. [PMID: 33013648 PMCID: PMC7511868 DOI: 10.3389/fneur.2020.00980] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/28/2020] [Indexed: 01/01/2023] Open
Abstract
Background: Stroke with basal ganglia damage (SBG) is a neurological disorder characterized by cognitive impairment. The neurobiological mechanism of cognitive impairment in stroke patients with basal ganglia damage (SBG patients) remains unclear. This study aimed to explore the underlying neurobiological mechanism of cognitive impairment in SBG patients using resting-state functional magnetic resonance imaging (rs-fMRI). Methods: The differences in functional connectivity (FC) between 14 SBG patients (average age: 61.00 ± 7.45 years) and 21 healthy controls (HC) (average age: 60.67 ± 6.95 years) were examined using voxel-mirrored homotopic connectivity (VMHC) and degree centrality (DC). Moreover, we compared the cognitive functions of SBG patients with HC using the Chinese Revised Wechsler Adult Intelligence Scale (WAIS-RC) and Wechsler Memory Scale (WMS). Results: Full-scale intelligence quotient (FIQ) (t = 2.810, p < 0.010) and memory quotient (MQ) (t = 2.920, p < 0.010) scores of SBG patients were significantly lower than those of HC. Compared with HC, significantly decreased VMHC values in the bilateral angular gyrus, supramarginal gyrus, inferior frontal gyrus, middle temporal gyrus, hippocampus, precuneus, precentral gyrus, and middle occipital gyrus and decreased DC values in the right supramarginal gyrus, bilateral angular gyrus, and right postcentral gyrus were observed in SBG patients. Moreover, the VMHC values in the angular gyrus, inferior frontal gyrus, supramarginal gyrus, and middle temporal gyrus and the DC values in the right supramarginal gyrus were significantly correlated with cognitive functions in all participants. Conclusion: Our findings may provide a neural basis for cognitive impairments in SBG patients. Furthermore, local abnormalities of functional networks and interhemispheric interaction deficits may provide new ideas and insights for understanding and treating SBG patients' cognitive impairments.
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Affiliation(s)
- Guanqun Yao
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Jing Li
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Sha Liu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Jiaojian Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Xiaohua Cao
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Xinrong Li
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Long Cheng
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
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26
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Schevenels K, Price CJ, Zink I, De Smedt B, Vandermosten M. A Review on Treatment-Related Brain Changes in Aphasia. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2020; 1:402-433. [PMID: 37215585 PMCID: PMC10158631 DOI: 10.1162/nol_a_00019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 06/29/2020] [Indexed: 05/24/2023]
Abstract
Numerous studies have investigated brain changes associated with interventions targeting a range of language problems in patients with aphasia. We strive to integrate the results of these studies to examine (1) whether the focus of the intervention (i.e., phonology, semantics, orthography, syntax, or rhythmic-melodic) determines in which brain regions changes occur; and (2a) whether the most consistent changes occur within the language network or outside, and (2b) whether these are related to individual differences in language outcomes. The results of 32 studies with 204 unique patients were considered. Concerning (1), the location of treatment-related changes does not clearly depend on the type of language processing targeted. However, there is some support that rhythmic-melodic training has more impact on the right hemisphere than linguistic training. Concerning (2), we observed that language recovery is not only associated with changes in traditional language-related structures in the left hemisphere and homolog regions in the right hemisphere, but also with more medial and subcortical changes (e.g., precuneus and basal ganglia). Although it is difficult to draw strong conclusions, because there is a lack of systematic large-scale studies on this topic, this review highlights the need for an integrated approach to investigate how language interventions impact on the brain. Future studies need to focus on larger samples preserving subject-specific information (e.g., lesion effects) to cope with the inherent heterogeneity of stroke-induced aphasia. In addition, recovery-related changes in whole-brain connectivity patterns need more investigation to provide a comprehensive neural account of treatment-related brain plasticity and language recovery.
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Affiliation(s)
- Klara Schevenels
- Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Cathy J. Price
- Welcome Centre for Human Neuroimaging, Institute of Neurology, University College London, UK
| | - Inge Zink
- Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Bert De Smedt
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Maaike Vandermosten
- Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, Leuven, Belgium
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27
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Ramage AE, Aytur S, Ballard KJ. Resting-State Functional Magnetic Resonance Imaging Connectivity Between Semantic and Phonological Regions of Interest May Inform Language Targets in Aphasia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:3051-3067. [PMID: 32755498 PMCID: PMC7890222 DOI: 10.1044/2020_jslhr-19-00117] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 03/16/2020] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
Purpose Brain imaging has provided puzzle pieces in the understanding of language. In neurologically healthy populations, the structure of certain brain regions is associated with particular language functions (e.g., semantics, phonology). In studies on focal brain damage, certain brain regions or connections are considered sufficient or necessary for a given language function. However, few of these account for the effects of lesioned tissue on the "functional" dynamics of the brain for language processing. Here, functional connectivity (FC) among semantic-phonological regions of interest (ROIs) is assessed to fill a gap in our understanding about the neural substrates of impaired language and whether connectivity strength can predict language performance on a clinical tool in individuals with aphasia. Method Clinical assessment of language, using the Western Aphasia Battery-Revised, and resting-state functional magnetic resonance imaging data were obtained for 30 individuals with chronic aphasia secondary to left-hemisphere stroke and 18 age-matched healthy controls. FC between bilateral ROIs was contrasted by group and used to predict Western Aphasia Battery-Revised scores. Results Network coherence was observed in healthy controls and participants with stroke. The left-right premotor cortex connection was stronger in healthy controls, as reported by New et al. (2015) in the same data set. FC of (a) connections between temporal regions, in the left hemisphere and bilaterally, predicted lexical-semantic processing for auditory comprehension and (b) ipsilateral connections between temporal and frontal regions in both hemispheres predicted access to semantic-phonological representations and processing for verbal production. Conclusions Network connectivity of brain regions associated with semantic-phonological processing is predictive of language performance in poststroke aphasia. The most predictive connections involved right-hemisphere ROIs-particularly those for which structural adaptions are known to associate with recovered word retrieval performance. Predictions may be made, based on these findings, about which connections have potential as targets for neuroplastic functional changes with intervention in aphasia. Supplemental Material https://doi.org/10.23641/asha.12735785.
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Affiliation(s)
- Amy E. Ramage
- Department of Communication Sciences and Disorders, University of New Hampshire, Durham
| | - Semra Aytur
- Department of Health Policy and Management, University of New Hampshire, Durham
| | - Kirrie J. Ballard
- Faculty of Medicine and Health and the Brain and Mind Centre, The University of Sydney, New South Wales, Australia
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28
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Griffis JC, Metcalf NV, Corbetta M, Shulman GL. Structural Disconnections Explain Brain Network Dysfunction after Stroke. Cell Rep 2020; 28:2527-2540.e9. [PMID: 31484066 DOI: 10.1016/j.celrep.2019.07.100] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/29/2019] [Accepted: 07/26/2019] [Indexed: 12/29/2022] Open
Abstract
Stroke causes focal brain lesions that disrupt functional connectivity (FC), a measure of activity synchronization, throughout distributed brain networks. It is often assumed that FC disruptions reflect damage to specific cortical regions. However, an alternative explanation is that they reflect the structural disconnection (SDC) of white matter pathways. Here, we compare these explanations using data from 114 stroke patients. Across multiple analyses, we find that SDC measures outperform focal damage measures, including damage to putative critical cortical regions, for explaining FC disruptions associated with stroke. We also identify a core mode of structure-function covariation that links the severity of interhemispheric SDCs to widespread FC disruptions across patients and that correlates with deficits in multiple behavioral domains. We conclude that a lesion's impact on the structural connectome is what determines its impact on FC and that interhemispheric SDCs may play a particularly important role in mediating FC disruptions after stroke.
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Affiliation(s)
- Joseph C Griffis
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Nicholas V Metcalf
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Maurizio Corbetta
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Anatomy and Neurobiology, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Bioengineering, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Neuroscience, University of Padua, Padua, Italy; Padua Neuroscience Center, Padua, Italy
| | - Gordon L Shulman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
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29
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Wei Y, Wang C, Liu J, Miao P, Wu L, Wang Y, Wang K, Cheng J. Progressive Gray Matter Atrophy and Abnormal Structural Covariance Network in Ischemic Pontine Stroke. Neuroscience 2020; 448:255-265. [PMID: 32890665 DOI: 10.1016/j.neuroscience.2020.08.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/10/2020] [Accepted: 08/26/2020] [Indexed: 01/02/2023]
Abstract
Our aim was to identify the longitudinal changes in gray matter volume (GMV) and secondary alterations of structural covariance after pontine stroke (PS). Structural MRI and behavioral scores were obtained at 1 week, 1 month, 3 months, 6 months in 11 patients with PS. Twenty healthy subjects underwent the same examination only once. We used voxel-based morphometry and seed-based structural covariance to investigate the altered GMV and structural covariance patterns. Furthermore, the associations between the GMV changes and behavioral scores were assessed. With the progression of the disease, GMV decreased significantly in the bilateral cerebellar posterior lobe (ipsilateral Crus II (CBE Crus II_IL) and contralateral Crus I (CBE Crus I_CL)), which were initially detected at the first month and then continued to decrease during the following 6 months. Based on the CBE Crus II_IL and CBE Crus I_CL as seed regions, structural covariance analysis revealed that there were more positively and negatively correlated brain regions in PS group, mainly distributed in the bilateral prefrontal lobe, parietal lobe, temporal lobe, paralimbic system and cerebellum. In addition, PS group showed more additional correlations between these covariant brain regions, and the changes of GMV in these regions were correlated with behavioral scores related to motor and cognitive functions. These findings indicate that PS could lead to significant GMV atrophy in the bilateral cerebellar posterior lobe at the early stage, accompanied by anomalous structural covariance patterns with more covariant brain regions and additional structural connectivity, which may provide useful information for understanding the neurobiological mechanisms of behavioral recovery after PS.
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Affiliation(s)
- Ying Wei
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Caihong Wang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingchun Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Peifang Miao
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Luobing Wu
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yingying Wang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kaiyu Wang
- GE Healthcare MR Research, Beijing, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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30
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Ptak R, Bourgeois A, Cavelti S, Doganci N, Schnider A, Iannotti GR. Discrete Patterns of Cross-Hemispheric Functional Connectivity Underlie Impairments of Spatial Cognition after Stroke. J Neurosci 2020; 40:6638-6648. [PMID: 32709694 PMCID: PMC7486659 DOI: 10.1523/jneurosci.0625-20.2020] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/06/2020] [Accepted: 07/04/2020] [Indexed: 12/17/2022] Open
Abstract
Despite intense research, the neural correlates of stroke-induced deficits of spatial cognition remain controversial. For example, several cortical regions and white-matter tracts have been designated as possible anatomic predictors of spatial neglect. However, many studies focused on local anatomy, an approach that does not harmonize with the notion that brain-behavior relationships are flexible and may involve interactions among distant regions. We studied in humans of either sex resting-state fMRI connectivity associated with performance in line bisection, reading and visual search, tasks commonly used for he clinical diagnosis of neglect. We defined left and right frontal, parietal, and temporal areas as seeds (or regions of interest, ROIs), and measured whole-brain seed-based functional connectivity (FC) and ROI-to-ROI connectivity in subacute right-hemisphere stroke patients. Performance on the line bisection task was associated with decreased FC between the right fusiform gyrus and left superior occipital cortex. Complementary increases and decreases of connectivity between both temporal and occipital lobes predicted reading errors. In addition, visual search deficits were associated with modifications of FC between left and right inferior parietal lobes and right insular cortex. These distinct connectivity patterns were substantiated by analyses of FC between left- and right-hemispheric ROIs, which revealed that decreased interhemispheric and right intrahemispheric FC was associated with higher levels of impairment. Together, these findings indicate that intrahemispheric and interhemispheric cooperation between brain regions lying outside the damaged area contributes to spatial deficits in a way that depends on the different cognitive components recruited during reading, spatial judgments, and visual exploration.SIGNIFICANCE STATEMENT Focal damage to the right cerebral hemisphere may result in a variety of deficits, often affecting the domain of spatial cognition. The neural correlates of these disorders have traditionally been studied with lesion-symptom mapping, but this method fails to capture the network dynamics that underlie cognitive performance. We studied functional connectivity in patients with right-hemisphere stroke and found a pattern of correlations between the left and right temporo-occipital, inferior parietal, and right insular cortex that were distinctively predictive of deficits in reading, spatial judgment, and visual exploration. This finding reveals the importance of interhemispheric interactions and network adaptations for the manifestation of spatial deficits after damage to the right hemisphere.
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Affiliation(s)
- Radek Ptak
- Laboratory of Cognitive Neurorehabilitation, Department of Clinical Neurosciences, Faculty of Medicine, University of Geneva, Geneva, 1206, Switzerland
- Division of Neurorehabilitation, University Hospitals of Geneva, Geneva, 1206, Switzerland
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, 1205, Switzerland
| | - Alexia Bourgeois
- Laboratory of Cognitive Neurorehabilitation, Department of Clinical Neurosciences, Faculty of Medicine, University of Geneva, Geneva, 1206, Switzerland
| | - Silvia Cavelti
- Laboratory of Cognitive Neurorehabilitation, Department of Clinical Neurosciences, Faculty of Medicine, University of Geneva, Geneva, 1206, Switzerland
| | - Naz Doganci
- Laboratory of Cognitive Neurorehabilitation, Department of Clinical Neurosciences, Faculty of Medicine, University of Geneva, Geneva, 1206, Switzerland
| | - Armin Schnider
- Laboratory of Cognitive Neurorehabilitation, Department of Clinical Neurosciences, Faculty of Medicine, University of Geneva, Geneva, 1206, Switzerland
- Division of Neurorehabilitation, University Hospitals of Geneva, Geneva, 1206, Switzerland
| | - Giannina Rita Iannotti
- Laboratory of Cognitive Neurorehabilitation, Department of Clinical Neurosciences, Faculty of Medicine, University of Geneva, Geneva, 1206, Switzerland
- Swiss Foundation for Innovation and Training in Surgery, University Hospitals of Geneva, Geneva, 1206, Switzerland
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31
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Mehler DMA, Williams AN, Whittaker JR, Krause F, Lührs M, Kunas S, Wise RG, Shetty HGM, Turner DL, Linden DEJ. Graded fMRI Neurofeedback Training of Motor Imagery in Middle Cerebral Artery Stroke Patients: A Preregistered Proof-of-Concept Study. Front Hum Neurosci 2020; 14:226. [PMID: 32760259 PMCID: PMC7373077 DOI: 10.3389/fnhum.2020.00226] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 05/20/2020] [Indexed: 02/04/2023] Open
Abstract
Ischemic stroke of the middle cerebral artery (MCA), a major brain vessel that supplies the primary motor and premotor cortex, is one of the most common causes for severe upper limb impairment. Currently available motor rehabilitation training largely lacks satisfying efficacy with over 70% of stroke survivors showing residual upper limb dysfunction. Motor imagery-based functional magnetic resonance imaging neurofeedback (fMRI-NF) has been suggested as a potential therapeutic technique to improve motor impairment in stroke survivors. In this preregistered proof-of-concept study (https://osf.io/y69jc/), we translated graded fMRI-NF training, a new paradigm that we have previously studied in healthy participants, to first-time MCA stroke survivors with residual mild to severe impairment of upper limb motor function. Neurofeedback was provided from the supplementary motor area (SMA) targeting two different neurofeedback target levels (low and high). We hypothesized that MCA stroke survivors will show (1) sustained SMA-region of interest (ROI) activation and (2) a difference in SMA-ROI activation between low and high neurofeedback conditions during graded fMRI-NF training. At the group level, we found only anecdotal evidence for these preregistered hypotheses. At the individual level, we found anecdotal to moderate evidence for the absence of the hypothesized graded effect for most subjects. These null findings are relevant for future attempts to employ fMRI-NF training in stroke survivors. The study introduces a Bayesian sequential sampling plan, which incorporates prior knowledge, yielding higher sensitivity. The sampling plan was preregistered together with a priori hypotheses and all planned analysis before data collection to address potential publication/researcher biases. Unforeseen difficulties in the translation of our paradigm to a clinical setting required some deviations from the preregistered protocol. We explicitly detail these changes, discuss the accompanied additional challenges that can arise in clinical neurofeedback studies, and formulate recommendations for how these can be addressed. Taken together, this work provides new insights about the feasibility of motor imagery-based graded fMRI-NF training in MCA stroke survivors and serves as a first example for comprehensive study preregistration of an (fMRI) neurofeedback experiment.
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Affiliation(s)
- David M. A. Mehler
- School of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff, United Kingdom
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Angharad N. Williams
- School of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff, United Kingdom
- Max Planck Adaptive Memory Research Group, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Joseph R. Whittaker
- School of Physics and Astronomy, Cardiff University, Cardiff, United Kingdom
| | - Florian Krause
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Michael Lührs
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, Netherlands
- Research Department, Brain Innovation B.V., Maastricht, Netherlands
| | - Stefanie Kunas
- School of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff, United Kingdom
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Richard G. Wise
- School of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff, United Kingdom
- Department of Neuroscience, Imaging and Clinical Sciences, Institute for Advanced Biomedical Technologies, D'Annunzio University of Chieti–Pescara, Chieti, Italy
| | | | - Duncan L. Turner
- School of Health, Sport and Bioscience, University of East London, London, United Kingdom
| | - David E. J. Linden
- School of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff, United Kingdom
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
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32
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Tanrıtanır AC, Villringer K, Galinovic I, Grittner U, Kirilina E, Fiebach JB, Villringer A, Khalil AA. The Effect of Scan Length on the Assessment of BOLD Delay in Ischemic Stroke. Front Neurol 2020; 11:381. [PMID: 32431665 PMCID: PMC7214917 DOI: 10.3389/fneur.2020.00381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/15/2020] [Indexed: 01/21/2023] Open
Abstract
Objectives: To evaluate the impact of resting-state functional MRI scan length on the diagnostic accuracy, image quality and lesion volume estimation of BOLD delay maps used for brain perfusion assessment in acute ischemic stroke. Methods: Sixty-three acute ischemic stroke patients received a 340 s resting-state functional MRI within 24 h of stroke symptom onset. BOLD delay maps were calculated from the full scan and four shortened versions (68 s, 136 s, 204 s, 272 s). The BOLD delay lesions on these maps were compared in terms of spatial overlap and volumetric agreement with the lesions derived from the full scans and with time-to-maximum (Tmax) lesions derived from DSC-MRI in a subset of patients (n = 10). In addition, the interpretability and quality of these maps were compared across different scan lengths using mixed models. Results: Shortened BOLD delay scans showed a small volumetric bias (ranging from 0.05 to 5.3 mL; between a 0.13% volumetric underestimation and a 7.7% overestimation relative to the mean of the volumes, depending on scan length) compared to the full scan. Decreased scan length was associated with decreased spatial overlap with both the BOLD delay lesions derived from the full scans and with Tmax lesions. Only the two shortest scan lengths (68 and 136 s) were associated with substantially decreased interpretability, decreased structure clarity, and increased noisiness of BOLD delay maps. Conclusions: BOLD delay maps derived from resting-state fMRI scans lasting 272 and 204 s provide sufficient diagnostic quality and adequate assessment of perfusion lesion volumes. Such shortened scans may be helpful in situations where quick clinical decisions need to be made.
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Affiliation(s)
| | - Kersten Villringer
- Center for Stroke Research, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ivana Galinovic
- Center for Stroke Research, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrike Grittner
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Evgeniya Kirilina
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Center for Cognitive Neuroscience Berlin, Free University, Berlin, Germany
| | - Jochen B Fiebach
- Center for Stroke Research, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Arno Villringer
- Berlin School of Mind and Brain, Humboldt Universität zu Berlin, Berlin, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Ahmed A Khalil
- Center for Stroke Research, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,Berlin School of Mind and Brain, Humboldt Universität zu Berlin, Berlin, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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33
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Damage to the shortest structural paths between brain regions is associated with disruptions of resting-state functional connectivity after stroke. Neuroimage 2020; 210:116589. [PMID: 32007498 DOI: 10.1016/j.neuroimage.2020.116589] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/18/2019] [Accepted: 01/27/2020] [Indexed: 01/07/2023] Open
Abstract
Focal brain lesions disrupt resting-state functional connectivity, but the underlying structural mechanisms are unclear. Here, we examined the direct and indirect effects of structural disconnections on resting-state functional connectivity in a large sample of sub-acute stroke patients with heterogeneous brain lesions. We estimated the impact of each patient's lesion on the structural connectome by embedding the lesion in a diffusion MRI streamline tractography atlas constructed using data from healthy individuals. We defined direct disconnections as the loss of direct structural connections between two regions, and indirect disconnections as increases in the shortest structural path length between two regions that lack direct structural connections. We then tested the hypothesis that functional connectivity disruptions would be more severe for disconnected regions than for regions with spared connections. On average, nearly 20% of all region pairs were estimated to be either directly or indirectly disconnected by the lesions in our sample, and extensive disconnections were associated primarily with damage to deep white matter locations. Importantly, both directly and indirectly disconnected region pairs showed more severe functional connectivity disruptions than region pairs with spared direct and indirect connections, respectively, although functional connectivity disruptions tended to be most severe between region pairs that sustained direct structural disconnections. Together, these results emphasize the widespread impacts of focal brain lesions on the structural connectome and show that these impacts are reflected by disruptions of the functional connectome. Further, they indicate that in addition to direct structural disconnections, lesion-induced increases in the structural shortest path lengths between indirectly structurally connected region pairs provide information about the remote functional disruptions caused by focal brain lesions.
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34
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Wu Q, Yue Z, Ge Y, Ma D, Yin H, Zhao H, Liu G, Wang J, Dou W, Pan Y. Brain Functional Networks Study of Subacute Stroke Patients With Upper Limb Dysfunction After Comprehensive Rehabilitation Including BCI Training. Front Neurol 2020; 10:1419. [PMID: 32082238 PMCID: PMC7000923 DOI: 10.3389/fneur.2019.01419] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 12/30/2019] [Indexed: 12/21/2022] Open
Abstract
Brain computer interface (BCI)-based training is promising for the treatment of stroke patients with upper limb (UL) paralysis. However, most stroke patients receive comprehensive treatment that not only includes BCI, but also routine training. The purpose of this study was to investigate the topological alterations in brain functional networks following comprehensive treatment, including BCI training, in the subacute stage of stroke. Twenty-five hospitalized subacute stroke patients with moderate to severe UL paralysis were assigned to one of two groups: 4-week comprehensive treatment, including routine and BCI training (BCI group, BG, n = 14) and 4-week routine training without BCI support (control group, CG, n = 11). Functional UL assessments were performed before and after training, including, Fugl-Meyer Assessment-UL (FMA-UL), Action Research Arm Test (ARAT), and Wolf Motor Function Test (WMFT). Neuroimaging assessment of functional connectivity (FC) in the BG was performed by resting state functional magnetic resonance imaging. After training, as compared with baseline, all clinical assessments (FMA-UL, ARAT, and WMFT) improved significantly (p < 0.05) in both groups. Meanwhile, better functional improvements were observed in FMA-UL (p < 0.05), ARAT (p < 0.05), and WMFT (p < 0.05) in the BG. Meanwhile, FC of the BG increased across the whole brain, including the temporal, parietal, and occipital lobes and subcortical regions. More importantly, increased inter-hemispheric FC between the somatosensory association cortex and putamen was strongly positively associated with UL motor function after training. Our findings demonstrate that comprehensive rehabilitation, including BCI training, can enhance UL motor function better than routine training for subacute stroke patients. The reorganization of brain functional networks topology in subacute stroke patients allows for increased coordination between the multi-sensory and motor-related cortex and the extrapyramidal system. Future long-term, longitudinal, controlled neuroimaging studies are needed to assess the effectiveness of BCI training as an approach to promote brain plasticity during the subacute stage of stroke.
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Affiliation(s)
- Qiong Wu
- Department of Rehabilitation Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Zan Yue
- Institute of Robotics and Intelligent Systems, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Yunxiang Ge
- Department of Electronic Engineering, Tsinghua University, Beijing, China
| | - Di Ma
- Department of Rehabilitation Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Hang Yin
- Department of Rehabilitation Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Hongliang Zhao
- Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Gang Liu
- Institute of Robotics and Intelligent Systems, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Jing Wang
- Institute of Robotics and Intelligent Systems, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Weibei Dou
- Department of Electronic Engineering, Tsinghua University, Beijing, China.,Beijing National Research Center for Information Science and Technology, Beijing, China
| | - Yu Pan
- Department of Rehabilitation Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
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35
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Ktena SI, Schirmer MD, Etherton MR, Giese AK, Tuozzo C, Mills BB, Rueckert D, Wu O, Rost NS. Brain Connectivity Measures Improve Modeling of Functional Outcome After Acute Ischemic Stroke. Stroke 2019; 50:2761-2767. [PMID: 31510905 PMCID: PMC6756947 DOI: 10.1161/strokeaha.119.025738] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background and Purpose- The ability to model long-term functional outcomes after acute ischemic stroke represents a major clinical challenge. One approach to potentially improve prediction modeling involves the analysis of connectomics. The field of connectomics represents the brain's connectivity as a graph, whose topological properties have helped uncover underlying mechanisms of brain function in health and disease. Specifically, we assessed the impact of stroke lesions on rich club organization, a high capacity backbone system of brain function. Methods- In a hospital-based cohort of 41 acute ischemic stroke patients, we investigated the effect of acute infarcts on the brain's prestroke rich club backbone and poststroke functional connectomes with respect to poststroke outcome. Functional connectomes were created using 3 anatomic atlases, and characteristic path-length (L) was calculated for each connectome. The number of rich club regions affected were manually determined using each patient's diffusion weighted image. We investigated differences in L with respect to outcome (modified Rankin Scale score; 90 days) and the National Institutes of Health Stroke Scale (NIHSS; early: 2-5 days; late: 90-day follow-up). Furthermore, we assessed the effect of including number of rich club regions and L in outcome models, using linear regression and assessing the explained variance (R2). Results- Of 41 patients (mean age [range]: 70 [45-89] years), 61% were male. Lower L was generally associated with better outcome. Including number of rich club regions in the backward selection models of outcome, R2 increased between 1.3- and 2.6-fold beyond that of traditional markers (age and acute lesion volume) for NIHSS and modified Rankin Scale score. Conclusions- In this proof-of-concept study, we showed that information on network topology can be leveraged to improve modeling of poststroke functional outcome. Future studies are warranted to validate this approach in larger prospective studies of outcome prediction in stroke.
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Affiliation(s)
- Sofia Ira Ktena
- From the Stroke Division and Massachusetts General Hospital, J. Philip Kistler Stroke Research Center, Harvard Medical School, Boston (S.I.K., M.D.S., M.R.E., A.-K.G., C.T., B.B.M., N.S.R.)
- Biomedical Image Analysis Group, Department of Computing, Imperial College London, United Kingdom (S.I.K., D.R.)
| | - Markus D Schirmer
- From the Stroke Division and Massachusetts General Hospital, J. Philip Kistler Stroke Research Center, Harvard Medical School, Boston (S.I.K., M.D.S., M.R.E., A.-K.G., C.T., B.B.M., N.S.R.)
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge (M.D.S.)
- Department of Population Health Sciences, German Centre for Neurodegenerative Diseases (DZNE), Bonn, Germany (M.D.S.)
| | - Mark R Etherton
- From the Stroke Division and Massachusetts General Hospital, J. Philip Kistler Stroke Research Center, Harvard Medical School, Boston (S.I.K., M.D.S., M.R.E., A.-K.G., C.T., B.B.M., N.S.R.)
| | - Anne-Katrin Giese
- From the Stroke Division and Massachusetts General Hospital, J. Philip Kistler Stroke Research Center, Harvard Medical School, Boston (S.I.K., M.D.S., M.R.E., A.-K.G., C.T., B.B.M., N.S.R.)
| | - Carissa Tuozzo
- From the Stroke Division and Massachusetts General Hospital, J. Philip Kistler Stroke Research Center, Harvard Medical School, Boston (S.I.K., M.D.S., M.R.E., A.-K.G., C.T., B.B.M., N.S.R.)
| | - Brittany B Mills
- From the Stroke Division and Massachusetts General Hospital, J. Philip Kistler Stroke Research Center, Harvard Medical School, Boston (S.I.K., M.D.S., M.R.E., A.-K.G., C.T., B.B.M., N.S.R.)
| | - Daniel Rueckert
- Biomedical Image Analysis Group, Department of Computing, Imperial College London, United Kingdom (S.I.K., D.R.)
| | - Ona Wu
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown (O.W.)
| | - Natalia S Rost
- From the Stroke Division and Massachusetts General Hospital, J. Philip Kistler Stroke Research Center, Harvard Medical School, Boston (S.I.K., M.D.S., M.R.E., A.-K.G., C.T., B.B.M., N.S.R.)
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Wang X, Seguin C, Zalesky A, Wong WW, Chu WCW, Tong RKY. Synchronization lag in post stroke: relation to motor function and structural connectivity. Netw Neurosci 2019; 3:1121-1140. [PMID: 31637341 PMCID: PMC6777982 DOI: 10.1162/netn_a_00105] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 07/25/2019] [Indexed: 12/20/2022] Open
Abstract
Stroke is characterized by delays in the resting-state hemodynamic response, resulting in synchronization lag in neural activity between brain regions. However, the structural basis of this lag remains unclear. In this study, we used resting-state functional MRI (rs-fMRI) to characterize synchronization lag profiles between homotopic regions in 15 individuals (14 males, 1 female) with brain lesions consequent to stroke as well as a group of healthy comparison individuals. We tested whether the network communication efficiency of each individual's structural brain network (connectome) could explain interindividual and interregional variation in synchronization lag profiles. To this end, connectomes were mapped using diffusion MRI data, and communication measures were evaluated under two schemes: shortest paths and navigation. We found that interindividual variation in synchronization lags was inversely associated with communication efficiency under both schemes. Interregional variation in lag was related to navigation efficiency and navigation distance, reflecting its dependence on both distance and structural constraints. Moreover, severity of motor deficits significantly correlated with average synchronization lag in stroke. Our results provide a structural basis for the delay of information transfer between homotopic regions inferred from rs-fMRI and provide insight into the clinical significance of structural-functional relationships in stroke individuals.
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Affiliation(s)
- Xin Wang
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, China
| | - Caio Seguin
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Australia
| | - Wan-wa Wong
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, China
| | - Winnie Chiu-wing Chu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
| | - Raymond Kai-yu Tong
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, China
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Correlated Resting-State Functional MRI Activity of Frontostriatal, Thalamic, Temporal, and Cerebellar Brain Regions Differentiates Stroke Survivors with High Compared to Low Depressive Symptom Scores. Neural Plast 2019; 2019:2357107. [PMID: 31467520 PMCID: PMC6701282 DOI: 10.1155/2019/2357107] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 05/11/2019] [Accepted: 05/29/2019] [Indexed: 01/04/2023] Open
Abstract
Background One in three survivors of stroke experience poststroke depression (PSD). PSD has been linked with poorer recovery of function and cognition, yet our understanding of potential mechanisms is currently limited. Alterations in resting-state functional MRI have been investigated to a limited extent. Fluctuations in low frequency signal are reported, but it is unknown if interactions are present between the level of depressive symptom score and intrinsic brain activity in varying brain regions. Objective To investigate potential interaction effects between whole-brain resting-state activity and depressive symptoms in stroke survivors with low and high levels of depressive symptoms. Methods A cross-sectional analysis of 63 stroke survivors who were assessed at 3 months poststroke for depression, using the Montgomery–Åsberg Depression Rating Scale (MÅDRS-SIGMA), and for brain activity using fMRI. A MÅDRS-SIGMA score of >8 was classified as high depressive symptoms. Fractional amplitude of frequency fluctuations (fALFF) data across three frequency bands (broadband, i.e., ~0.01–0.08; subbands, i.e., slow-5: ~0.01–0.027 Hz, slow-4: 0.027–0.07) was examined. Results Of the 63 stroke survivors, 38 were classified as “low-depressive symptoms” and 25 as “high depressive symptoms.” Six had a past history of depression. We found interaction effects across frequency bands in several brain regions that differentiated the two groups. The broadband analysis revealed interaction effects in the left insula and the left superior temporal lobe. The subband analysis showed contrasting fALFF response between the two groups in the left thalamus, right caudate, and left cerebellum. Across the three frequency bands, we found contrasting fALFF response in areas within the fronto-limbic-thalamic network and cerebellum. Conclusions We provide evidence that fALFF is sensitive to changes in poststroke depressive symptom severity and implicates frontostriatal and cerebellar regions, consistent with previous studies. The use of multiband analysis could be an effective method to examine neural correlates of depression after stroke. The START-PrePARE trial is registered with the Australian New Zealand Clinical Trial Registry, number ACTRN12610000987066.
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38
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Kim YH, Cho AH, Kim D, Kim SM, Lim HT, Kwon SU, Kim JS, Kang DW. Early Functional Connectivity Predicts Recovery from Visual Field Defects after Stroke. J Stroke 2019; 21:207-216. [PMID: 31161764 PMCID: PMC6549059 DOI: 10.5853/jos.2018.02999] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 03/03/2019] [Indexed: 11/11/2022] Open
Abstract
Background and Purpose We aimed to assess whether early resting-state functional connectivity (RSFC) changes measured via functional magnetic resonance imaging (fMRI) could predict recovery from visual field defect (VFD) in acute stroke patients.
Methods Patients with VFD due to acute ischemic stroke in the visual cortex and age-matched healthy controls were prospectively enrolled. Serial resting-state (RS)-fMRI and Humphrey visual field (VF) tests were performed within 1 week and at 1 and 3 months (additional VF test at 6 months) after stroke onset in the patient group. The control group also underwent RS-fMRI and a Humphrey VF test. The changes in RSFCs and VF scores (VFSs) over time and their correlations were investigated.
Results In 32 patients (65±10 years, 25 men), the VFSs were lower and the interhemispheric RSFC in the visual cortices was decreased compared to the control group (n=15, 62±6 years, seven men). The VFSs and interhemispheric RSFC in the visual cortex increased mainly within the first month after stroke onset. The interhemispheric RSFC and VFSs were positively correlated at 1 month after stroke onset. Moreover, the interhemispheric RSFCs in the visual cortex within 1 week were positively correlated with the follow-up VFSs.
Conclusions Interhemispheric RSFCs in the visual cortices within 1 week after stroke onset may be a useful biomarker to predict long-term VFD recovery.
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Affiliation(s)
- Yong-Hwan Kim
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | - A-Hyun Cho
- Department of Neurology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dongho Kim
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | - Seung Min Kim
- Department of Neurology, Veterans Health Service Medical Center, Seoul, Korea
| | - Hyun Taek Lim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun U Kwon
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong S Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong-Wha Kang
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea.,Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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39
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Ito KL, Kumar A, Zavaliangos-Petropulu A, Cramer SC, Liew SL. Pipeline for Analyzing Lesions After Stroke (PALS). Front Neuroinform 2018; 12:63. [PMID: 30319385 PMCID: PMC6165891 DOI: 10.3389/fninf.2018.00063] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 09/05/2018] [Indexed: 02/04/2023] Open
Abstract
Lesion analyses are critical for drawing insights about stroke injury and recovery, and their importance is underscored by growing efforts to collect and combine stroke neuroimaging data across research sites. However, while there are numerous processing pipelines for neuroimaging data in general, few can be smoothly applied to stroke data due to complications analyzing the lesioned region. As researchers often use their own tools or manual methods for stroke MRI analysis, this could lead to greater errors and difficulty replicating findings over time and across sites. Rigorous analysis protocols and quality control pipelines are thus urgently needed for stroke neuroimaging. To this end, we created the Pipeline for Analyzing Lesions after Stroke (PALS; DOI: https://doi.org/10.5281/zenodo.1266980), a scalable and user-friendly toolbox to facilitate and ensure quality in stroke research specifically using T1-weighted MRIs. The PALS toolbox offers four modules integrated into a single pipeline, including (1) reorientation to radiological convention, (2) lesion correction for healthy white matter voxels, (3) lesion load calculation, and (4) visual quality control. In the present paper, we discuss each module and provide validation and example cases of our toolbox using multi-site data. Importantly, we also show that lesion correction with PALS significantly improves similarity between manual lesion segmentations by different tracers (z = 3.43, p = 0.0018). PALS can be found online at https://github.com/npnl/PALS. Future work will expand the PALS capabilities to include multimodal stroke imaging. We hope PALS will be a useful tool for the stroke neuroimaging community and foster new clinical insights.
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Affiliation(s)
- Kaori L Ito
- Neural Plasticity and Neurorehabilitation Laboratory, University of Southern California, Los Angeles, CA, United States
| | - Amit Kumar
- Neural Plasticity and Neurorehabilitation Laboratory, University of Southern California, Los Angeles, CA, United States
| | - Artemis Zavaliangos-Petropulu
- Neural Plasticity and Neurorehabilitation Laboratory, University of Southern California, Los Angeles, CA, United States.,Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, United States
| | - Steven C Cramer
- Department of Neurology, University of California, Irvine, Irvine, CA, United States
| | - Sook-Lei Liew
- Neural Plasticity and Neurorehabilitation Laboratory, University of Southern California, Los Angeles, CA, United States.,Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, United States
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40
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Watson CE, Gotts SJ, Martin A, Buxbaum LJ. Bilateral functional connectivity at rest predicts apraxic symptoms after left hemisphere stroke. Neuroimage Clin 2018; 21:101526. [PMID: 30612063 PMCID: PMC6319198 DOI: 10.1016/j.nicl.2018.08.033] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 06/22/2018] [Accepted: 08/31/2018] [Indexed: 12/11/2022]
Abstract
Increasing evidence indicates that focal lesions following stroke cause alterations in connectivity among functional brain networks. Functional connectivity between hemispheres has been shown to be particularly critical for predicting stroke-related behavioral deficits and recovery of motor function and attention. Much less is known, however, about the relevance of interhemispheric functional connectivity for cognitive abilities like praxis that rely on strongly lateralized brain networks. In the current study, we examine correlations between symptoms of apraxia-a disorder of skilled action that cannot be attributed to lower-level sensory or motor impairments-and spontaneous, resting brain activity in functional MRI in chronic left hemisphere stroke patients and neurologically-intact control participants. Using a data-driven approach, we identified 32 regions-of-interest in which pairwise functional connectivity correlated with two distinct measures of apraxia, even when controlling for age, head motion, lesion volume, and other artifacts: overall ability to pantomime the typical use of a tool, and disproportionate difficulty pantomiming the use of tools associated with different, competing use and grasp-to-move actions (e.g., setting a kitchen timer versus picking it up). Better performance on both measures correlated with stronger interhemispheric functional connectivity. Relevant regions in the right hemisphere were often homologous to left hemisphere areas associated with tool use and action. Additionally, relative to overall pantomime accuracy, disproportionate difficulty pantomiming the use of tools associated with competing use and grasp actions was associated with weakened functional connectivity among a more strongly left-lateralized and peri-Sylvian set of brain regions. Finally, patient performance on both measures of apraxia was best predicted by a model that incorporated information about lesion location and functional connectivity, and functional connectivity continued to explain unique variance in behavior even after accounting for lesion loci. These results indicate that interhemispheric functional connectivity is relevant even for a strongly lateralized cognitive ability like praxis and emphasize the importance of the right hemisphere in skilled action.
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Affiliation(s)
| | - Stephen J Gotts
- Laboratory of Brain and Cognition, National Institute of Mental Health, NIH, Bethesda, MD 20892, USA
| | - Alex Martin
- Laboratory of Brain and Cognition, National Institute of Mental Health, NIH, Bethesda, MD 20892, USA
| | - Laurel J Buxbaum
- Moss Rehabilitation Research Institute, Elkins Park, PA 19027, USA.
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41
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Changes in resting-state functional connectivity after stroke in a mouse brain lacking extracellular matrix components. Neurobiol Dis 2018; 112:91-105. [PMID: 29367009 DOI: 10.1016/j.nbd.2018.01.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 12/26/2017] [Accepted: 01/17/2018] [Indexed: 12/30/2022] Open
Abstract
In the brain, focal ischemia results in a local region of cell death and disruption of both local and remote functional neuronal networks. Tissue reorganization following stroke can be limited by factors such as extracellular matrix (ECM) molecules that prevent neuronal growth and synaptic plasticity. The brain's ECM plays a crucial role in network formation, development, and regeneration of the central nervous system. Further, the ECM is essential for proper white matter tract development and for the formation of structures called perineuronal nets (PNNs). PNNs mainly surround parvalbumin/GABA inhibitory interneurons, of importance for processing sensory information. Previous studies have shown that downregulating PNNs after stroke reduces the neurite-inhibitory environment, reactivates plasticity, and promotes functional recovery. Resting-state functional connectivity (RS-FC) within and across hemispheres has been shown to correlate with behavioral recovery after stroke. However, the relationship between PNNs and RS-FC has not been examined. Here we studied a quadruple knock-out mouse (Q4) that lacks four ECM components: brevican, neurocan, tenascin-C and tenascin-R. We applied functional connectivity optical intrinsic signal (fcOIS) imaging in Q4 mice and wild-type (129S1 mice) before and 14 days after photothrombotic stroke (PT) to understand how the lack of crucial ECM components affects neuronal networks and functional recovery after stroke. Limb-placement ability was evaluated at 2, 7 and 14 days of recovery through the paw-placement test. Q4 mice exhibited significantly impaired homotopic RS-FC compared to wild-type mice, especially in the sensory and parietal regions. Changes in RS-FC were significantly correlated with the number of interhemispheric callosal crossings in those same regions. PT caused unilateral damage to the sensorimotor cortex and deficits of tactile-proprioceptive placing ability in contralesional fore- and hindlimbs, but the two experimental groups did not present significant differences in infarct size. Two weeks after PT, a general down-scaling of regional RS-FC as well as the number of regional functional connections was visible for all cortical regions and most notable in the somatosensory areas of both Q4 and wild-type mice. Q4 mice exhibited higher intrahemispheric RS-FC in contralesional sensory and motor cortices compared to control mice. We propose that the lack of growth inhibiting ECM components in the Q4 mice potentially worsen behavioral outcome in the early phase after stroke, but subsequently facilitates modulation of contralesional RS-FC which is relevant for recovery of sensory motor function. We conclude that Q4 mice represent a valuable model to study how the elimination of ECM genes compromises neuronal function and plasticity mechanisms after stroke.
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42
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Siegel JS, Seitzman BA, Ramsey LE, Ortega M, Gordon EM, Dosenbach NUF, Petersen SE, Shulman GL, Corbetta M. Re-emergence of modular brain networks in stroke recovery. Cortex 2018; 101:44-59. [PMID: 29414460 DOI: 10.1016/j.cortex.2017.12.019] [Citation(s) in RCA: 139] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 11/01/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022]
Abstract
Studies of stroke have identified local reorganization in perilesional tissue. However, because the brain is highly networked, strokes also broadly alter the brain's global network organization. Here, we assess brain network structure longitudinally in adult stroke patients using resting state fMRI. The topology and boundaries of cortical regions remain grossly unchanged across recovery. In contrast, the modularity of brain systems i.e. the degree of integration within and segregation between networks, was significantly reduced sub-acutely (n = 107), but partially recovered by 3 months (n = 85), and 1 year (n = 67). Importantly, network recovery correlated with recovery from language, spatial memory, and attention deficits, but not motor or visual deficits. Finally, in-depth single subject analyses were conducted using tools for visualization of changes in brain networks over time. This exploration indicated that changes in modularity during successful recovery reflect specific alterations in the relationships between different networks. For example, in a patient with left temporo-parietal stroke and severe aphasia, sub-acute loss of modularity reflected loss of association between frontal and temporo-parietal regions bi-hemispherically across multiple modules. These long-distance connections then returned over time, paralleling aphasia recovery. This work establishes the potential importance of normalization of large-scale modular brain systems in stroke recovery.
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Affiliation(s)
- Joshua S Siegel
- Departments of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
| | - Benjamin A Seitzman
- Departments of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
| | - Lenny E Ramsey
- Departments of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
| | - Mario Ortega
- Departments of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
| | - Evan M Gordon
- VISN17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA.
| | - Nico U F Dosenbach
- Departments of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
| | - Steven E Petersen
- Departments of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychology, Washington University in St. Louis, St. Louis, MO, USA; Department of Neuroscience, Washington University School of Medicine, St. Louis, MO, USA.
| | - Gordon L Shulman
- Departments of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
| | - Maurizio Corbetta
- Departments of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychology, Washington University in St. Louis, St. Louis, MO, USA; Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA; Department of Neuroscience, University of Padua, Padua, Italy.
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43
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On the low dimensionality of behavioral deficits and alterations of brain network connectivity after focal injury. Cortex 2018; 107:229-237. [PMID: 29357980 PMCID: PMC6028302 DOI: 10.1016/j.cortex.2017.12.017] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 12/15/2017] [Accepted: 12/20/2017] [Indexed: 12/18/2022]
Abstract
Traditional neuropsychological approaches emphasize the specificity of behavioral deficits and the modular organization of the brain. At the population level, however, there is emerging evidence that deficits are correlated resulting in a low dimensional structure of post-stroke neurological impairments. Here we consider the implications of low dimensionality for the three-way mapping between structural damage, altered physiology, and behavioral deficits. Understanding this mapping will be aided by large-sample studies that apply multivariate models and focus on explained percentage of variance, as opposed to univariate lesion-symptom techniques that report statistical significance. The low dimensionality of behavioral deficits following stroke is paralleled by widespread, yet relatively consistent, changes in functional connectivity (FC), including a reduction in modularity. Both are related to the structural damage to white matter and subcortical grey commonly produced by stroke. We suggest that large-scale physiological abnormalities following a stroke reduce the variety of neural states visited during task processing and at rest, resulting in a limited repertoire of behavioral states.
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44
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Sergeeva SP, Savin AA, Litvitsky PF, Lyundup AV, Kiseleva EV, Gorbacheva LR, Breslavich ID, Kucenko KI, Balyasin MV. [Apoptosis as a systemic adaptive mechanism in ischemic stroke]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:38-45. [PMID: 30830115 DOI: 10.17116/jnevro201811812238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This paper presents a literature review considering the role and mechanism of apoptosis in the pathogenesis of ischemic stroke (IS). The authors introduce a new concept: the functional request of the patient as a set of external (the nature and intensity of rehabilitation measures, characteristics of everyday life, diet, etc.) and internal (genetic factors, internal picture of the disease, availability of rental and other psychological facilities and etc.) attributes. This concept allows a new angle in understanding the pathogenesis of IS and creates fundamental and clinical potential for more successful approaches to therapy and rehabilitation after IS.
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Affiliation(s)
- S P Sergeeva
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - A A Savin
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - P F Litvitsky
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - A V Lyundup
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - E V Kiseleva
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow, Russia
| | | | - I D Breslavich
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - K I Kucenko
- Bureau of Forensic Medicine of Moscow Healthcare Department, Moscow, Russia
| | - M V Balyasin
- Sechenov First Moscow State Medical University, Moscow, Russia
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45
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Mapping Language Networks Using the Structural and Dynamic Brain Connectomes. eNeuro 2017; 4:eN-MNT-0204-17. [PMID: 29109969 PMCID: PMC5672546 DOI: 10.1523/eneuro.0204-17.2017] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 09/24/2017] [Accepted: 09/28/2017] [Indexed: 11/22/2022] Open
Abstract
Lesion-symptom mapping is often employed to define brain structures that are crucial for human behavior. Even though poststroke deficits result from gray matter damage as well as secondary white matter loss, the impact of structural disconnection is overlooked by conventional lesion-symptom mapping because it does not measure loss of connectivity beyond the stroke lesion. This study describes how traditional lesion mapping can be combined with structural connectome lesion symptom mapping (CLSM) and connectome dynamics lesion symptom mapping (CDLSM) to relate residual white matter networks to behavior. Using data from a large cohort of stroke survivors with aphasia, we observed improved prediction of aphasia severity when traditional lesion symptom mapping was combined with CLSM and CDLSM. Moreover, only CLSM and CDLSM disclosed the importance of temporal-parietal junction connections in aphasia severity. In summary, connectome measures can uniquely reveal brain networks that are necessary for function, improving the traditional lesion symptom mapping approach.
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