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Carey LM. 2023 Sylvia Docker lecture: Ignite your passion, and connect, to make a difference. Aust Occup Ther J 2024; 71:4-17. [PMID: 38234045 DOI: 10.1111/1440-1630.12923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 01/19/2024]
Abstract
Together, we grow our profession of occupational therapy as we engage in understanding and addressing the issues that challenge the people we work with. In this Sylvia Docker Lecture, I will share the collective journeys of myself and other occupational therapists and health professionals who have undertaken (or are currently undertaking) their PhDs and are actively involved in research, to address these challenges. Together, we will explore three themes: understanding the WHY that ignites one's passion; living the journey-the EXPERIENCE; and making a difference-the IMPACT. Stories will be told through the lived experience of those engaged in research as currently enrolled PhD students, emerging researchers, and experienced researchers. These stories will capture the lived experience across individuals, and at different times in the research journey. Stories are summarised and captured using natural language processing. Topics are identified, concept maps visualised, and outputs interpreted in context of related theoretical models. Key topics identified include: the clinical and personal motivators that have ignited the passion in individuals; the value of connecting with others and growing networks; and how one's research has made a difference. The impact of discoveries and outcomes are highlighted, together with the importance of people and networks. Analysis of connections and synthesis over time revealed frequent and strong connections across themes, concepts and topics; with synthesising concepts of passion, networks, knowledge translation, opportunities, supervision and communication emerging and being shaped over time. These collective journeys provide inspiration and pathways to creative careers that have future potential in the growth of the profession of occupational therapy. It is recommended that each occupational therapist take the time to reflect on the 'why' that ignites your passion, your journey and how you can make a difference!
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Affiliation(s)
- Leeanne M Carey
- Department of Community and Clinical Health, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, Victoria, Australia
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Christidi F, Orgianelis I, Merkouris E, Koutsokostas C, Tsiptsios D, Karavasilis E, Psatha EA, Tsiakiri A, Serdari A, Aggelousis N, Vadikolias K. A Comprehensive Review on the Role of Resting-State Functional Magnetic Resonance Imaging in Predicting Post-Stroke Motor and Sensory Outcomes. Neurol Int 2024; 16:189-201. [PMID: 38392953 PMCID: PMC10892788 DOI: 10.3390/neurolint16010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/05/2024] [Accepted: 01/12/2024] [Indexed: 02/25/2024] Open
Abstract
Stroke is a major leading cause of chronic disability, often affecting patients' motor and sensory functions. Functional magnetic resonance imaging (fMRI) is the most commonly used method of functional neuroimaging, and it allows for the non-invasive study of brain activity. The time-dependent coactivation of different brain regions at rest is described as resting-state activation. As a non-invasive task-independent functional neuroimaging approach, resting-state fMRI (rs-fMRI) may provide therapeutically useful information on both the focal vascular lesion and the connectivity-based reorganization and subsequent functional recovery in stroke patients. Considering the role of a prompt and accurate prognosis in stroke survivors along with the potential of rs-fMRI in identifying patterns of neuroplasticity in different post-stroke phases, this review provides a comprehensive overview of the latest literature regarding the role of rs-fMRI in stroke prognosis in terms of motor and sensory outcomes. Our comprehensive review suggests that with the advancement of MRI acquisition and data analysis methods, rs-fMRI emerges as a promising tool to study the motor and sensory outcomes in stroke patients and evaluate the effects of different interventions.
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Affiliation(s)
- Foteini Christidi
- Neurology Department, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (I.O.); (E.M.); (C.K.); (A.T.); (K.V.)
| | - Ilias Orgianelis
- Neurology Department, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (I.O.); (E.M.); (C.K.); (A.T.); (K.V.)
| | - Ermis Merkouris
- Neurology Department, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (I.O.); (E.M.); (C.K.); (A.T.); (K.V.)
| | - Christos Koutsokostas
- Neurology Department, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (I.O.); (E.M.); (C.K.); (A.T.); (K.V.)
| | - Dimitrios Tsiptsios
- Neurology Department, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (I.O.); (E.M.); (C.K.); (A.T.); (K.V.)
| | - Efstratios Karavasilis
- Department of Radiology, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.K.); (E.A.P.)
| | - Evlampia A. Psatha
- Department of Radiology, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.K.); (E.A.P.)
| | - Anna Tsiakiri
- Neurology Department, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (I.O.); (E.M.); (C.K.); (A.T.); (K.V.)
| | - Aspasia Serdari
- Department of Child and Adolescent Psychiatry, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Nikolaos Aggelousis
- Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece;
| | - Konstantinos Vadikolias
- Neurology Department, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (I.O.); (E.M.); (C.K.); (A.T.); (K.V.)
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Kenzie JM, Rajashekar D, Goodyear BG, Dukelow SP. Resting state functional connectivity associated with impaired proprioception post-stroke. Hum Brain Mapp 2024; 45:e26541. [PMID: 38053448 PMCID: PMC10789217 DOI: 10.1002/hbm.26541] [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: 08/31/2022] [Revised: 10/30/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023] Open
Abstract
Deficits in proprioception, the knowledge of limb position and movement in the absence of vision, occur in ~50% of all strokes; however, our lack of knowledge of the neurological mechanisms of these deficits diminishes the effectiveness of rehabilitation and prolongs recovery. We performed resting-state functional magnetic resonance imaging (fMRI) on stroke patients to determine functional brain networks that exhibited changes in connectivity in association with proprioception deficits determined by a Kinarm robotic exoskeleton assessment. Thirty stroke participants were assessed for proprioceptive impairments using a Kinarm robot and underwent resting-state fMRI at 1 month post-stroke. Age-matched healthy control (n = 30) fMRI data were also examined and compared to stroke data in terms of the functional connectivity of brain regions associated with proprioception. Stroke patients exhibited reduced connectivity of the supplementary motor area and the supramarginal gyrus, relative to controls. Functional connectivity of these regions plus primary somatosensory cortex and parietal opercular area was significantly associated with proprioceptive function. The parietal lobe of the lesioned hemisphere is a significant node for proprioception after stroke. Assessment of functional connectivity of this region after stroke may assist with prognostication of recovery. This study also provides potential targets for therapeutic neurostimulation to aid in stroke recovery.
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Affiliation(s)
- Jeffrey M. Kenzie
- Department of Clinical NeurosciencesUniversity of CalgaryCalgaryAlbertaCanada
- Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health ServicesCalgaryAlbertaCanada
| | - Deepthi Rajashekar
- Department of Clinical NeurosciencesUniversity of CalgaryCalgaryAlbertaCanada
| | - Bradley G. Goodyear
- Department of Clinical NeurosciencesUniversity of CalgaryCalgaryAlbertaCanada
- Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health ServicesCalgaryAlbertaCanada
- Department of RadiologyUniversity of CalgaryCalgaryAlbertaCanada
- Hotchkiss Brain InstituteUniversity of CalgaryCalgaryAlbertaCanada
| | - Sean P. Dukelow
- Department of Clinical NeurosciencesUniversity of CalgaryCalgaryAlbertaCanada
- Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health ServicesCalgaryAlbertaCanada
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Senadheera I, Larssen BC, Mak-Yuen YYK, Steinfort S, Carey LM, Alahakoon D. Profiling Somatosensory Impairment after Stroke: Characterizing Common "Fingerprints" of Impairment Using Unsupervised Machine Learning-Based Cluster Analysis of Quantitative Measures of the Upper Limb. Brain Sci 2023; 13:1253. [PMID: 37759854 PMCID: PMC10526214 DOI: 10.3390/brainsci13091253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Altered somatosensory function is common among stroke survivors, yet is often poorly characterized. Methods of profiling somatosensation that illustrate the variability in impairment within and across different modalities remain limited. We aimed to characterize post-stroke somatosensation profiles ("fingerprints") of the upper limb using an unsupervised machine learning cluster analysis to capture hidden relationships between measures of touch, proprioception, and haptic object recognition. Raw data were pooled from six studies where multiple quantitative measures of upper limb somatosensation were collected from stroke survivors (n = 207) using the Tactile Discrimination Test (TDT), Wrist Position Sense Test (WPST) and functional Tactile Object Recognition Test (fTORT) on the contralesional and ipsilesional upper limbs. The Growing Self Organizing Map (GSOM) unsupervised machine learning algorithm was used to generate a topology-preserving two-dimensional mapping of the pooled data and then separate it into clusters. Signature profiles of somatosensory impairment across two modalities (TDT and WPST; n = 203) and three modalities (TDT, WPST, and fTORT; n = 141) were characterized for both hands. Distinct impairment subgroups were identified. The influence of background and clinical variables was also modelled. The study provided evidence of the utility of unsupervised cluster analysis that can profile stroke survivor signatures of somatosensory impairment, which may inform improved diagnosis and characterization of impairment patterns.
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Affiliation(s)
- Isuru Senadheera
- Centre for Data Analytics and Cognition, La Trobe Business School, La Trobe University, Melbourne, VIC 3086, Australia;
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia; (B.C.L.); (Y.Y.K.M.-Y.); (S.S.); (L.M.C.)
| | - Beverley C. Larssen
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia; (B.C.L.); (Y.Y.K.M.-Y.); (S.S.); (L.M.C.)
- Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Yvonne Y. K. Mak-Yuen
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia; (B.C.L.); (Y.Y.K.M.-Y.); (S.S.); (L.M.C.)
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3086, Australia
- Department of Occupational Therapy, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia
| | - Sarah Steinfort
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia; (B.C.L.); (Y.Y.K.M.-Y.); (S.S.); (L.M.C.)
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3086, Australia
| | - Leeanne M. Carey
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia; (B.C.L.); (Y.Y.K.M.-Y.); (S.S.); (L.M.C.)
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3086, Australia
| | - Damminda Alahakoon
- Centre for Data Analytics and Cognition, La Trobe Business School, La Trobe University, Melbourne, VIC 3086, Australia;
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Li CX, Tong F, Kempf D, Howell L, Zhang X. Longitudinal evaluation of the functional connectivity changes in the secondary somatosensory cortex (S2) of the monkey brain during acute stroke. CURRENT RESEARCH IN NEUROBIOLOGY 2023; 5:100097. [PMID: 37404949 PMCID: PMC10315998 DOI: 10.1016/j.crneur.2023.100097] [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: 06/12/2022] [Revised: 05/29/2023] [Accepted: 06/09/2023] [Indexed: 07/06/2023] Open
Abstract
Background Somatosensory deficits are frequently seen in acute stroke patients and may recover over time and affect functional outcome. However, the underlying mechanism of function recovery remains poorly understood. In the present study, progressive function alteration of the secondary somatosensory cortex (S2) and its relationship with regional perfusion and neurological outcome were examined using a monkey model of stroke. Methods and materials Rhesus monkeys (n = 4) were induced with permanent middle cerebral artery occlusion (pMCAo). Resting-state functional MRI, dynamic susceptibility contrast perfusion MRI, diffusion-weighted, T1 and T2 weighted images were collected before surgery and at 4-6, 48, and 96 h post stroke on a 3T scanner. Progressive changes of relative functional connectivity (FC), cerebral blood flow (CBF), and CBF/Tmax (Time to Maximum) of affected S2 regions were evaluated. Neurological deficits were assessed using the Spetzler approach. Results Ischemic lesion was evidently seen in the MCA territory including S2 in each monkey. Relative FC of injured S2 regions decreased substantially following stroke. Spetzler scores dropped substantially at 24 h post stroke but slightly recovered from Day 2 to Day 4. Relative FC progressively increased from 6 to 48 and 96 h post stroke and correlated significantly with relative CBFand CBF/Tmax changes. Conclusion The present study revealed the progressive alteration of function connectivity in S2 during acute stroke. The preliminary results suggested the function recovery might start couple days post occlusion and collateral circulation might play a key role in the recovery of somatosensory function after stroke insult. The relative function connectivity in S2 may provide additional information for prediction of functional outcome in stroke patients.
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Affiliation(s)
- Chun-Xia Li
- Emory National Primate Research Center, Emory University, Atlanta, 30329, Georgia
| | - Frank Tong
- Department of Radiology, Emory University School of Medicine, Atlanta, 30322, Georgia
| | - Doty Kempf
- Emory National Primate Research Center, Emory University, Atlanta, 30329, Georgia
| | - Leonard Howell
- Emory National Primate Research Center, Emory University, Atlanta, 30329, Georgia
| | - Xiaodong Zhang
- Emory National Primate Research Center, Emory University, Atlanta, 30329, Georgia
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Matyas TA, Mak-Yuen YYK, Boelsen-Robinson TP, Carey LM. Calibration of Impairment Severity to Enable Comparison across Somatosensory Domains. Brain Sci 2023; 13:brainsci13040654. [PMID: 37190619 DOI: 10.3390/brainsci13040654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/06/2023] [Accepted: 04/08/2023] [Indexed: 05/17/2023] Open
Abstract
Comparison across somatosensory domains, important for clinical and scientific goals, requires prior calibration of impairment severity. Provided test score distributions are comparable across domains, valid comparisons of impairment can be made by reference to score locations in the corresponding distributions (percentile rank or standardized scores). However, this is often not the case. Test score distributions for tactile texture discrimination (n = 174), wrist joint proprioception (n = 112), and haptic object identification (n = 98) obtained from pooled samples of stroke survivors in rehabilitation settings were investigated. The distributions showed substantially different forms, undermining comparative calibration via percentile rank or standardized scores. An alternative approach is to establish comparable locations in the psychophysical score ranges spanning performance from just noticeably impaired to maximally impaired. Several simulation studies and a theoretical analysis were conducted to establish the score distributions expected from completely insensate responders for each domain. Estimates of extreme impairment values suggested by theory, simulation and observed samples were consistent. Using these estimates and previously discovered values for impairment thresholds in each test domain, comparable ranges of impairment from just noticeable to extreme impairment were found. These ranges enable the normalization of the three test scales for comparison in clinical and research settings.
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Affiliation(s)
- Thomas A Matyas
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Heidelberg, Melbourne, VIC 3084, Australia
| | - Yvonne Y K Mak-Yuen
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Heidelberg, Melbourne, VIC 3084, Australia
- Department of Occupational Therapy, St Vincent's Hospital Melbourne, Fitzroy, Melbourne, VIC 3065, Australia
| | - Tristan P Boelsen-Robinson
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia
| | - Leeanne M Carey
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Heidelberg, Melbourne, VIC 3084, Australia
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Mak-Yuen YYK, Matyas TA, Carey LM. Characterizing Touch Discrimination Impairment from Pooled Stroke Samples Using the Tactile Discrimination Test: Updated Criteria for Interpretation and Brief Test Version for Use in Clinical Practice Settings. Brain Sci 2023; 13:brainsci13040533. [PMID: 37190498 DOI: 10.3390/brainsci13040533] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/19/2023] [Accepted: 03/20/2023] [Indexed: 05/17/2023] Open
Abstract
Somatosensory loss post-stroke is common, with touch sensation characteristically impaired. Yet, quantitative, standardized measures of touch discrimination available for clinical use are currently limited. We aimed to characterize touch impairment and re-establish the criterion of abnormality of the Tactile Discrimination Test (TDT) using pooled data and to determine the sensitivity and specificity of briefer test versions. Baseline data from stroke survivors (n = 207) and older neurologically healthy controls (n = 100) assessed on the TDT was extracted. Scores were re-analyzed to determine an updated criterion of impairment and the ability of brief test versions to detect impairment. Updated scoring using an area score was used to calculate the TDT percent maximum area (PMA) score. Touch impairment was common for the contralesional hand (83%) but also present in the ipsilesional hand (42%). The criterion of abnormality was established as 73.1 PMA across older adults and genders. High sensitivity and specificity were found for briefer versions of the TDT (25 vs. 50 trials; 12 or 15 vs. 25 trials), with sensitivity ranging between 91.8 and 96.4% and specificity between 72.5 and 95.0%. Conclusion: Updated criterion of abnormality and the high sensitivity and specificity of brief test versions support the use of the TDT in clinical practice settings.
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Affiliation(s)
- Yvonne Y K Mak-Yuen
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne 3084, Australia
- Department of Occupational Therapy, St Vincent's Hospital Melbourne, Melbourne 3065, Australia
| | - Thomas A Matyas
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne 3084, Australia
| | - Leeanne M Carey
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne 3084, Australia
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Lv Q, Zhang J, Pan Y, Liu X, Miao L, Peng J, Song L, Zou Y, Chen X. Somatosensory Deficits After Stroke: Insights From MRI Studies. Front Neurol 2022; 13:891283. [PMID: 35911919 PMCID: PMC9328992 DOI: 10.3389/fneur.2022.891283] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/15/2022] [Indexed: 11/28/2022] Open
Abstract
Somatosensory deficits after stroke are a major health problem, which can impair patients' health status and quality of life. With the developments in human brain mapping techniques, particularly magnetic resonance imaging (MRI), many studies have applied those techniques to unravel neural substrates linked to apoplexy sequelae. Multi-parametric MRI is a vital method for the measurement of stroke and has been applied to diagnose stroke severity, predict outcome and visualize changes in activation patterns during stroke recovery. However, relatively little is known about the somatosensory deficits after stroke and their recovery. This review aims to highlight the utility and importance of MRI techniques in the field of somatosensory deficits and synthesizes corresponding articles to elucidate the mechanisms underlying the occurrence and recovery of somatosensory symptoms. Here, we start by reviewing the anatomic and functional features of the somatosensory system. And then, we provide a discussion of MRI techniques and analysis methods. Meanwhile, we present the application of those techniques and methods in clinical studies, focusing on recent research advances and the potential for clinical translation. Finally, we identify some limitations and open questions of current imaging studies that need to be addressed in future research.
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Affiliation(s)
- Qiuyi Lv
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Junning Zhang
- Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Yuxing Pan
- Institute of Neuroscience, Chinese Academy of Science, Shanghai, China
| | - Xiaodong Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | | | - Jing Peng
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Lei Song
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Yihuai Zou
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Xing Chen
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
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Cassidy JM, Mark JI, Cramer SC. Functional connectivity drives stroke recovery: shifting the paradigm from correlation to causation. Brain 2022; 145:1211-1228. [PMID: 34932786 PMCID: PMC9630718 DOI: 10.1093/brain/awab469] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/20/2021] [Accepted: 11/26/2021] [Indexed: 11/14/2022] Open
Abstract
Stroke is a leading cause of disability, with deficits encompassing multiple functional domains. The heterogeneity underlying stroke poses significant challenges in the prediction of post-stroke recovery, prompting the development of neuroimaging-based biomarkers. Structural neuroimaging measurements, particularly those reflecting corticospinal tract injury, are well-documented in the literature as potential biomarker candidates of post-stroke motor recovery. Consistent with the view of stroke as a 'circuitopathy', functional neuroimaging measures probing functional connectivity may also prove informative in post-stroke recovery. An important step in the development of biomarkers based on functional neural network connectivity is the establishment of causality between connectivity and post-stroke recovery. Current evidence predominantly involves statistical correlations between connectivity measures and post-stroke behavioural status, either cross-sectionally or serially over time. However, the advancement of functional connectivity application in stroke depends on devising experiments that infer causality. In 1965, Sir Austin Bradford Hill introduced nine viewpoints to consider when determining the causality of an association: (i) strength; (ii) consistency; (iii) specificity; (iv) temporality; (v) biological gradient; (vi) plausibility; (vii) coherence; (viii) experiment; and (ix) analogy. Collectively referred to as the Bradford Hill Criteria, these points have been widely adopted in epidemiology. In this review, we assert the value of implementing Bradford Hill's framework to stroke rehabilitation and neuroimaging. We focus on the role of neural network connectivity measurements acquired from task-oriented and resting-state functional MRI, EEG, magnetoencephalography and functional near-infrared spectroscopy in describing and predicting post-stroke behavioural status and recovery. We also identify research opportunities within each Bradford Hill tenet to shift the experimental paradigm from correlation to causation.
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Affiliation(s)
- Jessica M Cassidy
- Department of Allied Health Sciences, Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jasper I Mark
- Department of Allied Health Sciences, Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Steven C Cramer
- Department of Neurology, University of California, Los Angeles; and California Rehabilitation Institute, Los Angeles, CA, USA
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10
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Huang Y, Jiao J, Hu J, Hsing C, Lai Z, Yang Y, Li Z, Hu X. Electroencephalographic Measurement on Post-stroke Sensory Deficiency in Response to Non-painful Cold Stimulation. Front Aging Neurosci 2022; 14:866272. [PMID: 35645770 PMCID: PMC9131028 DOI: 10.3389/fnagi.2022.866272] [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: 01/31/2022] [Accepted: 04/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Reduced elementary somatosensation is common after stroke. However, the measurement of elementary sensation is frequently overlooked in traditional clinical assessments, and has not been evaluated objectively at the cortical level. This study designed a new configuration for the measurement of post-stroke elementary thermal sensation by non-painful cold stimulation (NPCS). The post-stroke cortical responses were then investigated during elementary NPCS on sensory deficiency via electroencephalography (EEG) when compared with unimpaired persons. Method Twelve individuals with chronic stroke and fifteen unimpaired controls were recruited. A 64-channel EEG system was used to investigate the post-stroke cortical responses objectively during the NPCS. A subjective questionnaire of cold sensory intensity was also administered via a numeric visual analog scale (VAS). Three water samples with different temperatures (i.e., 25, 10, and 0°C) were applied to the skin surface of the ventral forearm for 3 s via glass beaker, with a randomized sequence on either the left or right forearm of a participant. EEG relative spectral power (RSP) and topography were used to evaluate the neural responses toward NPCS with respect to the independent factors of stimulation side and temperature. Results For unimpaired controls, NPCS initiated significant RSP variations, mainly located in the theta band with the highest discriminative resolution on the different temperatures (P < 0.001). For stroke participants, the distribution of significant RSP spread across all EEG frequency bands and the temperature discrimination was lower than that observed in unimpaired participants (P < 0.05). EEG topography showed that the NPCS could activate extensive and bilateral sensory cortical areas after stroke. Significant group differences on RSP intensities were obtained in each EEG band (P < 0.05). Meanwhile, significant asymmetry cortical responses in RSP toward different upper limbs were observed during the NPCS in both unimpaired controls and participants with stroke (P < 0.05). No difference was found between the groups in the VAS ratings of the different temperatures (P > 0.05). Conclusion The post-stroke cortical responses during NPCS on sensory deficiency were characterized by the wide distribution of representative RSP bands, lowered resolution toward different temperatures, and extensive activated sensory cortical areas.
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Affiliation(s)
- Yanhuan Huang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Jiao Jiao
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Junyan Hu
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Chihchia Hsing
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Zhangqi Lai
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Yang Yang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Zengyong Li
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Centre for Rehabilitation Technical Aids Beijing, Beijing, China
| | - Xiaoling Hu
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
- University Research Facility in Behavioral and Systems Neuroscience (UBSN), The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
- Research Institute for Smart Ageing (RISA), The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
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11
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Liang X, Koh CL, Yeh CH, Goodin P, Lamp G, Connelly A, Carey LM. Predicting Post-Stroke Somatosensory Function from Resting-State Functional Connectivity: A Feasibility Study. Brain Sci 2021; 11:brainsci11111388. [PMID: 34827387 PMCID: PMC8615819 DOI: 10.3390/brainsci11111388] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/07/2021] [Accepted: 10/18/2021] [Indexed: 12/02/2022] Open
Abstract
Accumulating evidence shows that brain functional deficits may be impacted by damage to remote brain regions. Recent advances in neuroimaging suggest that stroke impairment can be better predicted based on disruption to brain networks rather than from lesion locations or volumes only. Our aim was to explore the feasibility of predicting post-stroke somatosensory function from brain functional connectivity through the application of machine learning techniques. Somatosensory impairment was measured using the Tactile Discrimination Test. Functional connectivity was employed to model the global brain function. Behavioral measures and MRI were collected at the same timepoint. Two machine learning models (linear regression and support vector regression) were chosen to predict somatosensory impairment from disrupted networks. Along with two feature pools (i.e., low-order and high-order functional connectivity, or low-order functional connectivity only) engineered, four predictive models were built and evaluated in the present study. Forty-three chronic stroke survivors participated this study. Results showed that the regression model employing both low-order and high-order functional connectivity can predict outcomes based on correlation coefficient of r = 0.54 (p = 0.0002). A machine learning predictive approach, involving high- and low-order modelling, is feasible for the prediction of residual somatosensory function in stroke patients using functional brain networks.
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Affiliation(s)
- Xiaoyun Liang
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3084, Australia; (C.-L.K.); (P.G.); (G.L.); (L.M.C.)
- Victorian Infant Brain Studies (VIBeS) Group, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
- Correspondence:
| | - Chia-Lin Koh
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3084, Australia; (C.-L.K.); (P.G.); (G.L.); (L.M.C.)
- Department of Occupational Therapy, Social Work and Social Policy, School of Allied Health Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Chun-Hung Yeh
- Imaging Division, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3084, Australia; (C.-H.Y.); (A.C.)
- Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital, Taoyuan 33302, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan
| | - Peter Goodin
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3084, Australia; (C.-L.K.); (P.G.); (G.L.); (L.M.C.)
| | - Gemma Lamp
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3084, Australia; (C.-L.K.); (P.G.); (G.L.); (L.M.C.)
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia
| | - Alan Connelly
- Imaging Division, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3084, Australia; (C.-H.Y.); (A.C.)
| | - Leeanne M. Carey
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3084, Australia; (C.-L.K.); (P.G.); (G.L.); (L.M.C.)
- Department of Occupational Therapy, Social Work and Social Policy, School of Allied Health Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia
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12
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Koh CL, Yeh CH, Liang X, Vidyasagar R, Seitz RJ, Nilsson M, Connelly A, Carey LM. Structural Connectivity Remote From Lesions Correlates With Somatosensory Outcome Poststroke. Stroke 2021; 52:2910-2920. [PMID: 34134504 DOI: 10.1161/strokeaha.120.031520] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Chia-Lin Koh
- Neurorehabilitation and Recovery (C.-L.K., X.L., R.V., R.J.S., L.M.C.), Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia.,Occupational Therapy, School of Allied Health, Human Services and Sport, College of Science, Health, and Engineering, La Trobe University, Bundoora, Victoria, Australia (C.-L.K., M.N., L.M.C.).,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia (C.-L.K., C.-H.Y., X.L., R.V., M.N., A.C., L.M.C.).,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan (C.-L.K.)
| | - Chun-Hung Yeh
- Imaging Division (C.-H.Y., A.C.), Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia (C.-L.K., C.-H.Y., X.L., R.V., M.N., A.C., L.M.C.).,Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.-H.Y.).,Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.-H.Y.)
| | - Xiaoyun Liang
- Neurorehabilitation and Recovery (C.-L.K., X.L., R.V., R.J.S., L.M.C.), Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia (C.-L.K., C.-H.Y., X.L., R.V., M.N., A.C., L.M.C.).,Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia (X.L.)
| | - Rishma Vidyasagar
- Neurorehabilitation and Recovery (C.-L.K., X.L., R.V., R.J.S., L.M.C.), Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia (C.-L.K., C.-H.Y., X.L., R.V., M.N., A.C., L.M.C.)
| | - Rüdiger J Seitz
- Neurorehabilitation and Recovery (C.-L.K., X.L., R.V., R.J.S., L.M.C.), Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia.,Department of Neurology, Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany (R.J.S.)
| | - Michael Nilsson
- Occupational Therapy, School of Allied Health, Human Services and Sport, College of Science, Health, and Engineering, La Trobe University, Bundoora, Victoria, Australia (C.-L.K., M.N., L.M.C.).,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia (C.-L.K., C.-H.Y., X.L., R.V., M.N., A.C., L.M.C.).,School of Biomedical Sciences and Pharmacy and Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia (M.N.)
| | - Alan Connelly
- Imaging Division (C.-H.Y., A.C.), Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia (C.-L.K., C.-H.Y., X.L., R.V., M.N., A.C., L.M.C.)
| | - Leeanne M Carey
- Neurorehabilitation and Recovery (C.-L.K., X.L., R.V., R.J.S., L.M.C.), Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia.,Occupational Therapy, School of Allied Health, Human Services and Sport, College of Science, Health, and Engineering, La Trobe University, Bundoora, Victoria, Australia (C.-L.K., M.N., L.M.C.).,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia (C.-L.K., C.-H.Y., X.L., R.V., M.N., A.C., L.M.C.)
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13
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Yourganov G, Stark BC, Fridriksson J, Bonilha L, Rorden C. Effect of Stroke on Contralateral Functional Connectivity. Brain Connect 2021; 11:543-552. [PMID: 33757303 DOI: 10.1089/brain.2020.0901] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Stroke can induce large-scale functional reorganization of the brain; however, the spatial patterns of this reorganization remain largely unknown. Methods: Using a large (N = 116) sample of participants who were in the chronic stages of stroke, we present a systematic study of the association between brain damage and functional connectivity (FC) within the intact hemisphere. We computed correlations between regional cortical damage and contralateral FC. Results: We identified left-hemisphere regions that had the most pronounced effect on the right-hemisphere FC, and, conversely, right-hemisphere connections where the effect of damage was particularly strong. Notably, the vast majority of significant correlations were positive: damage was associated with an increase in regional contralateral connectivity. Discussion: These findings lend evidence of the reorganization of contralateral cortical networks as a response to brain damage, which is more pronounced in a set of well-connected regions where connectivity increases with the amount of damage.
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Affiliation(s)
- Grigori Yourganov
- Advanced Computing and Data Science, Cyberinfrastructure and Technology Integration, Clemson University, Clemson, South Carolina, USA
| | - Brielle C Stark
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, Indiana, USA.,Program in Neuroscience, Indiana University, Bloomington, Indiana, USA
| | - Julius Fridriksson
- Department of Communication Science and Disorders, University of South Carolina, Columbia, South Carolina, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Christopher Rorden
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
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14
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Kessner SS, Schlemm E, Gerloff C, Thomalla G, Cheng B. Grey and white matter network disruption is associated with sensory deficits after stroke. NEUROIMAGE-CLINICAL 2021; 31:102698. [PMID: 34023668 PMCID: PMC8163991 DOI: 10.1016/j.nicl.2021.102698] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 05/07/2021] [Accepted: 05/08/2021] [Indexed: 12/04/2022]
Abstract
Somatosensory deficits occur in about 60% of patients after ischaemic stroke. Clinical and imaging data of 101 ischaemic stroke patients were analysed. Stroke lesions may disrupt grey (GM) and/or white matter (WM) network. Lesion volume explains 23% of sensory deficit variance; GM / WM disruption adds 14% Subnetwork of postcentral, supramarginal, transverse temporal gyri involved.
Somatosensory deficits after ischaemic stroke are common and can occur in patients with lesions in the anterior parietal cortex and subcortical nuclei. It is less clear to what extent damage to white matter tracts within the somatosensory system may contribute to somatosensory deficits after stroke. We compared the roles of cortical damage and disruption of subcortical white matter tracts as correlates of somatosensory deficit after ischaemic stroke. Clinical and imaging data were assessed in incident stroke patients. Somatosensory deficits were measured using a standardized somatosensory test. Remote effects were quantified by projecting the MRI-based segmented stroke lesions onto a predefined atlas of white matter connectivity. Direct ischaemic damage to grey matter was computed by lesion overlap with grey matter areas. The association between lesion impact scores and sensory deficit was assessed statistically. In 101 patients, median sensory score was 188/193 (97.4%). Lesion volume was associated with somatosensory deficit, explaining 23.3% of variance. Beyond this, the stroke-induced grey and white matter disruption within a subnetwork of the postcentral, supramarginal, and transverse temporal gyri explained an additional 14% of the somatosensory outcome variability. On mutual comparison, white matter network disruption was a stronger predictor than grey matter damage. Ischaemic damage to both grey and white matter are structural correlates of acute somatosensory disturbance after ischaemic stroke. Our data suggest that white matter integrity of a somatosensory network of primary and secondary cortex is a prerequisite for normal processing of somatosensory inputs and might be considered as an additional parameter for stroke outcome prediction in the future.
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Affiliation(s)
- Simon S Kessner
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Eckhard Schlemm
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bastian Cheng
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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15
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De Bruyn N, Saenen L, Thijs L, Van Gils A, Ceulemans E, Essers B, Alaerts K, Verheyden G. Brain connectivity alterations after additional sensorimotor or motor therapy for the upper limb in the early-phase post stroke: a randomized controlled trial. Brain Commun 2021; 3:fcab074. [PMID: 33937771 PMCID: PMC8072522 DOI: 10.1093/braincomms/fcab074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 02/23/2021] [Accepted: 03/11/2021] [Indexed: 11/28/2022] Open
Abstract
Somatosensory function plays an important role for upper limb motor learning. However, knowledge about underlying mechanisms of sensorimotor therapy is lacking. We aim to investigate differences in therapy-induced resting-state functional connectivity changes between additional sensorimotor compared with motor therapy in the early-phase post stroke. Thirty first-stroke patients with a sensorimotor impairment were included for an assessor-blinded multi-centre randomized controlled trial within 8 weeks post stroke [13 (43%) females; mean age: 67 ± 13 years; mean time post stroke: 43 ± 13 days]. Patients were randomly assigned to additional sensorimotor (n = 18) or motor (n = 12) therapy, receiving 16 h of additional therapy within 4 weeks. Sensorimotor evaluations and resting-state functional magnetic resonance imaging were performed at baseline (T1), post-intervention (T2) and after 4 weeks follow-up (T3). Resting-state functional magnetic resonance imaging was also performed in an age-matched healthy control group (n = 19) to identify patterns of aberrant connectivity in stroke patients between hemispheres, or within ipsilesional and contralesional hemispheres. Mixed model analysis investigated session and treatment effects between stroke therapy groups. Non-parametric partial correlations were used to investigate brain−behaviour associations with age and frame-wise displacement as nuisance regressors. Connections within the contralesional hemisphere that showed hypo-connectivity in subacute stroke patients (compared with healthy controls) showed a trend towards a more pronounced pre-to-post normalization (less hypo-connectivity) in the motor therapy group, compared with the sensorimotor therapy group (mean estimated difference = −0.155 ± 0.061; P = 0.02). Further, the motor therapy group also tended to show a further pre-to-post increase in functional connectivity strength among connections that already showed hyper-connectivity in the stroke patients at baseline versus healthy controls (mean estimated difference = −0.144 ± 0.072; P = 0.06). Notably, these observed increases in hyper-connectivity of the contralesional hemisphere were positively associated with improvements in functional activity (r = 0.48), providing indications that these patterns of hyper-connectivity are compensatory in nature. The sensorimotor and motor therapy group showed no significant differences in terms of pre-to-post changes in inter-hemispheric connectivity or ipsilesional intrahemispheric connectivity. While effects are only tentative within this preliminary sample, results suggest a possible stronger normalization of hypo-connectivity and a stronger pre-to-post increase in compensatory hyper-connectivity of the contralesional hemisphere after motor therapy compared with sensorimotor therapy. Future studies with larger patient samples are however recommended to confirm these trend-based preliminary findings.
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Affiliation(s)
- Nele De Bruyn
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, 3001 Leuven, Belgium
| | - Leen Saenen
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, 3001 Leuven, Belgium
| | - Liselot Thijs
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, 3001 Leuven, Belgium
| | - Annick Van Gils
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, 3001 Leuven, Belgium
| | - Eva Ceulemans
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, 3001 Leuven, Belgium
| | - Bea Essers
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, 3001 Leuven, Belgium
| | - Kaat Alaerts
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, 3001 Leuven, Belgium
| | - Geert Verheyden
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, 3001 Leuven, Belgium
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16
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Zhou S, Huang Y, Jiao J, Hu J, Hsing C, Lai Z, Yang Y, Hu X. Impairments of cortico-cortical connectivity in fine tactile sensation after stroke. J Neuroeng Rehabil 2021; 18:34. [PMID: 33588877 PMCID: PMC7885375 DOI: 10.1186/s12984-021-00821-7] [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: 02/18/2020] [Accepted: 01/12/2021] [Indexed: 01/17/2023] Open
Abstract
Background Fine tactile sensation plays an important role in motor relearning after stroke. However, little is known about its dynamics in post-stroke recovery, principally due to a lack of effective evaluation on neural responses to fine tactile stimulation. This study investigated the post-stroke alteration of cortical connectivity and its functional structure in response to fine tactile stimulation via textile fabrics by electroencephalogram (EEG)-derived functional connectivity and graph theory analyses. Method Whole brain EEG was recorded from 64 scalp channels in 8 participants with chronic stroke and 8 unimpaired controls before and during the skin of the unilateral forearm contacted with a piece of cotton fabric. Functional connectivity (FC) was then estimated using EEG coherence. The fabric stimulation induced FC (SFC) was analyzed by a cluster-based permutation test for the FC in baseline and fabric stimulation. The functional structure of connectivity alteration in the brain was also investigated by assessing the multiscale topological properties of functional brain networks according to the graph theory. Results In the SFC distribution, an altered hemispheric lateralization (HL) (HL degree, 14%) was observed when stimulating the affected forearm in the stroke group, compared to stimulation of the unaffected forearm of the stroke group (HL degree, 53%) and those of the control group (HL degrees, 92% for the left and 69% for the dominant right limb). The involvement of additional brain regions, i.e., the distributed attention networks, was also observed when stimulating either limb of the stroke group compared with those of the control. Significantly increased (P < 0.05) global and local efficiencies were found when stimulating the affected forearm compared to the unaffected forearm. A significantly increased (P < 0.05) degree of inter-hemisphere FC (interdegree) mainly within ipsilesional somatosensory region and a significantly diminished degree of intra-hemisphere FC (intradegree) (P < 0.05) in ipsilesional primary somatosensory region were observed when stimulating the affected forearm, compared with the unaffected forearm. Conclusions The alteration of cortical connectivity in fine tactile sensation post-stroke was characterized by the compensation from the contralesional hemisphere and distributed attention networks related to involuntary attention. The interhemispheric connectivity could implement the compensation from the contralateral hemisphere to the ipsilesional somatosensory region. Stroke participants also exerted increased cortical activities in fine tactile sensation.
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Affiliation(s)
- Sa Zhou
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yanhuan Huang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jiao Jiao
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Junyan Hu
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Chihchia Hsing
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Zhangqi Lai
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yang Yang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xiaoling Hu
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China.
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17
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Carey LM, Mak-Yuen YYK, Matyas TA. The Functional Tactile Object Recognition Test: A Unidimensional Measure With Excellent Internal Consistency for Haptic Sensing of Real Objects After Stroke. Front Neurosci 2020; 14:542590. [PMID: 33071730 PMCID: PMC7538651 DOI: 10.3389/fnins.2020.542590] [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: 03/13/2020] [Accepted: 08/17/2020] [Indexed: 01/01/2023] Open
Abstract
Introduction Our hands, with their exquisite sensors, work in concert with our sensing brain to extract sensory attributes of objects as we engage in daily activities. One in two people with stroke experience impaired body sensation, with negative impact on hand use and return to previous valued activities. Valid, quantitative tools are critical to measure somatosensory impairment after stroke. The functional Tactile Object Recognition Test (fTORT) is a quantitative measure of tactile (haptic) object recognition designed to test one’s ability to recognize everyday objects across seven sensory attributes using 14 object sets. However, to date, knowledge of the nature of object recognition errors is limited, and the internal consistency of performance across item scores and dimensionality of the measure have not been established. Objectives To describe the original development and construction of the test, characterize the distribution and nature of performance errors after stroke, and to evaluate the internal consistency of item scores and dimensionality of the fTORT. Method Data from existing cohorts of stroke survivors (n = 115) who were assessed on the fTORT quantitative measure of sensory performance were extracted and pooled. Item and scale analyses were conducted on the raw item data. The distribution and type of errors were characterized. Results The 14 item sets of the fTORT form a well-behaved unidimensional scale and demonstrate excellent internal consistency (Cronbach alpha of 0.93). Deletion of any item failed to improve the Cronbach score. Most items displayed a bimodal score distribution, with function and attribute errors (score 0) or correct response (score 3) being most common. A smaller proportion of one- or two-attribute errors occurred. The total score range differentiated performance over a wide range of object recognition impairment. Conclusion Unidimensional scale and similar factor loadings across all items support simple addition of the 14 item scores on the fTORT. Therapists can use the fTORT to quantify impaired tactile object recognition in people with stroke based on the current set of items. New insights on the nature of haptic object recognition impairment after stroke are revealed.
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Affiliation(s)
- Leeanne M Carey
- Department of Occupational Therapy, Social Work and Social Policy, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia.,Neurorehabilitation and Recovery, The Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia
| | - Yvonne Y K Mak-Yuen
- Department of Occupational Therapy, Social Work and Social Policy, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia.,Neurorehabilitation and Recovery, The Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia
| | - Thomas A Matyas
- Department of Occupational Therapy, Social Work and Social Policy, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia
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18
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Mekbib DB, Zhao Z, Wang J, Xu B, Zhang L, Cheng R, Fang S, Shao Y, Yang W, Han J, Jiang H, Zhu J, Ye X, Zhang J, Xu D. Proactive Motor Functional Recovery Following Immersive Virtual Reality-Based Limb Mirroring Therapy in Patients with Subacute Stroke. Neurotherapeutics 2020; 17:1919-1930. [PMID: 32671578 PMCID: PMC7851292 DOI: 10.1007/s13311-020-00882-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Virtual reality (VR) is considered to be a promising therapeutic technology for the rehabilitation of upper extremities (UEs) post-stroke. Recently, we designed and then implemented a neuroscientifically grounded VR protocol for the rehabilitation of patients with stroke. The system provides unilateral and bilateral limb mirroring exercises in a fully immersive virtual environment that may stimulate and activate the mirror neuron system in the brain to help patients for their rehabilitation. Twelve patients with subacute stroke underwent the newly implemented VR treatment in addition to conventional rehabilitation for 8 consecutive weekdays. The treatment effect on brain reorganization and motor function was investigated using resting-state fMRI (rs-fMRI) and the Fugl-Meyer assessment for Upper Extremity (FM-UE), respectively. Fifteen healthy controls (HCs) also underwent rs-fMRI scanning one time. The study finally obtained usable data from 8 patients and 13 HCs. After the intervention, patients demonstrated significant improvement in their FM-UE scores (p values < 0.042). Voxel-wise functional connectivity (FC) analysis based on the rs-fMRI data found that HCs showed widespread bilateral FC patterns associated with the dominant hemispheric primary motor cortex (M1). However, the FC patterns in patients revealed intra-hemispheric association with the ipsilesional M1 seed and this association became visible in the contra-hemisphere after the intervention. Moreover, the change of FC values between the bilateral M1 was significantly correlated with the changes in FM-UE scores (p values < 0.037). We conclude that unilateral and bilateral limb mirroring exercise in an immersive virtual environment may enhance cortical reorganization and lead to improved motor function.
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Affiliation(s)
- Destaw B Mekbib
- Interdisciplinary Institute of Neuroscience and Technology, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, 310000, China
| | - Zhiyong Zhao
- Shanghai Key Laboratory of Magnetic Resonance, Institute of Cognitive Neuroscience, East China Normal University, Shanghai, 200064, China
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, 310027, China
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University & New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Jianbao Wang
- Key Laboratory of Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, 310029, China
- Department of Neurology of the Second Affiliated Hospital, Interdisciplinary Institute of Neuroscience and Technology,, Zhejiang University School of Medicine, Hangzhou, 310029, China
| | - Bin Xu
- Key Laboratory of Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, 310029, China
- Interdisciplinary Institute of Neuroscience and Technology, Qiushi Academy for Advanced Studies, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310029, China
| | - Li Zhang
- Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, China
| | - Ruiding Cheng
- Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, China
| | - Shan Fang
- Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, China
| | - Yuling Shao
- Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, China
| | - Wei Yang
- Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, China
| | - Jiawei Han
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310029, China
| | - Hongjie Jiang
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310029, China
| | - Junming Zhu
- Department of Neurology of the Second Affiliated Hospital, Interdisciplinary Institute of Neuroscience and Technology,, Zhejiang University School of Medicine, Hangzhou, 310029, China.
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310029, China.
| | - Xiangming Ye
- Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, China
| | - Jianmin Zhang
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310029, China
| | - Dongrong Xu
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University & New York State Psychiatric Institute, New York, NY, 10032, USA.
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19
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Laudenbach V, Charollais A, Radi S, Stumpf MH, Vincent A, Kaltwasser I, Tomczyk T, Benichou J, Leroux P, Marret S. Conditions requiring hospitalisations, more than general anaesthesia itself, are associated with diagnosis of learning disorders in children. Anaesth Crit Care Pain Med 2020; 39:777-783. [PMID: 32977071 DOI: 10.1016/j.accpm.2020.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Anaesthesia is neurotoxic in developing primates. Retrospective clinical studies show a correlation between exposure to anaesthesia during infancy and the occurrence of learning disorders (LD). Prospective studies failed to detect any influence of a single exposure to anaesthesia on neurodevelopment. We hypothesised that some specific populations of children were electively sensitive to anaesthesia-related neurotoxicity. METHODS Using a case-control design, we analysed the medical histories of children with LD, compared to those of their normally reading siblings. Interviews were conducted and medical records were reviewed. The numbers of hospitalisations and anaesthesia exposures before the age of five years were determined. RESULTS Four hundred fourteen dyslexic children were screened over a one-year period. Two hundred and seventy patients were excluded due to confounding variables (single child, all siblings showing LD or any condition placing the neurological prognosis at risk (N = 107/414 for the latter)) or inability to accurately collect evaluation criteria. In the 144 case-control pairs studied, the mean number of hospitalisations was significantly different (N = 1.097 ± 0 .135/case versus 0.667 ± 0.097/control, p = 0.0052), as was the proportion of hospitalised patients (54.2% versus 38.9%, p = 0.0031). The mean number of anaesthesia exposures per individual was not statistically different (N = 0.958 ± 0.183/case versus 0.569 ± 0.107/control, p = 0.0732), but the proportion of children anaesthetised at least once was (43.8% (cases) versus 33.3% (controls), p = 0.0301). DISCUSSION One or more hospitalisation(s) may reflect a health status and/or have an iatrogenic effect disrupting the normal setting up of learning abilities. Anaesthesia may play a role, but a correlation between LD and anaesthesia is of a lower magnitude than between LD and hospitalisation.
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Affiliation(s)
- Vincent Laudenbach
- Reference Centre for Learning Disorders, Rouen University Hospital, F-76031 Rouen Cedex, France; Department of Neonatology and Paediatric Intensive Care, Rouen University Hospital, F-76031 Cedex, France.
| | - Aude Charollais
- Reference Centre for Learning Disorders, Rouen University Hospital, F-76031 Rouen Cedex, France; Department of Neonatology and Paediatric Intensive Care, Rouen University Hospital, F-76031 Cedex, France; Laboratory ICONES EA4699, Faculty of Psychology, Sociology and Educational Sciences, University of Rouen, France
| | - Sophie Radi
- Reference Centre for Learning Disorders, Rouen University Hospital, F-76031 Rouen Cedex, France
| | - Marie-Hélène Stumpf
- Reference Centre for Learning Disorders, Rouen University Hospital, F-76031 Rouen Cedex, France
| | - Anne Vincent
- Reference Centre for Learning Disorders, Rouen University Hospital, F-76031 Rouen Cedex, France; Department of Neonatology and Paediatric Intensive Care, Rouen University Hospital, F-76031 Cedex, France
| | - Ingrid Kaltwasser
- Reference Centre for Learning Disorders, Rouen University Hospital, F-76031 Rouen Cedex, France
| | - Tiphaine Tomczyk
- Reference Centre for Learning Disorders, Rouen University Hospital, F-76031 Rouen Cedex, France; Department of Neonatology and Paediatric Intensive Care, Rouen University Hospital, F-76031 Cedex, France
| | - Jacques Benichou
- Department of Biostatistics, Rouen University Hospital, F-76031 Cedex, France
| | - Philippe Leroux
- Laboratory INSERM UMR 1245, Rouen School of Pharmacy and Medicine, Normandy University Rouen, 22 Bd Gambetta, F-76183 Rouen Cedex, France
| | - Stéphane Marret
- Reference Centre for Learning Disorders, Rouen University Hospital, F-76031 Rouen Cedex, France; Department of Neonatology and Paediatric Intensive Care, Rouen University Hospital, F-76031 Cedex, France; Laboratory INSERM UMR 1245, Rouen School of Pharmacy and Medicine, Normandy University Rouen, 22 Bd Gambetta, F-76183 Rouen Cedex, France
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20
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Huang Y, Jiao J, Hu J, Hsing C, Lai Z, Yang Y, Hu X. Measurement of sensory deficiency in fine touch after stroke during textile fabric stimulation by electroencephalography (EEG). J Neural Eng 2020; 17:045007. [PMID: 32613946 DOI: 10.1088/1741-2552/aba160] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Objective Sensory deficiency of fine touch limits the restoration of motor functions after stroke, and its evaluation was seldom investigated from a neurological perspective. In this study, we investigated the cortical response measured by electroencephalography (EEG) on the fine touch sensory impairment during textile fabric stimulation after stroke. Approach Both participants with chronic stroke (n = 12, stroke group) and those unimpaired (n = 15, control group) were recruited. To investigate fine touch during textile fabric stimulations, full brain EEG recordings (64-channel) were used, as well as the touch sensation questionnaires based on the American Association of Textile Chemists and Colorists (AATCC) Evaluation Procedure 5. During the EEG measurement, relative spectral power (RSP) and EEG topography were used to evaluate the neural responses toward the fabric stimuli. In the subjective questionnaire, the fine touch for fabric stimuli was rated and represented by 13 different sensation parameters. The correlation between the fine touch evaluated by the EEG and the questionnaire was also investigated. Main results The neural responses of individuals with fine touch impairments after stroke were characterized by a shifted power spectrum to a higher frequency band, enlarged sensory cortical areas and higher RSP intensity (P < 0.05). Asymmetric neural responses were obtained when stimulating different upper limbs for both unimpaired participants and stroke participants (P < 0.05). The fine touch sensation of the stroke participants was impaired even in the unaffected limb. However, as a result of different neural processes, the correlation between the EEG and the questionnaire was weak (r < 0.2). Significance EEG RSP was able to capture the varied cortical responses induced by textile fabric fine touch stimulations related to the fine touch sensory impairment after stroke.
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Affiliation(s)
- Yanhuan Huang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
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21
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Ingemanson ML, Rowe JR, Chan V, Riley J, Wolbrecht ET, Reinkensmeyer DJ, Cramer SC. Neural Correlates of Passive Position Finger Sense After Stroke. Neurorehabil Neural Repair 2019; 33:740-750. [PMID: 31319755 DOI: 10.1177/1545968319862556] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background. Proprioception of fingers is essential for motor control. Reduced proprioception is common after stroke and is associated with longer hospitalization and reduced quality of life. Neural correlates of proprioception deficits after stroke remain incompletely understood, partly because of weaknesses of clinical proprioception assessments. Objective. To examine the neural basis of finger proprioception deficits after stroke. We hypothesized that a model incorporating both neural injury and neural function of the somatosensory system is necessary for delineating proprioception deficits poststroke. Methods. Finger proprioception was measured using a robot in 27 individuals with chronic unilateral stroke; measures of neural injury (damage to gray and white matter, including corticospinal and thalamocortical sensory tracts), neural function (activation of and connectivity of cortical sensorimotor areas), and clinical status (demographics and behavioral measures) were also assessed. Results. Impairment in finger proprioception was present contralesionally in 67% and bilaterally in 56%. Robotic measures of proprioception deficits were more sensitive than standard scales and were specific to proprioception. Multivariable modeling found that contralesional proprioception deficits were best explained (r2 = 0.63; P = .0006) by a combination of neural function (connectivity between ipsilesional secondary somatosensory cortex and ipsilesional primary motor cortex) and neural injury (total sensory system injury). Conclusions. Impairment of finger proprioception occurs frequently after stroke and is best measured using a quantitative device such as a robot. A model containing a measure of neural function plus a measure of neural injury best explained proprioception performance. These measurements might be useful in the development of novel neurorehabilitation therapies.
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Affiliation(s)
| | | | - Vicky Chan
- 1 University of California, Irvine, CA, USA
| | - Jeff Riley
- 1 University of California, Irvine, CA, USA
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22
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Edwards LL, King EM, Buetefisch CM, Borich MR. Putting the "Sensory" Into Sensorimotor Control: The Role of Sensorimotor Integration in Goal-Directed Hand Movements After Stroke. Front Integr Neurosci 2019; 13:16. [PMID: 31191265 PMCID: PMC6539545 DOI: 10.3389/fnint.2019.00016] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 05/03/2019] [Indexed: 12/31/2022] Open
Abstract
Integration of sensory and motor information is one-step, among others, that underlies the successful production of goal-directed hand movements necessary for interacting with our environment. Disruption of sensorimotor integration is prevalent in many neurologic disorders, including stroke. In most stroke survivors, persistent paresis of the hand reduces function and overall quality of life. Current rehabilitative methods are based on neuroplastic principles to promote motor learning that focuses on regaining motor function lost due to paresis, but the sensory contributions to motor control and learning are often overlooked and currently understudied. There is a need to evaluate and understand the contribution of both sensory and motor function in the rehabilitation of skilled hand movements after stroke. Here, we will highlight the importance of integration of sensory and motor information to produce skilled hand movements in healthy individuals and individuals after stroke. We will then discuss how compromised sensorimotor integration influences relearning of skilled hand movements after stroke. Finally, we will propose an approach to target sensorimotor integration through manipulation of sensory input and motor output that may have therapeutic implications.
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Affiliation(s)
- Lauren L Edwards
- Neuroscience Graduate Program, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, United States
| | - Erin M King
- Neuroscience Graduate Program, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, United States
| | - Cathrin M Buetefisch
- Department of Rehabilitation Medicine, Laney Graduate School, Emory University, Atlanta, GA, United States.,Department of Neurology, Emory University, Atlanta, GA, United States.,Department of Radiology and Imaging Sciences, School of Medicine, Emory University, Atlanta, GA, United States
| | - Michael R Borich
- Department of Rehabilitation Medicine, Laney Graduate School, Emory University, Atlanta, GA, United States
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23
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Lamp G, Goodin P, Palmer S, Low E, Barutchu A, Carey LM. Activation of Bilateral Secondary Somatosensory Cortex With Right Hand Touch Stimulation: A Meta-Analysis of Functional Neuroimaging Studies. Front Neurol 2019; 9:1129. [PMID: 30687211 PMCID: PMC6335946 DOI: 10.3389/fneur.2018.01129] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 12/10/2018] [Indexed: 12/30/2022] Open
Abstract
Background: Brain regions involved in processing somatosensory information have been well documented through lesion, post-mortem, animal, and more recently, structural and functional neuroimaging studies. Functional neuroimaging studies characterize brain activation related to somatosensory processing; yet a meta-analysis synthesis of these findings is currently lacking and in-depth knowledge of the regions involved in somatosensory-related tasks may also be confounded by motor influences. Objectives: Our Activation Likelihood Estimate (ALE) meta-analysis sought to quantify brain regions that are involved in the tactile processing of the right (RH) and left hands (LH) separately, with the exclusion of motor related activity. Methods: The majority of studies (n = 41) measured activation associated with RH tactile stimulation. RH activation studies were grouped into those which conducted whole-brain analyses (n = 29) and those which examined specific regions of interest (ROI; n = 12). Few studies examined LH activation, though all were whole-brain studies (N = 7). Results: Meta-analysis of brain activation associated with RH tactile stimulation (whole-brain studies) revealed large clusters of activation in the left primary somatosensory cortex (S1) and bilaterally in the secondary somatosensory cortex (S2; including parietal operculum) and supramarginal gyrus (SMG), as well as the left anterior cingulate. Comparison between findings from RH whole-brain and ROI studies revealed activation as expected, but restricted primarily to S1 and S2 regions. Further, preliminary analyses of LH stimulation studies only, revealed two small clusters within the right S1 and S2 regions, likely limited due to the small number of studies. Contrast analyses revealed the one area of overlap for RH and LH, was right secondary somatosensory region. Conclusions: Findings from the whole-brain meta-analysis of right hand tactile stimulation emphasize the importance of taking into consideration bilateral activation, particularly in secondary somatosensory cortex. Further, the right parietal operculum/S2 region was commonly activated for right and left hand tactile stimulation, suggesting a lateralized pattern of somatosensory activation in right secondary somatosensory region. Implications for further research and for possible differences in right and left hemispheric stroke lesions are discussed.
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Affiliation(s)
- Gemma Lamp
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, VIC, Australia
- Occupational Therapy, School of Allied Health, La Trobe University, Bundoora, VIC, Australia
| | - Peter Goodin
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, VIC, Australia
| | - Susan Palmer
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, VIC, Australia
| | - Essie Low
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, VIC, Australia
- Department of Neurology, Sunshine Hospital, Western Health, Melbourne, VIC, Australia
- Department of Psychology, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Ayla Barutchu
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, VIC, Australia
- Balliol College, University of Oxford, Oxford, United Kingdom
| | - Leeanne M. Carey
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, VIC, Australia
- Occupational Therapy, School of Allied Health, La Trobe University, Bundoora, VIC, Australia
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24
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Umeki N, Murata J, Kubota S, Kogo H, Yamaguchi T, Higashijima M. Relationship Between Motor Paralysis and Impairments in Tactile Sensitivity in Elderly Stroke Patients. INT J GERONTOL 2018. [DOI: 10.1016/j.ijge.2018.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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25
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Chi NF, Ku HL, Chen DYT, Tseng YC, Chen CJ, Lin YC, Hsieh YC, Chan L, Chiou HY, Hsu CY, Hu CJ. Cerebral Motor Functional Connectivity at the Acute Stage: An Outcome Predictor of Ischemic Stroke. Sci Rep 2018; 8:16803. [PMID: 30429535 PMCID: PMC6235876 DOI: 10.1038/s41598-018-35192-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 10/16/2018] [Indexed: 12/17/2022] Open
Abstract
Sixty-seven patients with first acute ischemic stroke onset between 3 to 7 days and 25 age- and sex- matched controls were analyzed for the performance of a resting-state functional MRI to investigate whether the functional connectivity (FC) of the motor network in acute ischemic stroke is independently associated with functional outcomes. The FC of cortical motor network and default mode network was analyzed. The FC was compared between controls, patients with favorable outcomes (modified Rankin Scale, mRS ≤1), and patients with unfavorable outcomes (mRS ≥2) at 3 months. Of the 67 patients, 23 (34%) exhibited unfavorable outcomes. In multivariate analysis, the FC between ipsilesional primary motor cortex (M1) and contralesional dorsal premotor area (PMd) ≤0.63, were independently associated with unfavorable outcomes (odds ratio = 6.32, P = 0.032), whereas the FC of default mode network was not different between groups. The interhemispheric FC of the motor network is an independent predictor of functional outcomes in patients with acute ischemic stroke.
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Affiliation(s)
- Nai-Fang Chi
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Neurology, Stroke Center, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Brain and Consciousness Research Center, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Lun Ku
- Brain and Consciousness Research Center, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - David Yen-Ting Chen
- Brain and Consciousness Research Center, Taipei Medical University, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ying-Chi Tseng
- Brain and Consciousness Research Center, Taipei Medical University, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chi-Jen Chen
- Brain and Consciousness Research Center, Taipei Medical University, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ying-Chin Lin
- Department of Family Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan.,Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Chen Hsieh
- The PhD Program of Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Lung Chan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Neurology, Stroke Center, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan
| | - Hung-Yi Chiou
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,School of Public Health, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chung Y Hsu
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Chaur-Jong Hu
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. .,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. .,Department of Neurology, Stroke Center, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan. .,Graduate Institute of Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
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26
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De Bruyn N, Meyer S, Kessner SS, Essers B, Cheng B, Thomalla G, Peeters A, Sunaert S, Duprez T, Thijs V, Feys H, Alaerts K, Verheyden G. Functional network connectivity is altered in patients with upper limb somatosensory impairments in the acute phase post stroke: A cross-sectional study. PLoS One 2018; 13:e0205693. [PMID: 30312350 PMCID: PMC6185852 DOI: 10.1371/journal.pone.0205693] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 09/28/2018] [Indexed: 11/19/2022] Open
Abstract
Background Aberrant functional connectivity in brain networks associated with motor impairment after stroke is well described, but little is known about the association with somatosensory impairments. Aim The objective of this cross-sectional observational study was to investigate the relationship between brain functional connectivity and severity of somatosensory impairments in the upper limb in the acute phase post stroke. Methods Nineteen first-ever stroke patients underwent resting-state functional magnetic resonance imaging (rs-fMRI) and a standardized clinical somatosensory profile assessment (exteroception and higher cortical somatosensation) in the first week post stroke. Integrity of inter- and intrahemispheric (ipsilesional and contralesional) functional connectivity of the somatosensory network was assessed between patients with severe (Em-NSA< 13/32) and mild to moderate (Em-NSA> 13/32) somatosensory impairments. Results Patients with severe somatosensory impairments displayed significantly lower functional connectivity indices in terms of interhemispheric (p = 0.001) and ipsilesional intrahemispheric (p = 0.035) connectivity compared to mildly to moderately impaired patients. Significant associations were found between the perceptual threshold of touch assessment and interhemispheric (r = -0.63) and ipsilesional (r = -0.51) network indices. Additional significant associations were found between the index of interhemispheric connectivity and light touch (r = 0.55) and stereognosis (r = 0.64) evaluation. Conclusion Patients with more severe somatosensory impairments have lower inter- and ipsilesional intrahemispheric connectivity of the somatosensory network. Lower connectivity indices are related to more impaired exteroception and higher cortical somatosensation. This study highlights the importance of network integrity in terms of inter- and ipsilesional intrahemispheric connectivity for somatosensory function. Further research is needed investigating the effect of therapy on the re-establishment of these networks.
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Affiliation(s)
- Nele De Bruyn
- KU Leuven—University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
- * E-mail:
| | - Sarah Meyer
- KU Leuven—University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Simon S. Kessner
- University Medical Center Hamburg-Eppendorf, Department of Neurology, Hamburg, Germany
| | - Bea Essers
- KU Leuven—University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Bastian Cheng
- University Medical Center Hamburg-Eppendorf, Department of Neurology, Hamburg, Germany
| | - Götz Thomalla
- University Medical Center Hamburg-Eppendorf, Department of Neurology, Hamburg, Germany
| | - Andre Peeters
- Cliniques Universitaires Saint-Luc, Department of Neurology, Brussels, Belgium
| | - Stefan Sunaert
- KU Leuven—University of Leuven, Department of Imaging and Pathology, Leuven, Belgium
- University Hospitals Leuven, Department of Radiology, Leuven, Belgium
| | - Thierry Duprez
- Cliniques Universitaires Saint-Luc, Department of Radiology, Brussels, Belgium
| | - Vincent Thijs
- University of Melbourne, Florey Institute of Neuroscience and Mental Health, Victoria, Australia
- University of Melbourne, Department of Neurology, Austin Health, Victoria, Australia
| | - Hilde Feys
- KU Leuven—University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Kaat Alaerts
- KU Leuven—University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Geert Verheyden
- KU Leuven—University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
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27
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A systematic review investigating the relationship of electroencephalography and magnetoencephalography measurements with sensorimotor upper limb impairments after stroke. J Neurosci Methods 2018; 311:318-330. [PMID: 30118725 DOI: 10.1016/j.jneumeth.2018.08.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 07/17/2018] [Accepted: 08/09/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND Predicting sensorimotor upper limb outcome receives continued attention in stroke. Neurophysiological measures by electroencephalography (EEG) and magnetoencephalography (MEG) could increase the accuracy of predicting sensorimotor upper limb recovery. NEW METHOD The aim of this systematic review was to summarize the current evidence for EEG/MEG-based measures to index neural activity after stroke and the relationship between abnormal neural activity and sensorimotor upper limb impairment. Relevant papers from databases EMBASE, CINHAL, MEDLINE and pubMED were identified. Methodological quality of selected studies was assessed with the Modified Downs and Black form. Data collected was reported descriptively. RESULTS Seventeen papers were included; 13 used EEG and 4 used MEG applications. Findings showed that: (a) the presence of somatosensory evoked potentials in the acute stage are related to better outcome of upper limb motor impairment from 10 weeks to 6 months post-stroke; (b) an interhemispheric imbalance of cortical oscillatory signals associated with upper limb impairment; and (c) predictive models including beta oscillatory cortical signal factors with corticospinal integrity and clinical measures could enhance upper limb motor prognosis. COMPARING WITH EXISTING METHOD The combination of neurological biomarkers with clinical measures results in higher statistical power than using neurological biomarkers alone when predicting motor recovery in stroke. CONCLUSIONS Alterations in neural activity by means of EEG and MEG are demonstrated from the early post-stroke stage onwards, and related to sensorimotor upper limb impairment. Future work exploring cortical oscillatory signals in the acute stage could provide further insight about prediction of upper limb sensorimotor recovery.
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28
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Boyd LA, Hayward KS, Ward NS, Stinear CM, Rosso C, Fisher RJ, Carter AR, Leff AP, Copland DA, Carey LM, Cohen LG, Basso DM, Maguire JM, Cramer SC. Biomarkers of Stroke Recovery: Consensus-Based Core Recommendations from the Stroke Recovery and Rehabilitation Roundtable. Neurorehabil Neural Repair 2018; 31:864-876. [PMID: 29233071 DOI: 10.1177/1545968317732680] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The most difficult clinical questions in stroke rehabilitation are "What is this patient's potential for recovery?" and "What is the best rehabilitation strategy for this person, given her/his clinical profile?" Without answers to these questions, clinicians struggle to make decisions regarding the content and focus of therapy, and researchers design studies that inadvertently mix participants who have a high likelihood of responding with those who do not. Developing and implementing biomarkers that distinguish patient subgroups will help address these issues and unravel the factors important to the recovery process. The goal of the present paper is to provide a consensus statement regarding the current state of the evidence for stroke recovery biomarkers. Biomarkers of motor, somatosensory, cognitive and language domains across the recovery timeline post-stroke are considered; with focus on brain structure and function, and exclusion of blood markers and genetics. We provide evidence for biomarkers that are considered ready to be included in clinical trials, as well as others that are promising but not ready and so represent a developmental priority. We conclude with an example that illustrates the utility of biomarkers in recovery and rehabilitation research, demonstrating how the inclusion of a biomarker may enhance future clinical trials. In this way, we propose a way forward for when and where we can include biomarkers to advance the efficacy of the practice of, and research into, rehabilitation and recovery after stroke.
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Affiliation(s)
- Lara A Boyd
- 1 Department of Physical Therapy & the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Kathryn S Hayward
- 2 Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Nick S Ward
- 3 Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
| | - Cathy M Stinear
- 4 Department of Medicine and Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Charlotte Rosso
- 5 Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, France; AP-HP, Stroke Unit, Pitié-Salpêtrière Hospital, France
| | - Rebecca J Fisher
- 6 Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| | - Alexandre R Carter
- 7 Department of Neurology, Washington University in Saint Louis, St Louis, MO, USA
| | - Alex P Leff
- 8 Department of Brain Repair and Rehabilitation, Institute of Neurology & Institute of Cognitive Neuroscience, University College London, Queens Square, London, UK
| | - David A Copland
- 9 School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, Australia; and University of Queensland Centre for Clinical Research, Brisbane, Australia
| | - Leeanne M Carey
- 10 School of Allied Health, College of Science, Health and Engineering, La Trobe, University, Bundoora, Australia; and Neurorehabilitation and Recovery, Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Leonardo G Cohen
- 11 Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
| | - D Michele Basso
- 12 School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Jane M Maguire
- 13 Faculty of Health, University of Technology Sydney, Ultimo, Sydney, Australia
| | - Steven C Cramer
- 14 University of California, Irvine, CA, USA; Depts. Neurology, Anatomy & Neurobiology, and Physical Medicine & Rehabilitation, Irvine, CA, USA
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29
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Pundik S, Scoco A, Skelly M, McCabe JP, Daly JJ. Greater Cortical Thickness Is Associated With Enhanced Sensory Function After Arm Rehabilitation in Chronic Stroke. Neurorehabil Neural Repair 2018; 32:590-601. [DOI: 10.1177/1545968318778810] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective. Somatosensory function is critical to normal motor control. After stroke, dysfunction of the sensory systems prevents normal motor function and degrades quality of life. Structural neuroplasticity underpinnings of sensory recovery after stroke are not fully understood. The objective of this study was to identify changes in bilateral cortical thickness (CT) that may drive recovery of sensory acuity. Methods. Chronic stroke survivors (n = 20) were treated with 12 weeks of rehabilitation. Measures were sensory acuity (monofilament), Fugl-Meyer upper limb and CT change. Permutation-based general linear regression modeling identified cortical regions in which change in CT was associated with change in sensory acuity. Results. For the ipsilesional hemisphere in response to treatment, CT increase was significantly associated with sensory improvement in the area encompassing the occipital pole, lateral occipital cortex (inferior and superior divisions), intracalcarine cortex, cuneal cortex, precuneus cortex, inferior temporal gyrus, occipital fusiform gyrus, supracalcarine cortex, and temporal occipital fusiform cortex. For the contralesional hemisphere, increased CT was associated with improved sensory acuity within the posterior parietal cortex that included supramarginal and angular gyri. Following upper limb therapy, monofilament test score changed from 45.0 ± 13.3 to 42.6 ± 12.9 mm ( P = .063) and Fugl-Meyer score changed from 22.1 ± 7.8 to 32.3 ± 10.1 ( P < .001). Conclusions. Rehabilitation in the chronic stage after stroke produced structural brain changes that were strongly associated with enhanced sensory acuity. Improved sensory perception was associated with increased CT in bilateral high-order association sensory cortices reflecting the complex nature of sensory function and recovery in response to rehabilitation.
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Affiliation(s)
- Svetlana Pundik
- Case Western Reserve University, Cleveland, OH, USA
- Cleveland VA Medical Center, Cleveland, OH, USA
| | - Aleka Scoco
- Case Western Reserve University, Cleveland, OH, USA
| | | | | | - Janis J. Daly
- University of Florida, Gainesville, FL, USA
- Gainesville VA Medical Center, Gainesville, FL, USA
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De Bruyn N, Essers B, Thijs L, Van Gils A, Tedesco Triccas L, Meyer S, Alaerts K, Verheyden G. Does sensorimotor upper limb therapy post stroke alter behavior and brain connectivity differently compared to motor therapy? Protocol of a phase II randomized controlled trial. Trials 2018; 19:242. [PMID: 29678195 PMCID: PMC5910616 DOI: 10.1186/s13063-018-2609-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/27/2018] [Indexed: 12/17/2022] Open
Abstract
Background The role of somatosensory feedback in motor performance has been warranted in the literature. Although sensorimotor deficits are common after stroke, current rehabilitation approaches primarily focus on restoring upper limb motor ability. Evidence for integrative sensorimotor rehabilitation approaches is scarce, as is knowledge about neural correlates of somatosensory impairments after stroke and the effect of rehabilitation on brain connectivity level. Therefore, we aim to investigate changes in sensorimotor function and brain connectivity following a sensorimotor therapy program compared to an attention-matched motor therapy program for the upper limb after stroke. Methods An assessor-blinded randomized controlled trial will be conducted. Sixty inpatient rehabilitation patients up to eight weeks after stroke will be included. Patients will be randomized to either an experimental group receiving sensorimotor therapy or a control group receiving attention-matched motor therapy for the upper limb, with both groups receiving conventional therapy. Thus, all patients will receive extra therapy, a total of 16 1-h sessions over four weeks. Patients will be assessed at baseline, after four weeks of training, and after four weeks of follow-up. Primary outcome measure is the Action Research Arm Test. Secondary outcome measures will consist of somatosensory, motor and cognitive assessments, and a standardized resting-state functional magnetic resonance imaging protocol. Discussion The integration of sensory and motor rehabilitation into one therapy model might provide the added value of this therapy to improve sensorimotor performance post stroke. Insight in the behavioral and brain connectivity changes post therapy will lead to a better understanding of working mechanisms of therapy and will provide new knowledge for patient-tailored therapy approaches. Trial registration ClinicalTrials.gov, NCT03236376. Registered on 8 August 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-2609-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nele De Bruyn
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Tervuursevest 101, box 1501, 3001, Leuven, Belgium.
| | - Bea Essers
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Tervuursevest 101, box 1501, 3001, Leuven, Belgium
| | - Liselot Thijs
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Tervuursevest 101, box 1501, 3001, Leuven, Belgium
| | - Annick Van Gils
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Tervuursevest 101, box 1501, 3001, Leuven, Belgium
| | - Lisa Tedesco Triccas
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Tervuursevest 101, box 1501, 3001, Leuven, Belgium
| | - Sarah Meyer
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Tervuursevest 101, box 1501, 3001, Leuven, Belgium
| | - Kaat Alaerts
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Tervuursevest 101, box 1501, 3001, Leuven, Belgium
| | - Geert Verheyden
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Tervuursevest 101, box 1501, 3001, Leuven, Belgium
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Boyd LA, Hayward KS, Ward NS, Stinear CM, Rosso C, Fisher RJ, Carter AR, Leff AP, Copland DA, Carey LM, Cohen LG, Basso DM, Maguire JM, Cramer SC. Biomarkers of stroke recovery: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable. Int J Stroke 2018; 12:480-493. [PMID: 28697711 DOI: 10.1177/1747493017714176] [Citation(s) in RCA: 225] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The most difficult clinical questions in stroke rehabilitation are "What is this patient's potential for recovery?" and "What is the best rehabilitation strategy for this person, given her/his clinical profile?" Without answers to these questions, clinicians struggle to make decisions regarding the content and focus of therapy, and researchers design studies that inadvertently mix participants who have a high likelihood of responding with those who do not. Developing and implementing biomarkers that distinguish patient subgroups will help address these issues and unravel the factors important to the recovery process. The goal of the present paper is to provide a consensus statement regarding the current state of the evidence for stroke recovery biomarkers. Biomarkers of motor, somatosensory, cognitive and language domains across the recovery timeline post-stroke are considered; with focus on brain structure and function, and exclusion of blood markers and genetics. We provide evidence for biomarkers that are considered ready to be included in clinical trials, as well as others that are promising but not ready and so represent a developmental priority. We conclude with an example that illustrates the utility of biomarkers in recovery and rehabilitation research, demonstrating how the inclusion of a biomarker may enhance future clinical trials. In this way, we propose a way forward for when and where we can include biomarkers to advance the efficacy of the practice of, and research into, rehabilitation and recovery after stroke.
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Affiliation(s)
- Lara A Boyd
- 1 Department of Physical Therapy & the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Kathryn S Hayward
- 2 Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Nick S Ward
- 3 Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
| | - Cathy M Stinear
- 4 Department of Medicine and Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Charlotte Rosso
- 5 Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,6 AP-HP, Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Paris, France
| | - Rebecca J Fisher
- 7 Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| | - Alexandre R Carter
- 8 Department of Neurology, Washington University in Saint Louis, St Louis, MO, USA
| | - Alex P Leff
- 9 Department of Brain Repair and Rehabilitation, Institute of Neurology & Institute of Cognitive Neuroscience, University College London, Queens Square, London, UK
| | - David A Copland
- 10 School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, Australia; and University of Queensland Centre for Clinical Research, Brisbane, Australia
| | - Leeanne M Carey
- 11 School of Allied Health, College of Science, Health and Engineering, La Trobe, University, Bundoora, Australia; and Neurorehabilitation and Recovery, Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Leonardo G Cohen
- 12 Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
| | - D Michele Basso
- 13 School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Jane M Maguire
- 14 Faculty of Health, University of Technology, Ultimo, Sydney, Australia
| | - Steven C Cramer
- 15 University of California, Irvine, CA, USA; Depts. Neurology, Anatomy & Neurobiology, and Physical Medicine & Rehabilitation, Irvine, CA, USA
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Griffin K, O'Hearn M, Franck CC, Courtney CA. Passive accessory joint mobilization in the multimodal management of chronic dysesthesia following thalamic stroke. Disabil Rehabil 2018; 41:1981-1986. [PMID: 29557687 DOI: 10.1080/09638288.2018.1450453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Study design: Case Report. Purpose: Stroke is the most common cause of long-term disability. Dysesthesia, an unpleasant sensory disturbance, is common following thalamic stroke and evidence-based interventions for this impairment are limited. The purpose of this case report was to describe a decrease in dysesthesia following manual therapy intervention in a patient with history of right lacunar thalamic stroke. Case description: A 66-year-old female presented with tingling and dysesthesia in left hemisensory distribution including left trunk and upper/lower extremities, limiting function. Decreased left shoulder active range of motion, positive sensory symptoms but no sensory loss in light touch was found. She denied pain and moderate shoulder muscular weakness was demonstrated. Laterality testing revealed right/left limb discrimination deficits and neglect-like symptoms were reported. Passive accessory joint motion assessment of glenohumeral and thoracic spine revealed hypomobility and provoked dysesthesia. Interventions included passive oscillatory joint mobilization of glenohumeral joint, thoracic spine, ribs and shoulder strengthening. Results: After six sessions, shoulder function, active range of motion, strength improved and dysesthesia decreased. Global Rating of Change Scale was +5 and QuickDASH score decreased from 45% to 22% disability. Laterality testing was unchanged. Conclusion: Manual therapy may be a beneficial intervention in management of thalamic stroke-related dysesthesia. Implications for Rehabilitation While pain is common following thalamic stroke, patients may present with chronic paresthesia or dysesthesia, often in a hemisensory distribution. Passive movement may promote inhibition of hyperexcitable cortical pathways, which may diminish aberrant sensations. Passive oscillatory manual therapy may be an effective way to treat sensory disturbances such as paresthesias or dysesthesia.
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Affiliation(s)
- Kristina Griffin
- a Outpatient Orthopedics , Shirley Ryan Ability Lab , Chicago , IL , USA.,b Department of Physical Therapy , University of Illinois at Chicago , Chicago , IL , USA
| | - Michael O'Hearn
- b Department of Physical Therapy , University of Illinois at Chicago , Chicago , IL , USA.,c Outpatient Orthopedics , Lakeland Health , St. Joseph , MI , USA
| | - Carla C Franck
- b Department of Physical Therapy , University of Illinois at Chicago , Chicago , IL , USA
| | - Carol A Courtney
- b Department of Physical Therapy , University of Illinois at Chicago , Chicago , IL , USA
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Buard I, Berliner JM, Kluger BM. Low Frequency repetitive Transcranial Magnetic Stimulation: Potential role in treatment of patients with hemispheric cerebellar strokes. Brain Stimul 2018; 11:653-655. [PMID: 29500042 DOI: 10.1016/j.brs.2018.02.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 02/16/2018] [Accepted: 02/19/2018] [Indexed: 10/17/2022] Open
Affiliation(s)
- Isabelle Buard
- Department of Neurology, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA.
| | - Jean M Berliner
- Rehabilitation Science PhD Program, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Benzi M Kluger
- Department of Neurology, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
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Altered functional connectivity differs in stroke survivors with impaired touch sensation following left and right hemisphere lesions. NEUROIMAGE-CLINICAL 2018; 18:342-355. [PMID: 29487791 PMCID: PMC5814381 DOI: 10.1016/j.nicl.2018.02.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/18/2018] [Accepted: 02/07/2018] [Indexed: 12/15/2022]
Abstract
One in two survivors experience impairment in touch sensation after stroke. The nature of this impairment is likely associated with changes associated with the functional somatosensory network of the brain; however few studies have examined this. In particular, the impact of lesioned hemisphere has not been investigated. We examined resting state functional connectivity in 28 stroke survivors, 14 with left hemisphere and 14 with right hemisphere lesion, and 14 healthy controls. Contra-lesional hands showed significantly decreased touch discrimination. Whole brain functional connectivity (FC) data was extracted from four seed regions, i.e. primary (S1) and secondary (S2) somatosensory cortices in both hemispheres. Whole brain FC maps and Laterality Indices (LI) were calculated for subgroups. Inter-hemispheric FC was greater in healthy controls compared to the combined stroke cohort from the left S1 seed and bilateral S2 seeds. The left lesion subgroup showed decreased FC, relative to controls, from left ipsi-lesional S1 to contra-lesional S1 and to distributed temporal, occipital and parietal regions. In comparison, the right lesion group showed decreased connectivity from contra-lesional left S1 and bilateral S2 to ipsi-lesional parietal operculum (S2), and to occipital and temporal regions. The right lesion group also showed increased intra-hemispheric FC from ipsi-lesional right S1 to inferior parietal regions compared to controls. In comparison to the left lesion group, those with right lesion showed greater intra-hemispheric connectivity from left S1 to left parietal and occipital regions and from right S1 to right angular and parietal regions. Laterality Indices were significantly greater for stroke subgroups relative to matched controls for contra-lesional S1 (left lesion group) and contra-lesional S2 (both groups). We provide evidence of altered functional connectivity within the somatosensory network, across both hemispheres, and to other networks in stroke survivors with impaired touch sensation. Hemisphere of lesion was associated with different patterns of altered functional connectivity within the somatosensory network and with related function was associated with different patterns of altered functional connectivity within the somatosensory network and with related functional networks. Examined somatosensory resting functional connectivity (RSFC) in left/right lesion stroke patients and/healthy controls. Seed based voxel wise (SB) and laterality index (LI) analyses were used. Left lesion SB results showed decreased RSFC in somatosensory and attention regions vs. controls/right lesion patients. Right lesion patients showed increased RSFC compared to controls and left lesion patients to inferior parietal areas. LI results showed increased laterality in both left and right lesion groups between the somatosensory seeds. This suggests RSFC may differ depending on laterality of lesion damage, with altered connectivity profiles between networks.
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35
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Hakon J, Quattromani MJ, Sjölund C, Tomasevic G, Carey L, Lee JM, Ruscher K, Wieloch T, Bauer AQ. Multisensory stimulation improves functional recovery and resting-state functional connectivity in the mouse brain after stroke. NEUROIMAGE-CLINICAL 2017; 17:717-730. [PMID: 29264113 PMCID: PMC5726755 DOI: 10.1016/j.nicl.2017.11.022] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/27/2017] [Accepted: 11/23/2017] [Indexed: 10/25/2022]
Abstract
Stroke causes direct structural damage to local brain networks and indirect functional damage to distant brain regions. Neuroplasticity after stroke involves molecular changes within perilesional tissue that can be influenced by regions functionally connected to the site of injury. Spontaneous functional recovery can be enhanced by rehabilitative strategies, which provides experience-driven cell signaling in the brain that enhances plasticity. Functional neuroimaging in humans and rodents has shown that spontaneous recovery of sensorimotor function after stroke is associated with changes in resting-state functional connectivity (RS-FC) within and across brain networks. At the molecular level, GABAergic inhibitory interneurons can modulate brain plasticity in peri-infarct and remote brain regions. Among this cell-type, a decrease in parvalbumin (PV)-immunoreactivity has been associated with improved behavioral outcome. Subjecting rodents to multisensory stimulation through exposure to an enriched environment (EE) enhances brain plasticity and recovery of function after stroke. Yet, how multisensory stimulation relates to RS-FC has not been determined. In this study, we investigated the effect of EE on recovery of RS-FC and behavior in mice after stroke, and if EE-related changes in RS-FC were associated with levels of PV-expressing neurons. Photothrombotic stroke was induced in the sensorimotor cortex. Beginning 2 days after stroke, mice were housed in either standard environment (STD) or EE for 12 days. Housing in EE significantly improved lost tactile-proprioceptive function compared to mice housed in STD environment. RS-FC in the mouse was measured by optical intrinsic signal imaging 14 days after stroke or sham surgery. Stroke induced a marked reduction in RS-FC within several perilesional and remote brain regions. EE partially restored interhemispheric homotopic RS-FC between spared motor regions, particularly posterior secondary motor. Compared to mice housed in STD cages, EE exposure lead to increased RS-FC between posterior secondary motor regions and contralesional posterior parietal and retrosplenial regions. The increased regional RS-FC observed in EE mice after stroke was significantly correlated with decreased PV-immunoreactivity in the contralesional posterior motor region. In conclusion, experimental stroke and subsequent housing in EE induces dynamic changes in RS-FC in the mouse brain. Multisensory stimulation associated with EE enhances RS-FC among distinct brain regions relevant for recovery of sensorimotor function and controlled movements that may involve PV/GABA interneurons. Our results indicate that targeting neural circuitry involving spared motor regions across hemispheres by neuromodulation and multimodal sensory stimulation could improve rehabilitation after stroke.
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Key Words
- EE, enriched environment
- Enriched environment
- GSR, global signal regression
- M1, primary motor cortex
- M2, secondary motor cortex
- M2p, posterior secondary motor cortex
- MSR, multiple signal regression
- NDc, interhemispheric (contralateral) node degree
- NDi, intrahemispheric node degree
- Optical imaging
- PP, posterior parietal cortex
- PV, parvalbumin
- Parvalbumin
- ROI, region of interest
- RS, retrosplenial cortex
- RS-FC, resting-state functional connectivity
- Recovery
- Resting-state functional connectivity
- SFL, somatosensory forelimb cortex
- STD, standard environment
- Stroke
- VIS, visual cortex
- fcOIS, functional connectivity optical intrinsic signal imaging
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Affiliation(s)
- Jakob Hakon
- Laboratory for Experimental Brain Research, Division of Neurosurgery, Department of Clinical Sciences, Lund University, BMC A13, 22184 Lund, Sweden.
| | - Miriana Jlenia Quattromani
- Laboratory for Experimental Brain Research, Division of Neurosurgery, Department of Clinical Sciences, Lund University, BMC A13, 22184 Lund, Sweden
| | - Carin Sjölund
- Laboratory for Experimental Brain Research, Division of Neurosurgery, Department of Clinical Sciences, Lund University, BMC A13, 22184 Lund, Sweden
| | - Gregor Tomasevic
- Laboratory for Experimental Brain Research, Division of Neurosurgery, Department of Clinical Sciences, Lund University, BMC A13, 22184 Lund, Sweden; Department of Neurosurgery, University Hospital of Lund, Lund, Sweden
| | - Leeanne Carey
- School of Allied Health, La Trobe University, Melbourne, Vic., Australia; Neurorehabilitation and Recovery Laboratory, Florey Institute of Neuroscience and Mental Health, Melbourne, Vic., Australia
| | - Jin-Moo Lee
- Department of Radiology, Washington University, Saint Louis, MO 63110, USA; Department of Neurology, Washington University, Saint Louis, MO 63110, USA; Department of Biomedical Engineering, Washington University, Saint Louis, MO 63110, USA
| | - Karsten Ruscher
- Laboratory for Experimental Brain Research, Division of Neurosurgery, Department of Clinical Sciences, Lund University, BMC A13, 22184 Lund, Sweden
| | - Tadeusz Wieloch
- Laboratory for Experimental Brain Research, Division of Neurosurgery, Department of Clinical Sciences, Lund University, BMC A13, 22184 Lund, Sweden
| | - Adam Q Bauer
- Department of Radiology, Washington University, Saint Louis, MO 63110, USA
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Regionally Specific Regulation of Sensorimotor Network Connectivity Following Tactile Improvement. Neural Plast 2017; 2017:5270532. [PMID: 29230329 PMCID: PMC5688375 DOI: 10.1155/2017/5270532] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 09/28/2017] [Indexed: 01/15/2023] Open
Abstract
Correlations between inherent, task-free low-frequency fluctuations in the blood oxygenation level-dependent (BOLD) signals of the brain provide a potent tool to delineate its functional architecture in terms of intrinsic functional connectivity (iFC). Still, it remains unclear how iFC is modulated during learning. We employed whole-brain resting-state magnetic resonance imaging prior to and after training-independent repetitive sensory stimulation (rSS), which is known to induce somatosensory cortical reorganization. We investigated which areas in the sensorimotor network are susceptible to neural plasticity (i.e., where changes in functional connectivity occurred) and where iFC might be indicative of enhanced tactile performance. We hypothesized iFC to increase in those brain regions primarily receiving the afferent tactile input. Strengthened intrinsic connectivity within the sensorimotor network after rSS was found not only in the postcentral gyrus contralateral to the stimulated hand, but also in associative brain regions, where iFC correlated positively with tactile performance or learning. We also observed that rSS led to attenuation of the network at higher cortical levels, which possibly promotes facilitation of tactile discrimination. We found that resting-state BOLD fluctuations are linked to behavioral performance and sensory learning, indicating that network fluctuations at rest are predictive of behavioral changes and neuroplasticity.
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Abstract
We examined the effect of lesion on the resting-state functional connectivity in chronic post-stroke patients. We found many instances of strong correlations in BOLD signal measured at different locations within the lesion, making it hard to distinguish from the connectivity between intact and strongly connected regions. Regression of the mean cerebro-spinal fluid signal did not alleviate this problem. The connectomes computed by exclusion of lesioned voxels were not good predictors of the behavioral measures. We came up with a novel method that utilizes Independent Component Analysis (as implemented in FSL MELODIC) to identify the sources of variance in the resting-state fMRI data that are driven by the lesion, and to remove this variance. The resulting functional connectomes show better correlations with the behavioral measures of speech and language, and improve the out-of-sample prediction accuracy of multivariate analysis. We therefore advocate this preprocessing method for studies of post-stroke functional connectivity, particularly in samples with large lesions. fMRI signal is correlated across spatial locations within a post-stroke lesion. These high correlations present problems for functional connectivity analysis. Regression of mean CSF signal does not solve this issue. ICA can be used to successfully remove these artifacts.
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Jannusch K, Jockwitz C, Bidmon HJ, Moebus S, Amunts K, Caspers S. A Complex Interplay of Vitamin B1 and B6 Metabolism with Cognition, Brain Structure, and Functional Connectivity in Older Adults. Front Neurosci 2017; 11:596. [PMID: 29163003 PMCID: PMC5663975 DOI: 10.3389/fnins.2017.00596] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 10/10/2017] [Indexed: 11/13/2022] Open
Abstract
Aging is associated with brain atrophy, functional brain network reorganization and decline of cognitive performance, albeit characterized by high interindividual variability. Among environmental influencing factors accounting for this variability, nutrition and particularly vitamin supply is thought to play an important role. While evidence exists that supplementation of vitamins B6 and B1 might be beneficial for cognition and brain structure, at least in deficient states and neurodegenerative diseases, little is known about this relation during healthy aging and in relation to reorganization of functional brain networks. We thus assessed the relation between blood levels of vitamins B1 and B6 and cognitive performance, cortical folding, and functional resting-state connectivity in a large sample of older adults (N > 600; age: 55-85 years), drawn from the population-based 1000BRAINS study. In addition to blood sampling, subjects underwent structural and functional resting-state neuroimaging as well as extensive neuropsychological testing in the domains of executive functions, (working) memory, attention, and language. Brain regions showing changes in the local gyrification index as calculated using FreeSurfer in relation to vitamin levels were used for subsequent seed-based resting-state functional connectivity analysis. For B6, a positive correlation with local cortical folding was found throughout the brain, while only slight changes in functional connectivity were observed. Contrarily, for B1, a negative correlation with cortical folding as well as problem solving and visuo-spatial working memory performance was found, which was accompanied by pronounced increases of interhemispheric and decreases of intrahemispheric functional connectivity. While the effects for B6 expand previous knowledge on beneficial effects of B6 supplementation on brain structure, they also showed that additional effects on cognition might not be recognizable in healthy older subjects with normal B6 blood levels. The cortical atrophy and pronounced functional reorganization associated with B1, contrarily, was more in line with the theory of a disturbed B1 metabolism in older adults, leading to B1 utilization deficits, and thus, an effective B1 deficiency in the brain, despite normal to high-normal blood levels.
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Affiliation(s)
- Kai Jannusch
- C. & O. Vogt Institute for Brain Research, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Christiane Jockwitz
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany
- JARA–BRAIN, Jülich Aachen Research Alliance, Research Centre Jülich, Jülich, Germany
| | - Hans-Jürgen Bidmon
- C. & O. Vogt Institute for Brain Research, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Susanne Moebus
- Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Katrin Amunts
- C. & O. Vogt Institute for Brain Research, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- JARA–BRAIN, Jülich Aachen Research Alliance, Research Centre Jülich, Jülich, Germany
| | - Svenja Caspers
- C. & O. Vogt Institute for Brain Research, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- JARA–BRAIN, Jülich Aachen Research Alliance, Research Centre Jülich, Jülich, Germany
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Kim J, Yeon J, Ryu J, Park JY, Chung SC, Kim SP. Neural Activity Patterns in the Human Brain Reflect Tactile Stickiness Perception. Front Hum Neurosci 2017; 11:445. [PMID: 28936171 PMCID: PMC5595153 DOI: 10.3389/fnhum.2017.00445] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 08/21/2017] [Indexed: 11/13/2022] Open
Abstract
Our previous human fMRI study found brain activations correlated with tactile stickiness perception using the uni-variate general linear model (GLM) (Yeon et al., 2017). Here, we conducted an in-depth investigation on neural correlates of sticky sensations by employing a multivoxel pattern analysis (MVPA) on the same dataset. In particular, we statistically compared multi-variate neural activities in response to the three groups of sticky stimuli: A supra-threshold group including a set of sticky stimuli that evoked vivid sticky perception; an infra-threshold group including another set of sticky stimuli that barely evoked sticky perception; and a sham group including acrylic stimuli with no physically sticky property. Searchlight MVPAs were performed to search for local activity patterns carrying neural information of stickiness perception. Similar to the uni-variate GLM results, significant multi-variate neural activity patterns were identified in postcentral gyrus, subcortical (basal ganglia and thalamus), and insula areas (insula and adjacent areas). Moreover, MVPAs revealed that activity patterns in posterior parietal cortex discriminated the perceptual intensities of stickiness, which was not present in the uni-variate analysis. Next, we applied a principal component analysis (PCA) to the voxel response patterns within identified clusters so as to find low-dimensional neural representations of stickiness intensities. Follow-up clustering analyses clearly showed separate neural grouping configurations between the Supra- and Infra-threshold groups. Interestingly, this neural categorization was in line with the perceptual grouping pattern obtained from the psychophysical data. Our findings thus suggest that different stickiness intensities would elicit distinct neural activity patterns in the human brain and may provide a neural basis for the perception and categorization of tactile stickiness.
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Affiliation(s)
- Junsuk Kim
- Department of Human Perception, Cognition and Action, Max Planck Institute for Biological CyberneticsTübingen, Germany.,Department of Brain and Cognitive Engineering, Korea UniversitySeoul, South Korea
| | - Jiwon Yeon
- School of Psychology, Georgia Institute of TechnologyAtlanta, GA, United States
| | - Jaekyun Ryu
- Center for Neuroscience Imaging Research, Institute for Basic ScienceSuwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan UniversitySuwon, South Korea
| | - Jang-Yeon Park
- Center for Neuroscience Imaging Research, Institute for Basic ScienceSuwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan UniversitySuwon, South Korea
| | - Soon-Cheol Chung
- School of Biomedical Engineering, Konkuk UniversityChungju, South Korea
| | - Sung-Phil Kim
- Department of Human Factors Engineering, Ulsan National Institute of Science and TechnologyUlsan, South Korea
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Let thy left brain know what thy right brain doeth: Inter-hemispheric compensation of functional deficits after brain damage. Neuropsychologia 2016; 93:407-412. [DOI: 10.1016/j.neuropsychologia.2016.06.016] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 05/06/2016] [Accepted: 06/12/2016] [Indexed: 12/18/2022]
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41
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Decoding pressure stimulation locations on the fingers from human neural activation patterns. Neuroreport 2016; 27:1232-6. [PMID: 27631540 DOI: 10.1097/wnr.0000000000000683] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In this functional MRI study, we investigated how the human brain activity represents tactile location information evoked by pressure stimulation on fingers. Using the searchlight multivoxel pattern analysis, we looked for local activity patterns that could be decoded into one of four stimulated finger locations. The supramarginal gyrus (SMG) and the thalamus were found to contain distinct multivoxel patterns corresponding to individual stimulated locations. In contrast, the univariate general linear model analysis contrasting stimulation against resting phases for each finger identified activations mainly in the primary somatosensory cortex (S1), but not in SMG or in thalamus. Our results indicate that S1 might be involved in the detection of the presence of pressure stimuli, whereas the SMG and the thalamus might play a role in identifying which finger is stimulated. This finding may provide additional evidence for hierarchical information processing in the human somatosensory areas.
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Cassidy JM, Cramer SC. Spontaneous and Therapeutic-Induced Mechanisms of Functional Recovery After Stroke. Transl Stroke Res 2016; 8:33-46. [PMID: 27109642 DOI: 10.1007/s12975-016-0467-5] [Citation(s) in RCA: 162] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 04/13/2016] [Accepted: 04/18/2016] [Indexed: 01/05/2023]
Abstract
With increasing rates of survival throughout the past several years, stroke remains one of the leading causes of adult disability. Following the onset of stroke, spontaneous mechanisms of recovery at the cellular, molecular, and systems levels ensue. The degree of spontaneous recovery is generally incomplete and variable among individuals. Typically, the best recovery outcomes entail the restitution of function in injured but surviving neural matter. An assortment of restorative therapies exists or is under development with the goal of potentiating restitution of function in damaged areas or in nearby ipsilesional regions by fostering neuroplastic changes, which often rely on mechanisms similar to those observed during spontaneous recovery. Advancements in stroke rehabilitation depend on the elucidation of both spontaneous and therapeutic-driven mechanisms of recovery. Further, the implementation of neural biomarkers in research and clinical settings will enable a multimodal approach to probing brain state and predicting the extent of post-stroke functional recovery. This review will discuss spontaneous and therapeutic-induced mechanisms driving post-stroke functional recovery while underscoring several potential restorative therapies and biomarkers.
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Affiliation(s)
- Jessica M Cassidy
- Department of Neurology, University of California, Irvine Medical Center, 200 S. Manchester Ave, Suite 206, Orange, CA, 92868-4280, USA
| | - Steven C Cramer
- Department of Neurology, University of California, Irvine Medical Center, 200 S. Manchester Ave, Suite 206, Orange, CA, 92868-4280, USA. .,Department of Anatomy & Neurobiology, University of California, Irvine, Irvine, CA, 92697, USA. .,Department of Physical Medicine & Rehabilitation, University of California, Irvine Medical Center, 200 S. Manchester Ave, Suite 210, Orange, CA, 92868-5397, USA. .,Sue & Bill Gross Stem Cell Research Center, University of California, Irvine, 845 Health Sciences Rd, Irvine, 92697, CA, USA.
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