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Belcaro G, Dugall M, Hosoi M, Feragalli B, Cotellese R, Saggino A, Cesarone MR, Ippolito E, Cornelli U, Ledda A, Cox DB. Pycnogenol® improves cognitive function in post-stroke patients: a 6 month-study. J Neurosurg Sci 2024; 68:109-116. [PMID: 38299491 DOI: 10.23736/s0390-5616.22.05855-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
BACKGROUND This pilot study in post-stroke patients evaluated the effects of supplementation with Pycnogenol® on alterations in cognitive functions (COFU) over a period of 6 months, starting 4 weeks after the stroke. METHODS The effects of supplementation - possibly acting on residual brain edema, on global cognitive function, attention and on mental performance - were studied. A control group used standard management (SM) and the other group added Pycnogenol®, 150 mg daily to SM. RESULTS 38 post-stroke patients completed the 6-month-study, 20 in the Pycnogenol® group and 18 in the control group. No side effects were observed with the supplement. The tolerability was very good. The patients included into the two groups were comparable for age, sex and clinical distribution. There were 2 dropouts in the control group, due to non-medical problems. Main COFU parameters (assessed by a cognitive questionnaire) were significantly improved (all single items) with the supplement compared to controls (P<0.05). Additional observations indicate that Pycnogenol® patients experienced significantly less mini-accidents (including falls) than controls (P<0.05). The incidences of (minor) psychotic episodes or conflicts and distress and other problems including rare occurrence of minor hallucinations, were lower with the supplementation than in controls (P<0.05). Single observations concerning daily tasks indicated a better effect of Pycnogenol® compared to controls (P<0.05). Plasma free radicals also decreased significantly with the supplement in comparison to controls (P<0.05). Globally, supplemented subjects had a better recovery than controls. CONCLUSIONS In post-stroke subjects, Pycnogenol® supplementation resulted in better recovery outcome and faster COFU 'normalization' after the stroke in comparison with SM; it can be considered a safe, manageable post-stroke, adjuvant management possibly reducing local brain edema. Nevertheless, more patients and a longer period of evaluation are needed to confirm these results.
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Affiliation(s)
- Gianni Belcaro
- IRVINE3 Labs, Chieti-Pescara University, Chieti, Italy -
| | - Mark Dugall
- IRVINE3 Labs, Chieti-Pescara University, Chieti, Italy
| | - Morio Hosoi
- IRVINE3 Labs, Chieti-Pescara University, Chieti, Italy
| | | | | | | | | | | | | | - Andrea Ledda
- IRVINE3 Labs, Chieti-Pescara University, Chieti, Italy
| | - David B Cox
- IRVINE3 Labs, Chieti-Pescara University, Chieti, Italy
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Meier EL, Bunker LD, Kim H, Hillis AE. Resting-State Connectivity in Acute and Subacute Poststroke Aphasia: A Functional Near-Infrared Spectroscopy Pilot Study. Brain Connect 2023; 13:441-452. [PMID: 37097208 PMCID: PMC10618818 DOI: 10.1089/brain.2022.0065] [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] [Indexed: 04/26/2023] Open
Abstract
Background: Understanding how brain function and language skills change during early (acute and subacute) stroke phases is critical for maximizing patient recovery, yet functional neuroimaging studies of early aphasia are scarce. In this pilot study, we used functional near-infrared spectroscopy (fNIRS) to investigate how resting-state functional connectivity (rs-FC) in early aphasia differs from neurologically healthy adults and is related to language deficits. Materials and Methods: Twenty individuals with aphasia (12 acute and 8 subacute phase) and 15 healthy controls underwent rs-fNIRS imaging with a 46-channel montage centered over bilateral perisylvian language areas. FC was computed using a prewhitening, autoregressive Pearson correlation routine applied to preprocessed oxyhemoglobin (HbO) data. Connections were classified as left intra-, right intra-, or interhemispheric. We then compared rs-FC between groups by connection type and examined Spearman correlations between rs-FC averages and language measures within patients. Results: Participants in the acute phase had significantly reduced global rs-FC across all HbO-based connections compared to healthy controls. No significant differences were found in rs-FC between controls and patients in the subacute phase. Controlling for days since stroke, stronger right intra- and interhemispheric rs-FC was related to milder aphasia across all patients. Exploratory correlations revealed that relationships between language measures and rs-FC differed between acute and subacute patient groups. Conclusion: This study provides preliminary evidence that fNIRS-based rs-FC measures may be a viable metric to index the early impacts of stroke in people with aphasia.
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Affiliation(s)
- Erin L. Meier
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Lisa D. Bunker
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hana Kim
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Cognitive Science, Johns Hopkins University, Baltimore, Maryland, USA
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Girolamo T, Butler L, Canale R, Aslin RN, Eigsti IM. fNIRS Studies of Individuals with Speech and Language Impairment Underreport Sociodemographics: A Systematic Review. Neuropsychol Rev 2023:10.1007/s11065-023-09618-y. [PMID: 37747652 PMCID: PMC10961255 DOI: 10.1007/s11065-023-09618-y] [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: 11/04/2022] [Accepted: 09/08/2023] [Indexed: 09/26/2023]
Abstract
Functional near-infrared spectroscopy (fNIRS) is a promising tool for scientific discovery and clinical application. However, its utility depends upon replicable reporting. We evaluate reporting of sociodemographics in fNIRS studies of speech and language impairment and asked the following: (1) Do refereed fNIRS publications report participant sociodemographics? (2) For what reasons are participants excluded from analysis? This systematic review was preregistered with PROSPERO (CRD42022342959) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Searches in August 2022 included the terms: (a) fNIRS or functional near-infrared spectroscopy or NIRS or near-infrared spectroscopy, (b) speech or language, and (c) disorder or impairment or delay. Searches yielded 38 qualifying studies from 1997 to present. Eight studies (5%) reported at least partial information on race or ethnicity. Few studies reported SES (26%) or language background (47%). Most studies reported geographic location (100%) and gender/sex (89%). Underreporting of sociodemographics in fNIRS studies of speech and language impairment hinders the generalizability of findings. Replicable reporting is imperative for advancing the utility of fNIRS.
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Affiliation(s)
- Teresa Girolamo
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, CA, USA.
- Institute for the Brain and Cognitive Sciences, Storrs, CT, USA.
| | - Lindsay Butler
- Institute for the Brain and Cognitive Sciences, Storrs, CT, USA
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, Storrs, CT, USA
| | - Rebecca Canale
- Institute for the Brain and Cognitive Sciences, Storrs, CT, USA
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Richard N Aslin
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
- Child Study Center and Department of Psychology, Yale University, New Haven, CT, USA
| | - Inge-Marie Eigsti
- Institute for the Brain and Cognitive Sciences, Storrs, CT, USA
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
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Li H, Liu J, Tian S, Fan S, Wang T, Qian H, Liu G, Zhu Y, Wu Y, Hu R. Language reorganization patterns in global aphasia-evidence from fNIRS. Front Neurol 2023; 13:1025384. [PMID: 36686505 PMCID: PMC9853054 DOI: 10.3389/fneur.2022.1025384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/09/2022] [Indexed: 01/09/2023] Open
Abstract
Background Exploring the brain reorganization patterns associated with language recovery would promote the treatment of global aphasia. While functional near-infrared spectroscopy (fNIRS) has been widely used in the study of speech and language impairment, its application in the field of global aphasia is still limited. Aims We aimed to identify cortical activation patterns of patients with global aphasia during naming and repetition tasks. Methods and procedures We recruited patients with post-stroke aphasia from the Department of Rehabilitation Medicine at Huashan Hospital. These individuals were diagnosed with global aphasia without cognitive impairments, as assessed by speech-language pathology evaluations. Age- and sex-matched healthy controls were recruited from the greater Shanghai area. During fNIRS measurement, patients and healthy controls completed the picture-naming and phrase repetition task. Cortical activation patterns on each of these language tasks were then compared between groups. Outcomes and results A total of nine patients with global aphasia and 14 healthy controls were included in this study. Compared with the healthy subjects, patients with global aphasia showed increased activation in the left Broca's area, middle temporal gyrus (MTG), superior temporal gyrus (STG), and pre-motor and supplementary motor cortex (SMA) (p < 0.05) in the picture-naming task. Furthermore, the latency of the oxyhemoglobin (HbO) concentration in the left supramarginal gyrus (SMG) region had a strong negative correlation with their score of the naming task (p < 0.01). In the phrase repetition task, decreased activation was detected in the left SMA and SMG (p < 0.05) of patients relative to controls. Conclusion The left SMG plays a critical role in the language function of patients with global aphasia, especially in their abilities to name and repeat. fNIRS is a promising approach to revealing the changes in brain activities in patients with aphasia, and we believe it will contribute to a deeper understanding of the neurological mechanisms and the establishment of a novel treatment approach for global aphasia.
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Affiliation(s)
- Haozheng Li
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jianju Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shan Tian
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Shunjuan Fan
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Tingwei Wang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Hong Qian
- Department of Rehabilitation Medicine, Shanghai Fifth Rehabilitation Hospital, Shanghai, China
| | - Gang Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yulian Zhu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yi Wu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China,*Correspondence: Yi Wu ✉
| | - Ruiping Hu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China,Ruiping Hu ✉
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Functional near-infrared spectroscopy reveals brain activity on the move. Proc Natl Acad Sci U S A 2022; 119:e2208729119. [PMID: 35709323 PMCID: PMC9231602 DOI: 10.1073/pnas.2208729119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Varkanitsa M, Kiran S. Understanding, facilitating and predicting aphasia recovery after rehabilitation. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 24:248-259. [PMID: 35603543 PMCID: PMC9398975 DOI: 10.1080/17549507.2022.2075036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Purpose: This paper reviews several studies whose aim was to understand the nature of language recovery in chronic aphasia and identify predictors of how people may recover their language functions after a brain injury.Method: Several studies that mostly draw from data collected within the Centre for Neurobiology of Language Recovery were reviewed and categorised in four aspects of language impairment and recovery in aphasia: (a) neural markers for language impairment and recovery, (b) language and cognitive markers for language impairment and recovery, (c) effective treatments and (d) predictive modelling of treatment-induced rehabilitation.Result: Language impairment and recovery in stroke-induced aphasia is multi-factorial, including patient-specific and treatment-specific factors. A combination of these factors may help us predict treatment responsiveness even before treatment begins.Conclusion: Continued work on this topic will lead to a better understanding of the mechanisms that underly language impairment and treatment-induced recovery in aphasia, and, consequently, use this information to predict each person's recovery profile trajectory and provide optimal prescriptions regarding the type and dosage of treatment.
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Affiliation(s)
- Maria Varkanitsa
- Aphasia Research Laboratory, Department of Speech, Language & Hearing Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, USA
| | - Swathi Kiran
- Aphasia Research Laboratory, Department of Speech, Language & Hearing Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, USA
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Liu L, Wang T, Du X, Zhang X, Xue C, Ma Y, Wang D. Concurrent Structural and Functional Patterns in Patients With Amnestic Mild Cognitive Impairment. Front Aging Neurosci 2022; 14:838161. [PMID: 35663572 PMCID: PMC9161636 DOI: 10.3389/fnagi.2022.838161] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/01/2022] [Indexed: 11/13/2022] Open
Abstract
Amnestic mild cognitive impairment (aMCI) is a clinical subtype of MCI, which is known to have a high risk of developing Alzheimer's disease (AD). Although neuroimaging studies have reported brain abnormalities in patients with aMCI, concurrent structural and functional patterns in patients with aMCI were still unclear. In this study, we combined voxel-based morphometry (VBM), amplitude of low-frequency fluctuations (ALFFs), regional homogeneity (Reho), and resting-state functional connectivity (RSFC) approaches to explore concurrent structural and functional alterations in patients with aMCI. We found that, compared with healthy controls (HCs), both ALFF and Reho were decreased in the right superior frontal gyrus (SFG_R) and right middle frontal gyrus (MFG_R) of patients with aMCI, and both gray matter volume (GMV) and Reho were decreased in the left inferior frontal gyrus (IFG_L) of patients with aMCI. Furthermore, we took these overlapping clusters from VBM, ALFF, and Reho analyses as seed regions to analyze RSFC. We found that, compared with HCs, patients with aMCI had decreased RSFC between SFG_R and the right temporal lobe (subgyral) (TL_R), the MFG_R seed and left superior temporal gyrus (STG_L), left inferior parietal lobule (IPL_L), and right anterior cingulate cortex (ACC_R), the IFG_L seed and left precentral gyrus (PRG_L), left cingulate gyrus (CG_L), and IPL_L. These findings highlighted shared imaging features in structural and functional magnetic resonance imaging (MRI), suggesting that SFG_R, MFG_R, and IFG_L may play a major role in the pathophysiology of aMCI, which might be useful to better understand the underlying neural mechanisms of aMCI and AD.
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Affiliation(s)
- Li Liu
- Affiliated Mental Health Center, Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tenglong Wang
- School of Humanities and Management, Graduate School of Wannan Medical College, Wuhu, China
| | - Xiangdong Du
- Department of Geriatric Psychiatry, Suzhou Mental Health Center, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiaobin Zhang
- Department of Geriatric Psychiatry, Suzhou Mental Health Center, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Chuang Xue
- Affiliated Mental Health Center, Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yu Ma
- Department of Geriatric Psychiatry, Suzhou Mental Health Center, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Dong Wang
- Department of Geriatric Psychiatry, Suzhou Mental Health Center, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
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Zekelman LR, Zhang F, Makris N, He J, Chen Y, Xue T, Liera D, Drane DL, Rathi Y, Golby AJ, O'Donnell LJ. White matter association tracts underlying language and theory of mind: An investigation of 809 brains from the Human Connectome Project. Neuroimage 2021; 246:118739. [PMID: 34856375 PMCID: PMC8862285 DOI: 10.1016/j.neuroimage.2021.118739] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 10/20/2021] [Accepted: 11/15/2021] [Indexed: 12/24/2022] Open
Abstract
Language and theory of mind (ToM) are the cognitive capacities that allow for the successful interpretation and expression of meaning. While functional MRI investigations are able to consistently localize language and ToM to specific cortical regions, diffusion MRI investigations point to an inconsistent and sometimes overlapping set of white matter tracts associated with these two cognitive domains. To further examine the white matter tracts that may underlie these domains, we use a two-tensor tractography method to investigate the white matter microstructure of 809 participants from the Human Connectome Project. 20 association white matter tracts (10 in each hemisphere) are uniquely identified by leveraging a neuroanatomist-curated automated white matter tract atlas. The fractional anisotropy (FA), mean diffusivity (MD), and number of streamlines (NoS) are measured for each white matter tract. Performance on neuropsychological assessments of semantic memory (NIH Toolbox Picture Vocabulary Test, TPVT) and emotion perception (Penn Emotion Recognition Test, PERT) are used to measure critical subcomponents of the language and ToM networks, respectively. Regression models are constructed to examine how structural measurements of left and right white matter tracts influence performance across these two assessments. We find that semantic memory performance is influenced by the number of streamlines of the left superior longitudinal fasciculus III (SLF-III), and emotion perception performance is influenced by the number of streamlines of the right SLF-III. Additionally, we find that performance on both semantic memory & emotion perception is influenced by the FA of the left arcuate fasciculus (AF). The results point to multiple, overlapping white matter tracts that underlie the cognitive domains of language and ToM. Results are discussed in terms of hemispheric dominance and concordance with prior investigations.
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Affiliation(s)
- Leo R Zekelman
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Speech and Hearing Bioscience and Technology, Harvard Medical School, Boston, USA.
| | - Fan Zhang
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Nikos Makris
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, USA; Center for Morphometric Analysis, Department of Psychiatry and Neurology, A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Psychiatric Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Jianzhong He
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Institution of Information Processing and Automation, Zhejiang University of Technology, Hangzhou, China
| | - Yuqian Chen
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; School of Computer Science, University of Sydney, NSW, Australia
| | - Tengfei Xue
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; School of Computer Science, University of Sydney, NSW, Australia
| | | | - Daniel L Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology, University of Washington School of Medicine, Seattle, WA, US
| | - Yogesh Rathi
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Alexandra J Golby
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Lauren J O'Donnell
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
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